Hello,
In an ER setting is it correct to simplify, diagnose CHF on cats if LA/AO considerably high # ( like > 2.5-3) and significant rocket lines ( as for pulmonary edema)? Is it enough?
I’m asking because to me it is so much easier to obtain a LA/AO in a cat that is in oxygen cage or flow by due to respiratory failure, before doing any x-rays.
Comments
The LA/AO heart base normal in a cat is up to 1.6. On your image its >>> 2.0 so volume overload is present and left chf makes sense.
Ive always maintained that in crit care scenarios where you have a few seconds just get a quick sdep echo position 1 3 sec long and short axis and put him back in the cage. Its enough to evaluate wherthere the meds you need are cardiac or non cardiac.
He has at least a lasix deficinecy to help stabilize.
Thank you EL. That is how I used focal/ limited Echo in the last few years but wanted to confirm that it is enough for first assesment.
Yes, I completely agree. In critical patients, I usually prefer ultrasound over radiographs since you can detect liquidothorax, interstitial syndrome (edema, inflammation etc), pneumothorax, mediastinal lymphoma and diaphragmatic hernia. If I see an interstitial syndrome (wet lung) in combination with an enlarged left atrium, there is always much suspicion of left sided CHF. Usually the left atrium is pretty large, as Eric stated. Yet, there are feline patients with congestive heart failure and only mildly enlarged left atrium. In these cases it can be difficult to distinguish CHF from heart disease + pneumonia or ARDS. Still, if I see a left atrial enlargement in a critical cat with wet lung sign or pleural effusion, my first suspicion is CHF, independent on how much enlarged the left atrium is and I give them a bolus of furosemide + oxygen + Butorphanol.
Thank you Peter