I have a scan next week on an 8-month-old puppy with possible congenital heart issues, a murmur was asculted.
What, if anything in particular should I be looking for in such a case? Or would this be scanned as any other routine echo?
I know if it happens to be a PDA case I need to get that doppler gate in the deep pulmonary artery, prior to the bifurcation.
What other congenital issues might I be looking at in this case?
Any comments are appreciated thx! ๐
I have a scan next week on an 8-month-old puppy with possible congenital heart issues, a murmur was asculted.
What, if anything in particular should I be looking for in such a case? Or would this be scanned as any other routine echo?
I know if it happens to be a PDA case I need to get that doppler gate in the deep pulmonary artery, prior to the bifurcation.
What other congenital issues might I be looking at in this case?
Any comments are appreciated thx! ๐
Comments
Hi
The most common congenital
Hi
The most common congenital cardiac disorders in dogs are Aortic stenosis, pulmonic stenosis and PDA. Other, more rare defects are ASD, VSD, TOF, valvular dysplasias,…
I would recommend to do a complete exam. Don’t leave any view out. This is particularly necessary if you want to review the images or have them reviewed by someone else. Means, all views for 2D, Color across the LVOT and aortic root, across the RVOT and pulmonary artery, deep pulmonary artery at level of bifurcation, color across the ventricular septum (basal on 5-chamber view), and on short axis views across the septum. Track the LVOT AV and AO with PW-Doppler and also the RVOT, PV and PA to look for turbulence and flow acceleration. Then make CW-measurements across the LVOT, RVOT and into the deep pulmonary artery (exact alignment). If you see any pathologic jet (e.g. PDA, valvular insufficiency), measure vmax with CW-Doppler.
Re PDA: If you see the continuous flow within the pulmonary artery out of the PDA, measure the velocities with CW-Doppler, not with PW. PW is not capable of measuring high velocities.
I would recommend taking a look at the congenital cases in the sonopath database so that you know what you have to expect.
Keep in mind: A “benign” or “flow murmur” in a puppy can only be diagnosed by exclusion of all possible congenital disorders.
Just keep cool. If you just go through a complete standard exam, there is not much chance of missing something!
Good luck!
Peter
Hi
The most common congenital
Hi
The most common congenital cardiac disorders in dogs are Aortic stenosis, pulmonic stenosis and PDA. Other, more rare defects are ASD, VSD, TOF, valvular dysplasias,…
I would recommend to do a complete exam. Don’t leave any view out. This is particularly necessary if you want to review the images or have them reviewed by someone else. Means, all views for 2D, Color across the LVOT and aortic root, across the RVOT and pulmonary artery, deep pulmonary artery at level of bifurcation, color across the ventricular septum (basal on 5-chamber view), and on short axis views across the septum. Track the LVOT AV and AO with PW-Doppler and also the RVOT, PV and PA to look for turbulence and flow acceleration. Then make CW-measurements across the LVOT, RVOT and into the deep pulmonary artery (exact alignment). If you see any pathologic jet (e.g. PDA, valvular insufficiency), measure vmax with CW-Doppler.
Re PDA: If you see the continuous flow within the pulmonary artery out of the PDA, measure the velocities with CW-Doppler, not with PW. PW is not capable of measuring high velocities.
I would recommend taking a look at the congenital cases in the sonopath database so that you know what you have to expect.
Keep in mind: A “benign” or “flow murmur” in a puppy can only be diagnosed by exclusion of all possible congenital disorders.
Just keep cool. If you just go through a complete standard exam, there is not much chance of missing something!
Good luck!
Peter
Great! Depending on the size
Great! Depending on the size of the patient do you recommend the 6s or 3s?
I have a bit of a difficult time getting clean images (not fuzzy/dark) when using anything but the 8c probe for cardiacs.
Great! Depending on the size
Great! Depending on the size of the patient do you recommend the 6s or 3s?
I have a bit of a difficult time getting clean images (not fuzzy/dark) when using anything but the 8c probe for cardiacs.
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Great advice Peter… and
Great advice Peter… and to plug the SDEP echo… A well done perfect SDEP echo will obtain th eviews for 95% of congenital cardiac disease. … so if you perfect the SDEP you will get the lesion… Color first, pw, then cw if aliasing on every valve and outflow including th edeep PA to get the PDA. Ask the vet what he is expecting… PDA? SAS? PS?…VSD is see in more than one sdep view just keep the color flowing and if the heart is wacky and not in its normal place then follow it with the probe up the ribs, cranial a rib space, find your sweet spot keep your “brick” (right PS 4 chamber long axis) long… to ensure you have the right measurement criteria that is taught in your SDEP program.
We are planning on doing the SDEP echo to back the SDEP abdomen in Puerto Rico later this year. Since we had a sellout of the sdep abdomen lab we need to do echo as well.
http://sonopath.com/products
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ย
Great advice Peter… and
Great advice Peter… and to plug the SDEP echo… A well done perfect SDEP echo will obtain th eviews for 95% of congenital cardiac disease. … so if you perfect the SDEP you will get the lesion… Color first, pw, then cw if aliasing on every valve and outflow including th edeep PA to get the PDA. Ask the vet what he is expecting… PDA? SAS? PS?…VSD is see in more than one sdep view just keep the color flowing and if the heart is wacky and not in its normal place then follow it with the probe up the ribs, cranial a rib space, find your sweet spot keep your “brick” (right PS 4 chamber long axis) long… to ensure you have the right measurement criteria that is taught in your SDEP program.
We are planning on doing the SDEP echo to back the SDEP abdomen in Puerto Rico later this year. Since we had a sellout of the sdep abdomen lab we need to do echo as well.
http://sonopath.com/products
I don’t think he has anything
I don’t think he has anything in mind; no symptoms as of yet. But it is a newly asculted murmur so I think they are ensuring nothing else is cooking in the cardiac realm.
I am a religious SDEPer so I should be able to get those views plus apply Peter’s recs as well. Lots of color and CW on the menu. ๐
I don’t think he has anything
I don’t think he has anything in mind; no symptoms as of yet. But it is a newly asculted murmur so I think they are ensuring nothing else is cooking in the cardiac realm.
I am a religious SDEPer so I should be able to get those views plus apply Peter’s recs as well. Lots of color and CW on the menu. ๐
Re probes: Sorry, can’t help
Re probes: Sorry, can’t help here, I’m Esaote user, we don’t have a 3s or 6s probe ๐
Peter
Re probes: Sorry, can’t help
Re probes: Sorry, can’t help here, I’m Esaote user, we don’t have a 3s or 6s probe ๐
Peter
Regarding 3S and 6S probe
Regarding 3S and 6S probe selection/settings….. I sometimes use both for cats and dogs under 40-50# and only 3S for larger dogs.
Getting good color can be a challenge. I find I have to adjust maching settings (I use a Logiq E) with each patient I scan.
I attached a photo of a slide presented at a recent advanced echo class at Sound (credit to Dr. Gordon and June Boon here) that speaks to adjusting machine settings in a particular order when the CF image is underwhelming (not much flow detected).
This slide does not speak to line density which is on the menu arrow buttons on the GE machine. In general you would increase line density when the heart rates are lower. This would improve the image as well.
Hope this helps.
Tom
Regarding 3S and 6S probe
Regarding 3S and 6S probe selection/settings….. I sometimes use both for cats and dogs under 40-50# and only 3S for larger dogs.
Getting good color can be a challenge. I find I have to adjust maching settings (I use a Logiq E) with each patient I scan.
I attached a photo of a slide presented at a recent advanced echo class at Sound (credit to Dr. Gordon and June Boon here) that speaks to adjusting machine settings in a particular order when the CF image is underwhelming (not much flow detected).
This slide does not speak to line density which is on the menu arrow buttons on the GE machine. In general you would increase line density when the heart rates are lower. This would improve the image as well.
Hope this helps.
Tom
What does SDEP stand for?
What does SDEP stand for?
What does SDEP stand for?
What does SDEP stand for?
thanks Tom great addition.
thanks Tom great addition. June and Sonia are the best!
Electocute, SDEP stands for SonoPath Diagnostic Efficiency Program… there is an abdominal and a echo version.
The posters for each are in products and these are the scanning methods I and my team teach to ensure we get all the views from multiple angles in chest and abdomen in rapid time.
We are doing the abominal wetlab and clinpathology lecture series in Puerto Rico end of this month and will do an echo version later this year. Its a combination of taking what works form the field and what techniology offers and rendering it simpler while obtaining all the necessary views desired by the radiology and cardiology gods.
Its a brand new innovative way to look at sclinical sonography made for vet techs, rdms and drs. I’ve taught this successfully to > 100 people and they all have done very well with it in rapid time.
All this may be found in products section. Sorry for the infomercial but needed to explain it out. I’ve been doing it privately for a couple of years and now have gone public with seminars/wetlabs.
The video lecture explaining these techniques will be available for download on sonopath products later this month as well.
http://sonopath.com/products
thanks Tom great addition.
thanks Tom great addition. June and Sonia are the best!
Electocute, SDEP stands for SonoPath Diagnostic Efficiency Program… there is an abdominal and a echo version.
The posters for each are in products and these are the scanning methods I and my team teach to ensure we get all the views from multiple angles in chest and abdomen in rapid time.
We are doing the abominal wetlab and clinpathology lecture series in Puerto Rico end of this month and will do an echo version later this year. Its a combination of taking what works form the field and what techniology offers and rendering it simpler while obtaining all the necessary views desired by the radiology and cardiology gods.
Its a brand new innovative way to look at sclinical sonography made for vet techs, rdms and drs. I’ve taught this successfully to > 100 people and they all have done very well with it in rapid time.
All this may be found in products section. Sorry for the infomercial but needed to explain it out. I’ve been doing it privately for a couple of years and now have gone public with seminars/wetlabs.
The video lecture explaining these techniques will be available for download on sonopath products later this month as well.
http://sonopath.com/products
SonoPath Diagnostic
SonoPath Diagnostic Efficiency Program. ๐
And thank you Tom! ๐
Thankfully the dog did not have anything scary such as PDA.
SonoPath Diagnostic
SonoPath Diagnostic Efficiency Program. ๐
And thank you Tom! ๐
Thankfully the dog did not have anything scary such as PDA.
Your views would have picked
Your views would have picked it up KV as you did a near perfect SDEP echo. The deep PA was right on .
Woo-hoo! ๐
Woo-hoo! ๐
Your views would have picked
Your views would have picked it up KV as you did a near perfect SDEP echo. The deep PA was right on .
Woo-hoo! ๐
Woo-hoo! ๐
Can you post a pic of that
Can you post a pic of that deep PA?
Can you post a pic of that
Can you post a pic of that deep PA?
Here is your image from that
Here is your image from that CHihuahua you were worried about. This is a heart based view with the PA as this is a still shot from one of your SDEP echo clips position 2 on the protocol tail of probe down. Arrow marks the deep PA betweent the bifurcation below and the pv above. This is the pda spot.
here is a nice pda from the basic search to see one in action:)
http://sonopath.com/members/case-studies/cases/patent-ductus-arteriosis-pda-and-secondary-pulmonic-insufficiency-1-year-
Here is your image from that
Here is your image from that CHihuahua you were worried about. This is a heart based view with the PA as this is a still shot from one of your SDEP echo clips position 2 on the protocol tail of probe down. Arrow marks the deep PA betweent the bifurcation below and the pv above. This is the pda spot.
here is a nice pda from the basic search to see one in action:)
http://sonopath.com/members/case-studies/cases/patent-ductus-arteriosis-pda-and-secondary-pulmonic-insufficiency-1-year-
Ok, thanks!
Ok, thanks!
Ok, thanks!
Ok, thanks!