Page 326 - Feline Cardiology
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Chapter 21: Systemic Hypertension  335









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                 C                                               D                                                      Systemic Hypertension
              Figure 21.10.  Instrumentation	for	routine	measurement	of	BP	in	cats.	(A)	The	Doppler	ultrasonic	unit,	with	probe	(1),	a	bottle	of
              ultrasonic	coupling	gel	(2),	assorted	cuffs	of	various	sizes	(3),	and	a	measuring	tape	for	accurate	cuff	sizing	(4).	(B)	A	standard,	spring-
              operated	sphygmomanometer	with	cuff.	(C)	Plantar	surface	of	a	cat’s	right	metatarsus;	the	cat	is	in	left	lateral	recumbency	facing	away
              from	the	camera,	and	the	tail	is	off	the	left	side	of	the	image	(not	seen).	Minimal	restraint	(gentle	holding	of	the	forelimbs	only,	hindlimbs
              unrestrained),	soft	speaking	to	the	cat,	and	gentle	petting	of	the	head	are	part	of	a	calm	environment	that	is	least	likely	to	produce
              anxiety-related	hypertension	in	this	cat.	A	square	of	hair	has	been	shaved	away	from	the	area	over	the	metatarsal	arteries,	on	the	plantar
              surface	≤1	cm	proximal	to	the	metatarsal	pad	(arrows).	(D)	Proper	placement	of	the	Doppler	probe,	concave	side	to	the	cat,	on	the	area
              shown	in	(C).	Note	that	the	finger	holds	the	probe	wire	for	good	contact	between	the	probe	and	the	patient,	but	minimal	to	no	pressure
              is	placed	on	the	probe	itself.	This	precaution	helps	avoids	inadvertent	occlusion	of	the	artery,	which	could	hamper	the	measurement	or
              give	erroneous	results.	Photos	courtesy	of	E.	Côté.


              in BP of up to 15 mm Hg is normal, and a mean of 3   owner  in  the  exam  room  at  the  beginning  of  the
              readings  (discarding  the  highest  and  lowest)  is  deter­  appointment,  before  the  clinician  arrives  or  tests  or
              mined to be the cat’s systolic arterial BP.        procedures  are  completed,  to  minimize  anxiety.
                 If  a  cat  is  fractious,  seems  very  anxious,  or  other­  Another option is for the owner to hire a veterinarian
              wise  does  not  allow  BP  measurement  that  appears  to   or technician to make a house call. Simply scheduling
              the  clinician  to  reflect  a  calm  cat,  other  options   a  repeat  visit  on  a  separate  day  to  allow  the  cat  to
              should  be  considered.  Better  measurements  are  often   rest  from  the  hospital  visit  is  also  an  option.  Finally,
              possible  when  the  cat  and  owner  are  together  in  a   sedation  of  fractious  or  anxious  cats  solely  for  the
              quiet exam room. During future visits, when BP mea­  purposes of measuring BP is not recommended, since
              surement  is  planned,  it  can  be  performed  with  the   all  sedatives  can  alter  BP  to  a  greater  degree  than  is
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