Blood pressure measurement

image of Blood pressure measurement
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The increasing recognition of systemic hypertension as a cause of clinical signs and a complication of common medical conditions makes blood pressure measurement an important diagnostic test in clinical veterinary medicine. Reliable measurement techniques, accurate assessment of results and effective therapeutic choices are needed to manage hypertension in dogs and cats successfully. Direct blood pressure measurement (i.e. intra-arterial needle or catheter) is accurate but technically challenging in dogs and cats. Measurement of blood pressure using non-invasive methods requires less technical skill but results may be inaccurate if careful attention is not paid to technique. The advantages enjoyed by physicians in measuring human blood pressure (i.e. generally cylinder-shaped appendages that easily allow cuff placement at the level of the heart; heart rates usually <150 beats/minute; lack of panting; and patient familiarity with the procedure) are not routinely present in conscious pet dogs and cats. Patient anxiety or excitement due to unfamiliarity with the procedure, rapid heart rates and the requirement that the patient remain motionless in what may be an abnormal position may lead to results that are inconsistent and difficult to interpret. These problems may be lessened, if not completely ameliorated, by excellent and consistent measurement techniques. This chapter looks at Indications; Techniques; and Technical aspects of clinical use of indirect methods.

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13.2 Feline eye with detached retina visible on basic penlight examination. The cat was presented for acute blindness. (Courtesy of E. Bentley.)
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13.3 Placement of an intra-arterial catheter into the femoral artery of a dog. Once in place, the catheter is attached by stiff-walled tubing to a pressure transducer. The ‘flash’ of blood in the needle hub indicates successful arterial puncture.
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13.6 The cuff is fitted snugly around the cat’s forelimb at the level of the radius and is held at the level of the heart for measurement. The Doppler crystal (with gel) is gently held in place over the ventral metacarpal arterial arch. The technician inflates the cuff with a hand-inflated bulb (lower left) while listening for the audible Doppler signal from the amplifier (bottom right).
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13.8 The cuff is fitted at the level of the metatarsus and is level with the dog’s sternum during measurement in lateral recumbency. The oscillometric device delivers systolic, diastolic and mean blood pressure with heart rate. The cuff is positioned at the base of the tail in a cat. Note that the tailhead is at the level of the heart when the cat is resting comfortably in sternal recumbency.
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