Influence of the observer’s level of experience on systolic and diastolic arterial blood pressure measurements using Doppler ultrasonography in healthy conscious cats

Abstract

The objective of this study was to determine the influence of the observer's level of experience on within- and between-day variability, and the percentage of successful systolic (SAP) and diastolic arterial blood pressure (DAP) measurements obtained by Doppler ultrasonography (DU) in awake cats. For this purpose, six healthy conscious cats were used and four observers with different levels of training performed 144 SAP and DAP measurements on 4 days using DU. Measurements were recorded five consecutive times, and mean values were used for statistical analysis. Only the two most skilled observers - a PhD student in cardiology and a Dipl ECVIM-CA (cardiology) - had within- and between-day coefficients of variation (CVs) for SAP ⩽16% (13-16%). Conversely, the two less experienced observers - a fifth-year student and an assistant - had high between-day CVs (61% and 73%). For DAP, only the most experienced observer (Dipl ECVIM-CA) succeeded in 100% of the attempts, with within- and between-day CVs of 11% and 4%, respectively. Conversely, DAP could not be measured by the other three observers in 8%, 19% and 56% of attempts (from the highest to the lowest level of experience); therefore, the corresponding CV values could not be calculated. In conclusion, SAP may be assessed using DU in healthy awake cats with good repeatability and reproducibility by a well-trained observer. Measurement of DAP is more difficult than of SAP, and needs a longer training period, which represents one of the limitations of DU in cats.

Clinical, epidemiological and echocardiographic features and prognostic factors in cats with restrictive cardiomyopathy: A retrospective study of 92 cases (2001‐2015)

“…The presence of concurrent systemic disease and treatment at diagnosis were recorded. Cats with hyperthyroidism and those with systemic arterial hypertension (systolic arterial blood pressure measured in awake cats by the standard Doppler method [811‐BL; Parks Medical Electronics, Inc, Aloha, Oregon] >160 mm Hg in unstressed animals) were not included in the study, nor were cats with systolic cranial motion of the mitral valve or focal hypertrophy of the IVS. The International Renal Interest Society (IRIS) serum creatinine cutoff concentrations were used to assess the renal status of patients (IRIS stages 1‐4), when corresponding data were available…”

“…The aim of our retrospective study was therefore to (1) mm Hg in unstressed animals) 11,12 were not included in the study, nor were cats with systolic cranial motion of the mitral valve or focal hypertrophy of the IVS. The International Renal Interest Society (IRIS) serum creatinine cutoff concentrations were used to assess the renal status of patients (IRIS stages [1][2][3][4], when corresponding data were available.…”

ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats

“…The individual taking the measurements should be skilled and experienced in the handling of animals and the equipment. Studies have shown that operator experience can have a significant impact on BP measurements . Often the most skilled individual is a well‐trained technician and not a veterinarian.…”

“…Blood pressure measurement results in normal animals are highly variable based on breed, temperament, patient position, measurement method, operator experience, and intrapatient variability, and it is difficult to determine a single value and range that might be applicable to all dogs or cats. Ranges of expected values in many studies of normal dogs and cats using various measurement techniques are presented in Table .…”

Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats

“…Systolic (SAP) and diastolic (DAP) arterial BP can be measured; however, the DAP measurement can be difficult to obtain, and the accuracy of these measurements is dependent on the operator's experience, particularly when measuring DAP. 2,21 It can be difficult to obtain BP values in fractious and uncooperative cats. Oscillometric devices are technically easier to use than Doppler machines.…”