Flow Veterinary Cardiology

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Flow Veterinary Cardiology

Flow Veterinary Cardiology provides a Advanced Practitioner led Small Animal Cardiology referral service for dogs and cats. Our service is based in Co. Cork.

08/03/2024

Do you feel confident detecting puppy murmurs on auscultation?

🧭Locating the point of maximal intensity of a murmur (where it sounds loudest) will help you to narrow down your list of differentials of congenital heart disease - a very helpful skill to master! 🤓

🩺Thorough auscultation of both sides of the chest, at the base and apex, is essential for detecting these murmurs.

🎯This is easier said than done, a sniffing, wriggling, excited puppy is a noisy moving target! My top tip is to auscultate wriggly pups held up in your arms - this helps to limit their movement and can improve the quality of your auscultation in these cases ✅

❤️ It is most important not to forget to listen high up in the left axilla (armpit), where we would expect to hear the continuous machinery like murmur of a PDA; a condition where prompt diagnosis and management with either surgical or interventional occlusion is critical to ensure a good outcome for the patient.

Has this post been helpful? If so, save it for reference later! ✅

28/02/2024

🩺 Do you feel confident grading murmurs following auscultation?

🤓 Murmurs are usually graded 1-6 depending on intensity and the presence or absence of a thrill, however the simpler approach of grading murmurs as soft, moderate, loud or thrilling is perhaps an easier and less stressful approach to grading murmurs in general practice.

😅 I find that many vets seem to worry about the accuracy of their murmur grading when speaking to colleagues or referring a case for cardiac work up. But really there is no need to worry - most cardiologists are happy with an indication of whether the murmur is loud or soft and an indication of where you feel the murmur is heard at its loudest (point of maximal intensity) ie. the left or right chest. Deciding whether the murmur is loudest at the base or apex is the cherry on top and completes the description of your auscultation.

👂Remember that there is a degree of subjectivity in interpreting auscultation, leading to a slight variation in grading between colleagues, which is to be expected and not a cause for concern. So don’t worry if your ears hear things a grade differently to a colleague - the important thing is to be consistent within your own auscultation.

25/02/2024

🧐Are you comfortable characterising murmurs you have heard on auscultation?

✅Detecting whether a murmur is systolic, diastolic or continuous is important as this provides information which will help you to form a differential diagnosis list and assist you in formulating a sensible diagnostic plan.

❤️The vast majority of murmurs you will auscultate will be systolic, with diastolic murmurs being reasonably rare. Continuous murmurs are especially important not to miss, as the most common differential is a patent ductus arteriosus (PDA); a condition in puppies where prompt diagnosis and management is critical.

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♥️ If a pet is on several cardiac medications, as most patients in congestive heart failure are, I would recommend giving the owner a prioritised list of medications, with number one being the most essential, life saving medication where a dose can’t be missed under any circumstances, down to the least essential medication ( say number 3 or 4 on the priority list for example), where if a dose of the medication is missed it is not critical. This is particularly important for patients on chronic meds that don’t always cooperate for taking their medications - we all know that some pets can find ninja like skills in spitting out tablets when they want to. It’s not easy being an owner of a pet needing chronic medications. We want to preserve the human animal bond in these tricky situations . This prioritisation means that on those tough days where your owner is struggling to get their pet to take the tablets, that they can focus on prioritising the most important one and stay friends with their pet. It’s a win win - stress reduction for the pet and pet owner and you make sure the pet gets its essential life saving medication. ♥️ Explain how the medication works and why it benefits their pet in simple, accessible terms. Understanding why we are going to the trouble and expense of giving the medication may help the owner to persevere when medicating becomes challenging. ♥️ Information sheets about the pet’s condition will empower your pet owner to learn about the ‘ins and outs’ of their pet’s heart condition, why medication is needed and the expected disease course from a reliable source that you have either created or from a reliable free resource that you have found online (my favourite free resource for this is veterinarypartner.vin.com - and they actively encourage printing their resources for client education). In my experience, the more background knowledge of the heart condition we can give a pet carer, the more likely they are to gain

Have you been in this nightmare situation before? 😳 😱 As vets and vet nurses, we deal with compliance issues regularly, however in a situation such as congestive heart failure, diuretic non-compliance can be catastrophic. 🤔 Poor compliance with medicating or at home monitoring of patients is of course multi factorial and individual to each patient situation, however in my experience and opinion, most issues can be avoided by investing time in educating the client appropriately on their pet’s condition and treatment. I appreciate this is not an easy thing to do amidst the time pressures of practice! ❤️ Pet owners want to do the very best by their beloved pet; in most cases I find that poor compliance was unintentional, due to misunderstanding or embarrassment about admitting difficulty with medication administration. All very understandable issues! 😊 ✅ Stay tuned for my upcoming posts where I will give you my easy top tips for how to encourage great owner compliance in your cardio cases ❤️ #vetcardiology #vetcardiologist #vetcardio #vet #vetnurse #vetinternalmedicine

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Welcome to Flow Veterinary Referrals

Flow Referrals Ireland is a veterinary cardiology referral service for pets based in Millstreet, Co. Cork.

Established by Veterinary Cardiologist Jane Pigott, an RCVS Advanced Practitioner in Veterinary Cardiology.

Jane and the cardiology nursing team are looking forward to welcoming you and your pets to Millstreet. At Flow Referrals we pride ourselves on providing an excellent referral service to pet owners.

Pet Owners: Please contact your primary care family veterinarian to obtain a referral to visit our cardiologist. We’ll work closely with your vet every step of the way, and after consultation and treatment your general practice vet will provide continued care. You may be concerned that your pet needs to see a cardiologist - But don’t worry, your pet is in the perfect place to get the right treatment.