By Paula Fitzsimmons
When you’re not feeling well, your first call is likely to your primary care physician. If your case is particularly complex or requires a second opinion, your doctor may refer you to a specialist.
Veterinary care works similarly. Bringing your pet to a primary care veterinarian will probably be your first point of contact. As with human healthcare, vets can now call upon a growing number of veterinary specialists. One type of specialist your pet may need to see is a cardiologist, a veterinarian with in-depth training in conditions related to your pet’s heart and circulatory system.
The following are some top reasons why your pet may need to see a cardiologist.
If your pet needs to see a veterinary cardiologist, chances are it’s because your primary vet referred you. While primary care vets are trained to diagnose and treat a number of cardiovascular conditions, specialists have received advanced training. After earning a Doctor of Veterinary Medicine (DVM) degree, Rebecca Stepien, a clinical professor of veterinary cardiology at the University of Wisconsin School of Veterinary Medicine, says vets complete an internship of at least one year, followed by a three-year cardiology residency program.
To become certified by the American College of Veterinary Internal Medicine (ACVIM) and qualify for Diplomate status as a cardiologist, a vet must pass a board certification exam, participate in cardiology research, pass a rigorous specialty cardiology exam, and submit credentials demonstrating their proficiency in cardiology.
This level of training prepares cardiologists to treat more complex cases. Calico Schmidt, a primary care clinical instructor at the school says, “some patients have a severe disease or do not respond as well as hoped with initial treatment recommendations. Some patients require multiple medications or more complicated testing and monitoring. These are situations in which cardiology specialists can be especially helpful.”
Pets with heart murmurs or irregular heart rhythms are often seen by cardiologists, says Darcy Adin, a clinical assistant professor of cardiology at the North Carolina State University Veterinary Hospital. If the animal is otherwise healthy, she says an appointment can be scheduled at your convenience. For example, “Young puppies and kittens often have soft murmurs not associated with heart disease, and that resolve by four to five months of age.” If a puppy or kitten’s murmur does not resolve as expected, a visit to a cardiologist would be a good idea.
However, a murmur or irregular heart beat accompanied by symptoms such as coughing, difficulty breathing, abdominal enlargement or collapse is considered urgent, says Adin, regardless of the age of the pet. These individuals should be promptly examined by a specialist.
The most common heart disease impacting dogs is Degenerative Mitral Valve Disease (DMVD), says Adin. In later stages of the disease, animals can present with symptoms like coughing, breathing difficulty and exercise intolerance. Cats are commonly seen for Hypertrophy Cardiomyopathy, which can cause such symptoms such as appetite loss, lethargy, rapid breathing, hind end paralysis and pain, and collapse.
These and other heart diseases can lead to congestive heart failure, explains Adin, but she says early diagnosis and treatment can delay progression. If congestive heart failure does occur, hospitalization may be required to adequately treat the condition and stabilize the dog or cat, she says. Since many cardiologists work in large hospital settings, they are better equipped to provide hospital and emergency care if needed.
Systemic hypertension – more commonly known as high blood pressure – is another condition that cardiologists commonly treat, Adin says. Hypertension in cats and dogs often develops as a result of another disease such as kidney failure or hyperthyroidism, so having a specialist perform an advanced exam is essential.
“Other testing is often recommended to determine the cause of these conditions, which adversely affect heart function,” she says.
Because of their training, experience and access to advanced diagnostic equipment, cardiologists are able to probe deeper to discover root causes of hypertension and make a plan to simultaneously treat multiple health conditions.
Cardiologists are trained to perform a number of advanced diagnostic procedures, says Adin, some of which include ultrasound of the heart, electrocardiography (ECG), and detailed chest X-ray interpretation.
They also have access to other highly specialized equipment, which may not be available to a general practitioner, she says. Example of these include 24-hour Holter monitoring (a portable device pets can wear that tracks their ECG for long periods of time), computed tomography (CT scans), and a dedicated, high resolution echocardiography machine with 3-D capabilities.
Cardiologists treat a wide range of diseases in many species, says Stepien, and typically have a deep understanding of a broad range of medications and the effects and complications of these medications.
In addition, if your pet is eligible to participate in clinical trials, a cardiologist would be a probable contact. “Veterinary cardiologists typically have knowledge of, and access to the most cutting-edge information on diagnosis and treatment of cardiovascular diseases, including the latest clinical trial results and newest therapies,” Stepien says.
Your pet’s health and well-being depends on the effective flow of communication between you, your primary vet and your pet’s cardiologist.
The communications process begins with your primary vet. Bianca Zaffarano, a primary care veterinarian at Lloyd Veterinary Medical Center at Iowa State University, says sending a patient’s complete record to the specialist prior to the consult expedites diagnosis and treatment. “This gives the cardiologist more time to read the record thoroughly, and consult with the primary veterinarian prior to seeing the patient,” she adds.
In return, Adin says after the cardiologist’s exam, a report with test results, diagnosis, and recommendations will be sent to the primary vet.
You should feel comfortable asking any questions relating to your pet’s care. But what should you ask? Schmidt suggests inquiring about diagnostic and treatment options, as well as expected outcomes and costs associated with each. She says you can also ask about your pet’s long-term prognosis, and symptoms to watch for. You’ll also need to know how often to bring your pet in for rechecks.
The in-depth training cardiologists receive during school and throughout their careers puts them in a unique position to treat a wide spectrum of complex heart and circulatory conditions. They have access to sophisticated diagnostic equipment, and are at the forefront of new treatment protocols.