East Coast Veterinary Cardiology is able to offer a complete cardiac evaluation for your patients, directly in your hospital. Should you feel that a cardiac evaluation is appropriate for your patient, we ask that you contact us directly to schedule the appointment. Our goal is collaborative cardiac care with maintenance of continuity of care. Our findings and recommendations are discussed directly with you as the primary veterinarian managing the case. Should an owner wish to meet with Dr. Orr at the time of the appointment, this can also be arranged. We will continue to be available to you for any questions or changes in your patient’s condition that may arise after the initial evaluation to ensure that continuity of care is maintained with the best quality cardiac care possible.
To help facilitate the mobile appointment, we ask to utilize a staff member from your hospital for the cardiac evaluation. This staff member will work with the patient for any diagnostics performed. Generally, most evaluations take less than 30 minutes to complete. We can use space in an exam room, treatment room, radiology or surgery – our goal is to minimize the impact on the daily workflow of your practice! Otherwise, no other special preparations are required. Although the referring veterinarian does not have to be present during the entire evaluation, we do ask for a window of opportunity to discuss our findings and plans directly with them or the findings can be discussed at a later time over the phone. We always welcome veterinarians or other staff members to be present during the evaluation and discuss any questions or concerns directly with Dr. Orr during that time.
It is rare that a patient requires sedation for a cardiac evaluation. However, if there is concern that a patient may be anxious or fractious for an examination, we ask that you please contact us prior to the appointment and we can help direct pre-evaluation sedatives. We have found that gabapentin for cats the night before and morning of the appointment has eliminated the requirement for more significant sedation the day of the evaluation. Furthermore, it does not have significant cardiac effects. Therefore, we do encourage gabapentin use for our anxious feline friends prior to their evaluation!
Our Mobile Cardiology Services
All new patient consultations will include a complete cardiovascular physical examination as well as complete review of all pertinent previous medical history, labwork and thoracic radiographs. A Doppler blood pressure (if not recently performed) and a 6-lead ECG rhythm analysis is also included with every consultation.
We provide a complete echocardiographic evaluation (2D, colour and spectral Doppler) by a board certified veterinary cardiologist with one of the newest portable echo machines available – the GE Vivid iq. All studies are stored in the cloud for easy access anytime from any computer for a total of 7 years. All findings are compiled into an easy to understand and detailed report that is generated same day as the evaluation. In addition to new patient echocardiograms, recheck studies are also available for those patients having a previous echocardiogram with East Coast Veterinary Cardiology.
6 & 9-lead Electrocardiogram (ECG)
Arrhythmias are common in patients with underlying heart disease and can represent a diagnostic challenge as some arrhythmias can be very complex. We offer both 6 & 9-lead ECG services which can help to diagnose difficult and complex arrhythmias better than a single lead ECG. ECGs are digitized so they may be sent to you and added to your records if needed.
Holter Monitoring (ambulatory ECG)
Arrhythmias in animals are often intermittent and can sometimes be difficult to document from an in-hospital ECG. Holter monitors therefore provide an extended period of rhythm analysis (24-48 hours) that are very useful in patients with a history of syncope, exercise intolerance or weakness. Holter monitors are also used to identify patients with occult (asymptomatic) heart disease such as dilated cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy as well as assess response to anti-arrhythmic therapy. Holter monitors are digital and lightweight meaning patients generally tolerate them well – as patients are discharged to their home environment wearing the Holter, this limits the factor of in-hospital stress on the patient which can be very helpful when assessing certain arrhythmias (such as response to medical therapy for atrial fibrillation). Upon return of the Holter, an interim report is generally available within 72 hours (with the exception of holidays and weekends) – this allows for institution of prompt medical therapy if needed with a complete final report available soon after. Recommendations for any necessary treatments or follow-up will be made.
Breeders may seek cardiac evaluation prior to breeding (particularly in high risk breeds) to confirm heart health. We offer complete cardiac screening (echocardiography, Holter monitors) for animals that will be used in a breeding program. Findings can then be used to OFA certify animals prior to breeding. These pre-breed evaluations are intended to evaluate animals for the presence of congenital or acquired heart disease but are not intended for those with known heart disease or those experiencing clinical signs suggestive of heart disease. Please note at this time we only offer advanced OFA cardiac assessments (echocardiography). We DO NOT offer the basic OFA cardiac assessment (the auscultation only assessment) on a mobile basis.
Prior to an anesthetic event, those patients who are asymptomatic but have physical evidence of heart disease (murmur) can be evaluated with a thorough cardiovascular examination and an echocardiogram to define the cause of the murmur but also evaluate anesthetic risk. Following the evaluation, an anesthetic plan can be tailored which accounts for the patient’s underlying heart disease with a risk assessment provided.
Therapeutic interventions such as thoracocentesis, pericardiocentesis and abdominocentesis are also available.