To refer a patient to the Cardiology service, please submit our online Patient Referral Form for Specialty Services. If you would prefer to complete a paper form, please complete our Specialty Referral Form and fax to 651-501-3763 or email to firstname.lastname@example.org.
Michelle Rose, DVM, DACVIM (Cardiology) is a board-certified veterinary cardiologist who is dedicated to diagnosing, managing, and treating disorders of the heart and cardiovascular system.
Dr. Rose sees dogs, cats, and exotic pets that are referred to her for suspected heart disease, or they may already have advanced cardiac disease and an optimal therapeutic plan is sought. Dr. Rose’s number one priority is that her patients have a good quality of life at home, for as long as possible. This is achieved by the following:
1. The pet owner must understand their pet’s general heart condition, know what to monitor at home (e.g. the resting respiratory rate), and know when to call for advice. Each new cardiology consultation (including diagnostic tests) is typically 90 minutes long to help achieve these goals.
2. If medications are necessary to control or prevent clinical signs of heart disease at home, the client’s lifestyle and pet’s temperament are taken into consideration. A terrified cat would not be prescribed four different diuretics and neurohormonal blockers, whereas an easy-going dog with a good appetite and often-available owner probably would receive this type of multimodal therapy.
3. Keeping the pet from being hospitalized too frequently from dyspnea is extremely important. Nothing will affect an owner’s perception of quality of life more than a dyspneic, coughing, lethargic pet. To this end, cardiac therapy must be aggressive enough to prevent clinical signs without causing side effects.
Another common reason that pets are referred to Dr. Rose is that their primary veterinarians detected a heart murmur or an arrhythmia on their physical exam prior to having anesthesia performed for a dental or surgery. Understandably, both the pet owner and veterinarian will wish to know what the animal’s risk of experiencing heart complications is during the anesthesia. While there is no test that will always answer this question with 100% accuracy, the many tools available to cardiologists – echocardiography, electrocardiography, Holter monitors, and blood tests (see below) – will reveal an enormous amount of information about how safe it is to go ahead with the planned procedure. (Alternatively, this information can also help determine how practical it is to do a surgical procedure in an animal with advanced heart disease.) Sometimes no medications are needed, and careful planning and extra vigilance during anesthesia are all that is required. Other times, the pet may need to be treated first to improve the cardiovascular system and help it become strong enough to withstand anesthesia. Infrequently, the advice given will be to not place the pet under anesthesia, as the risk is not worth the potential benefit.
Acquired heart disease (middle-age to late-onset) is one of the most common disorders affecting companion animals, but most pet owners are unaware that there is a problem early on. Dogs and cats with insufficient heart valves, weak or hypertrophied cardiac muscle, or arrhythmias often act completely normal for months to years before they start to show clinical signs. The only abnormality detected might be on the pet’s physical exam by its primary veterinarian. Early detection can make a huge and important difference in the pet’s prognosis.
Some of the clinical signs of advanced heart disease are as follows:
• Labored breathing
• Rapid breathing
• Exercise intolerance, weakness
• Poor appetite
• Weight loss
• Swollen abdomen
Dr. Rose performs the following specialized procedures:
• Echocardiography – A complete ultrasound study of the heart, evaluating the four heart valves; strength and thickness of the heart muscle; the pericardium; the great veins and arteries; and the diastolic (filling) and systolic (pumping) function of the heart. An echocardiogram can also identify cardiac tumors, as well as both congenital and acquired heart disease. Dr. Rose performs 98% of her echocardiograms with the pet awake (i.e. not sedated), as this is a noninvasive and painless test. If the pet is extremely anxious and the client prefers mild sedation, this is easily accommodated for.
• Electrocardiography (ECG) – The electrical activity of the heart is evaluated from 6-12 different angles to determine whether an arrhythmia exists, and how benign or malignant the arrhythmia is. This also determines the type of treatment the pet requires (if required at all).
• Holter monitors - These special monitors record the heart’s electrical activity for up to 96 hours at a time, storing every single heart beat digitally so that the heart rhythms can be evaluated closely at the conclusion of the study. Holter monitors are considered a “walking ECG” – the pet’s heart rate can be evaluated while sleeping, running, barking, eating, etc. A button can be pushed by the pet owner to mark when an unusual activity occurs, such as syncope or ataxia.
• Blood tests – Various blood tests are available (NT-proBNP, cardiac troponin I) to help stage and prognosticate heart disease. Other tests, such as taurine, can document a nutritional deficiency within the heart muscle.
What is the difference between a board-certified cardiologist and a traveling ultrasonographer?
Board-certified cardiologists have completed four years of veterinary school, a one-year internship, and three years of a cardiology residency under the supervision of other boarded cardiologists. They are required to pass two national board exams at the end of their second and third years of residency training. They also receive specialized training in the management of cardiac disease, and are familiar and comfortable with multimodal treatment protocols that optimize the patient’s quality of life. They are highly proficient in echocardiography, and use advanced imaging modalities such as color-flow Doppler, spectral Doppler, and tissue Doppler to best diagnose a pet’s type and stage of heart disease. Because cardiologists only see and treat heart disease all day long, they are required to be familiar with the most current veterinary literature and treatment protocols.
Dr. Rose is available for consultation on Mondays and Thursdays. She works out of the Oakdale location, and is also able to come to your veterinary clinic with her portable echocardiogram.
If you have a patient with heart-related problems or disease, please call us at (651) 501-3766 today.