Totally Vets is excited to offer cardiology referrals at our Feilding branch, seen by Jacqui Huxley and the team from Apex Cardiology.
Jacqui is the only board-certified veterinary cardiologist in New Zealand, has over a decade of experience in referral cardiorespiratory medicine and is an Adjunct Senior Lecturer in Veterinary Cardiology at Massey University. After qualifying as a Vet in the UK in 2003, she worked in first opinion practice for six years, before specialising in Cardiology. This involved six years of post-graduate training, passing some rigorous exams and demonstrating to the Australasian Veterinary Board Council and New Zealand Veterinary Council that she has sufficient expertise to be awarded Specialist status. She also holds a Masters in Veterinary Medicine, the subject of which was intermittent collapse in dogs and cats.
Jacqui established Apex Cardiology in 2016, and brings her expertise and advanced diagnostic kit to complement the equipment we already have here at Totally Vets, which is so useful for making accurate diagnoses and prognoses. Appointments for consultation or out-patient echocardiography (heart scan) can be booked through Totally Vets Feilding’s reception team. All cardiology referrals must have been seen by a one of our vets first; they will be able to advise as to whether referral is the right choice for you and your pet.
Which cases would benefit from referral to a Cardiologist?
- Puppies/kittens with a murmur should ideally have advanced, colour-doppler, echocardiography (‘heart scan’) at a young age as certain congenital (from birth) cardiac conditions can be cured, and many benefit from early, accurate diagnosis.
- Episodic/intermittent collapse (‘fainting’) can be the first sign of serious underlying cardiac disease, be completely benign, or anywhere in-between! It can be challenging to find a diagnosis in these cases, plus it is critical that the more serious conditions are identified early, so a comprehensive cardiac investigation is recommended.
- Older, small breed dogs with a typical heart murmur have almost certainly got chronic valve disease; but determining if/when to start medication is not always clear cut. Referral to a Cardiologist is not only recommended in the American College of Veterinary Internal Medicine Consensus Guidelines but has been shown to improve outcome. Plus, Cardiologists are able to identify concurrent conditions and determine if deterioration to heart failure is likely in the near future.
- Older, small breed dogs with a heart murmur and a cough have heart failure. Right? Wrong! Often, they have preclinical (‘asymptomatic’) chronic valve disease and concurrent lung/airway disease. These cases can be challenging to accurately identify the cause of the cough and rely on excellent thoracic radiographs (+/- advanced diagnostics), precise echocardiography, and a good understanding and experience of the diseases involved.
- Older, large breed dogs with a heart murmur may have dilated cardiomyopathy (DCM) – a disease of the heart muscle – which is a rule-out diagnosis that can only be made with comprehensive echocardiography and can be particularly challenging in athletic dogs whose hearts can mimic the changes seen in DCM whilst being perfectly healthy. DCM can be a devastating condition, although more recent advances in medicine have improved outcomes. At-risk breeds, with a high prevalence of sudden death such as Dobermans, Boxers and Great Danes, should ideally be screened by a Cardiologist annually and any large breed dog with a heart murmur should have cardiac assessment.
Older cats, being cats, don’t nicely fit into a brief summary! But they can be difficult to echo well and it’s easy to make a mis-diagnosis. Many cats with a heart murmur have a normal heart; and many cats with heart disease happily live a normal life. But, sadly, some do less well and it is important to identify these cats, so that we can help. To add to the feline fun, approximately 1/3 of cats with hypertrophic cardiomyopathy (the most common cat heart disease) don’t have any outward signs and approximately half of cats presenting with heart failure have a preceding event identified (such as anaesthesia or intravenous fluid administration). Thankfully, there is a blood test available which can be helpful to guide decision-making in these apparently well cats, prior to veterinary treatment. If cats have a tachyarrhythmia (a fast, abnormal heart rhythm) or gallop sounds there’s a good chance they have underlying heart disease and should have their heart checked (including echocardiography with diastolic (heart ‘filling’) function assessment).
Referrals can only be accepted from vets (the exception is breeders for heart testing) and can be arranged through the Totally Vets Feilding reception team or directly with Apex Cardiology. More information about Jacqui and the cardiology service can be found on their website: www.apexcardiology.co.nz.
Jacqui is happy to chat through cases with Totally Vets’ staff, or cast an eye over ECGs or chest x-rays, so please feel free to ask.