Presenter – Sarah M. A. Caney BVSc PhD DSAM(Feline) MRCVS RCVS Specialist in Feline Medicine
To be honest I am already convinced that blood pressure measurements are an essential tool in maintaining the health of our feline friends and, for this reason, I have been measuring blood pressure for many years. I therefore viewed this webinar as more of a ‘refresher’ on techniques for diagnosis and treatment and hoped it would make me feel just a little smug that I was doing all the right things.
Of course, it actually proved to be a lot more than just a ‘reminder’ and it was a real pleasure to listen to Dr Caney giving us some great advice on how to diagnose and deal with feline hypertension. It’s always refreshing to hear the opinions of a specialist that still consults on first opinion cases and who understands the challenges that we sometimes have to face in practice.
One concern I always have when measuring blood pressure on our feline patients is how their stress levels could affect our final blood pressure measurements. And this was justified by Dr Caney who stated that the infamous ‘white coat effect’ can increase a blood pressure measurement by up to 75mm/hg, so for this reason treatment should never be instigated on the basis of one reading.
Minimising stress levels can be achieved by taking measurements in cats as outpatients with the owner present and allowing them to acclimatise to their surroundings over 10 minutes. Headphones are also a great idea as we all know that ear splitting noise the machine makes when the gel goes on the probe (as an aside – you can never have enough gel – if in doubt put more on). This noise in itself will push the cat’s blood pressure up through the roof. The headphones also allow the owners to be totally unaware of the stress we can sometimes suffer when trying to find a pulse , another situation which can push our own blood pressure through the roof.
Dr Caney also discussed a point that I was totally unaware of. Whilst measuring systolic pressure as standard, we may also be able to measure diastolic pressure using the same technique. Systolic pressure is based on the figure when the pulse is heard again on deflating the cuff. Apparently the diastolic measure can also be ascertained when there is a change in the pulse’s tone, of which Dr Caney does a lovely rendition. As it stands we don’t know much about the significance of diastolic measurements but they could become relevant in the future and it may well be worthwhile putting on our musical hats and trying to tune into these subtle tone changes.
I am pleased to say after listening to this webinar, that I am mostly doing the right thing but I was certainly being arrogant in thinking that I didn’t have anything more to learn. I now know, thanks to Dr. Caney, that Conn’s disease in cats should be a differential for feline hypertension. Dr Caney believes this is an under-diagnosed disease, which doesn’t really surprise me as it is a condition that has never really been on my radar.
As well as all the additional great advice that Dr Caney has given us, I have finally learnt that turning on my musical switch and popping on my headphones is now no longer just something that I do in my spare time.
The Stethoscope (MRCVS)