Echocardiography

Assessing heart disease in cats and dogs does not end with listening to the chest or looking at a radiograph. Echocardiography, an ultrasound of the heart, lets us see both what the heart looks like and how it is working.

At this clinic a cardiac assessment is read together with the animal’s clinical signs and other tests. The examination is carried out by Vet. Hek. Berat Çelik, who has performed over a thousand echocardiographic studies to date.

The aim is not only to say whether something is wrong with the heart. It is to describe the state the heart is in, judge how much the finding matters, and produce the information that shapes treatment and follow-up.

What an echocardiogram shows

• The size of the heart chambers
• The thickness of the heart muscle
• How the heart contracts and relaxes
• The structure and movement of the valves
• Leaks across the valves
• The direction and speed of blood flow inside the heart
• Pressure changes across the heart
• Whether there is fluid around the heart
• Certain congenital heart conditions

Doppler echocardiography adds how the blood moves and how it flows, so the study describes function and not only appearance.

In cats

Heart disease in cats can advance for a long time without obvious signs. Some cardiomyopathies in particular give mild signs or none at all until the disease is well established.

What is assessed: hypertrophic cardiomyopathy, restrictive and other cardiomyopathies, valve disease, chamber enlargement, left atrial enlargement, pulmonary hypertension, fluid around the heart, congenital disease, and the risk of clot formation inside the heart.

Not every cat with a murmur has heart disease, and not every cat with heart disease has a murmur. That is why the decision is not left to the stethoscope alone.

A cardiac assessment is considered particularly where there is a murmur, fast breathing, laboured breathing, tiring easily, fainting, sudden weakness, or signs suggesting impaired circulation to the hind legs. It also gives useful information before anaesthesia or surgery in a cat suspected of heart disease.

In dogs

Heart disease in dogs presents differently with age, breed and genetic predisposition. Degenerative mitral valve disease is prominent in older small breeds, dilated cardiomyopathy in large and certain specific breeds.

What is assessed: mitral and other valve disease, dilated cardiomyopathy, congenital heart disease, pulmonary hypertension, chamber enlargement, impaired heart muscle function, pericardial disease, and suspected masses or clots within the heart.

Which signs call for a cardiac assessment

Some heart disease is found incidentally at a routine examination; in other animals the signs are clear:

• A heart murmur
• A fast or irregular heartbeat
• Breathing faster than normal at rest
• Difficulty breathing
• Tiring quickly on exercise
• Lethargy
• Fainting or episodes resembling fainting
• In dogs, a cough that worsens at night and when lying down
• A belly swollen with fluid
• Pale or bluish gums
• In cats, sudden weakness, pain and coldness in the hind legs
• Fluid collecting in the abdomen
• A change in the cardiac silhouette on a radiograph, or suspected enlargement
• Follow-up of heart disease already diagnosed
• Assessment before anaesthesia or planned surgery

One point matters: none of these signs belongs to the heart alone. Lung disease, anaemia, pain and hormonal problems produce the same picture. That is why an echocardiogram is read alongside the examination and the other tests rather than on its own.

Counting the resting respiratory rate at home supports this decision; how to do it is described in my cat is breathing fast. What a night cough means in dogs is in coughing in dogs.

The heart is not assessed alone

Heart disease rarely arrives alone and should not be read alone.

In cats, kidney disease, high blood pressure and hyperthyroidism directly affect how the heart works. The reverse is also true: in an animal with heart disease, the changes in circulation affect the kidneys and other organs. Some cardiac medications alter kidney values, so those values are monitored when treatment starts and afterwards.

Echocardiographic findings are therefore read, where needed, alongside blood pressure measurement, blood and urine tests, radiography, abdominal ultrasound and the clinical examination.

This gives more than a view of the change in the heart: it gives an understanding of the animal’s overall condition.

Why it matters in follow-up

What happens after the diagnosis matters as much as the first assessment. Heart disease may progress, hold steady, or respond to treatment, and the only way to see which is to repeat the measurements.

Reassessed at each check:

• The size of the heart chambers
• The function of the heart muscle
• The course of valve disease
• Changes in blood flow
• Findings related to pulmonary hypertension
• Whether the disease is advancing

This allows treatment to be adjusted to the animal’s current state. The interval between checks follows the stage of the disease and we tell you what it is.

What the result is for

An echocardiogram reaches a diagnosis, but its real value comes afterwards. The stage of the disease sets the treatment plan, the choice and dose of medication follow from it, and the interval between check-ups is built on it.

Repeating the same measurements shows whether the disease is progressing and whether the treatment is working. In an animal with heart disease, echocardiography is part of follow-up rather than a one-off procedure.

How we work

The information an echocardiogram produces is read together with the examination findings, laboratory results, blood pressure, current medication and any other conditions.

In an animal with heart disease, running the prescription alongside clinical follow-up makes changes over time far easier to read. That is the basis of the cardiac work here: accurate imaging, accurate clinical assessment, and regular follow-up.