Peer-reviewed veterinary case report
How ultrasound and NT-proBNP tests help diagnose breathing problems
By Janson, Cassandra Ostroski et al.Ā·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)Ā·2020Ā·Department of Clinical Sciences, United StatesĀ·View original on PubMed ā
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Original publication title: Focused cardiac ultrasound and point-of-care NT-proBNP assay in the emergency room for differentiation of cardiac and noncardiac causes of respiratory distress in cats.
- Species:
- cat
Plain-English summary
A group of 37 cats with breathing problems were evaluated in an emergency room to determine if their issues were caused by heart problems or something else. Emergency vets used a focused cardiac ultrasound and a quick blood test to help make a more accurate diagnosis. Initially, they correctly identified the cause in about 73% of cases, but after using the ultrasound, their accuracy improved to nearly 92%. The blood test also showed high accuracy in distinguishing between cardiac and noncardiac causes. These tools can be very helpful for vets when diagnosing cats in respiratory distress.
People also search for: cat breathing problems diagnosis Ā· cat heart disease symptoms Ā· emergency vet cat respiratory distress
Abstract
OBJECTIVE: To assess the accuracy of focused cardiac ultrasound (FOCUS) and point-of-care N-terminal proBNP assay in the emergency setting for differentiation of cardiac from noncardiac causes of respiratory distress in cats. DESIGN: Prospective diagnostic accuracy study between 2014 and 2016. SETTING: Emergency room at an urban university teaching hospital. ANIMALS: Forty-one client-owned cats presenting for evaluation of respiratory distress. INTERVENTIONS: Emergency clinicians made an initial diagnosis of noncardiac or cardiac cause of respiratory distress based on physical examination (PE) findings and history. The diagnoses were updated after performing FOCUS and point-of-care N-terminal B-type natriuretic peptide (POC-BNP). Reference standard diagnosis was determined by agreement of a board-certified cardiologist and critical care specialist with access to subsequent radiographs and echocardiograms. MEASUREMENTS AND MAIN RESULTS: Forty-one cats were enrolled. Three cats with incomplete data and 1 cat with an uncertain reference standard diagnosis were excluded. The remaining 37 cats were used for analysis: 21 cardiac and 16 noncardiac cases. The ratio of left atrial to aortic root diameter (LA:Ao) measured by FOCUS was significantly correlated with LA:Ao measured by echocardiography (R = 0.646, P < 0.0001). Emergency clinicians correctly diagnosed 27 of 37 (73.0%), yielding a PE positive percent agreement = 76.2% (95% CI, 52.8-91.8%) and negative percent agreement = 68.8% (95% CI, 41.3-89.0%). Five noncardiac and 5 cardiac cats were misdiagnosed. Post FOCUS, overall percent agreement improved to 34 of 37 (91.9%), with positive percent agreement = 95.2% (95% CI, 76.2-99.9%) and negative percent agreement = 87.5% (95% CI, 61.7-98.5%). The POC-BNP yielded an overall percent agreement = 32/34 (94.1%), positive percent agreement = 100% (95% CI, 82.4-100.0%), and negative percent agreement = 86.7% (95% CI, 59.5-98.3%) in differentiating cardiac versus noncardiac cases. CONCLUSIONS: FOCUS evaluation of basic cardiac structure and LA:Ao by trained emergency clinicians improved accuracy of diagnosis compared to PE in cats with respiratory distress. FOCUS and POC-BNP are useful diagnostics in the emergent setting.
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Search related cases āOriginal publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32579274/