Veterinary POCUS: Differentiating Primary Cardiac from Pulmonary and Pleural Space Diseases

Dr. Soren Boysen, DVM, DACVECC and Dr. Serge Chalhoub, BSc, DVM, DACVIM (SAIM) teach how to confidently treat a feline in respiratory distress without moving the patient. They demonstrate rapid point-of-care ultrasound techniques to diagnose pulmonary and cardiac pathology in under 5 minutes at the cage side.

In a case study, a cat presents with an acute onset of marked respiratory distress and is open mouth breathing. On auscultation, breath sounds are dull ventrally and harsh dorsally, with audible crackles present. The cat is administered an anxiolytic and placed on oxygen. The patient is too unstable to transport from the resuscitation area to obtain radiographs. What to do?

Should we give a dose of furosemide in the event it’s heart failure? What if it’s feline asthma – should we give an IV or IM dose of short acting steroids? What about Terbutaline? Maybe a shotgun approach of Terbutadexalasix to cover all the bases?!?! What if we guess wrong, can we make the patient worse?

Stop stressing, stop guessing, and start looking! With point-of-care ultrasound (POCUS) pleural and/or lung pathology can be identified in seconds. If either or both are identified, the heart can rapidly be assessed in under 5 minutes to determine if furosemide is indicated.

With a combined total of more than 25 peer-reviewed articles and book chapters on the subject of veterinary lung ultrasound, Drs. Boysen and Chalhoub are big proponents of using veterinary POCUS for quickly assessing small animals. This dynamic session will look at how clinically driven POCUS questions can be answered to help determine if a patient presenting with respiratory distress has primary cardiac, pulmonary or pleural space disease, with an emphasis on diagnosing congestive heart failure.