How pulse checks relate to blood pressure in emergency dogs

Abstract

OBJECTIVE: To assess the association between peripheral pulse palpation and Doppler-derived systolic blood pressure (SBP) measurement in dogs presenting to an emergency service. DESIGN: Prospective observational study. SETTING: University veterinary teaching hospital. ANIMALS: Ninety-three dogs that were presented to the emergency service. Dogs were eligible for inclusion in the study if a physical examination and a SBP measurement were performed prior to any interventions. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Both the femoral pulse quality and dorsal metatarsal pulse quality were digitally palpated and assessed as either strong, weak, or absent. The mean SBP in all dogs was 139 mm Hg (&#xb1; 39 mm Hg). Seventeen (17/93; 18%) dogs were hypotensive with a SBP < 90 mm Hg (range, 40-88 mm Hg). The median SBP was not significantly different between dogs in the absent and present femoral pulse groups (P&#xa0;=&#xa0;0.120) but the median SBP was significantly different between absent and present metatarsal pulse groups (P&#xa0;=&#xa0;0.002). Dogs with absent metatarsal pulses were 7.6 times more likely to be hypotensive with a SBP < 90 mm Hg (OR, 7.6; 95% CI, 1.8-32) as compared to dogs with palpable metatarsal pulses. The sensitivity of absent metatarsal pulses to diagnose hypotension (SBP < 90 mm Hg) was 33% (95% CI, 10-65%) and the specificity was 94% (95% CI, 86-98%). CONCLUSIONS: Absent metatarsal pulses are highly specific in the diagnosis of hypotension. However, dogs with palpable metatarsal pulses can still be hypotensive. Dorsal metatarsal pulse palpation is useful during triage assessment of dogs presenting to an emergency service, though it should not be used as the only indicator of a dog's cardiovascular stability and should not replace an actual blood pressure measurement.