Diagnostic utility of lung ultrasound for monitoring of congestive heart failure in dogs

Purpose of Study: 

The purpose of this study is to determine if lung ultrasound will be a useful addition to the diagnostic monitoring of dogs with congestive heart failure. Lung ultrasound is a new imaging modality that can help identify fluid in the lungs (pulmonary edema). We are attempting to determine if lung ultrasound is as good (or better) than traditional measures of pulmonary edema used to monitor patients during the resolution of congestive heart failure. Lung ultrasound is faster, less stressful, and less expensive than the other tests commonly used for this purpose (chest X-rays, cardiac biomarkers).

Eligibility: 

Your dog may qualify for this study if:

- He/She has been diagnosed with CHF based on a combination of the following:

  1. Clinical signs or physical examination findings consistent with CHF (tachypnea, dyspnea, cough, and/or exercise intolerance);
  2. Echocardiogram confirming presence of severe structural heart disease;
  3. TXR demonstrating presence of pulmonary edema (interstitial and/or alveolar pulmonary pattern);
  4. Positive clinical response to medical treatment for CHF (furosemide, pimobendan). 

- He/She requires an hospitalization of at least 6 hours for treatment of CHF

- The initial diagnostic testing for the study (lung ultrasound, thoracic radiographs, echocardigoraphy, bloodwork) can be performed within 6 hours of presentation

Exclusion: 

- Patients with moderate to severe pleural effusion
- Patients with concurrent pulmonary disease
- Patients for whom initial timepoint diagnostic testing cannot be completed within the required 6-hour window
- Patients who do not require hospitalization for at least 6 hours

Client Responsibilities: 

If you agree to have your animal participate in this study, the participation will occur during the current visit (at 2 study timepoints, one within 6 hours of admission and one within 2 hours of discharge), at a recheck visit in 5-10 days, and at additional routine follow-up visits for your dog’s congestive heart failure (every 3-6 months).

At each study timepoint, the following testing will be performed: physical examination; lung ultrasound; echocardiography; chest X-rays; and blood collection for cardiac biomarker testing (NT-proBNP). The physical examination, echocardiogram, and chest X-rays would already be a routine part of your dog’s visit at some of these timepoints, so the only “extra” testing being performed is lung ultrasound and NT-proBNP. We will also ask you at each time point to fill out a survey about your dog’s quality of life at home.

To perform lung ultrasound, your dog will be gently restrained (either standing or lying down). Some of the hair on your dog’s chest will be wetted with alcohol (no hair will be shaved) and the veterinarian will hold an ultrasound transducer up to the side of his/her chest to obtain images of your dog’s lungs. The lung ultrasound examination lasts approximately 2-3 minutes. 

Client Benefits: 

By participating in this study, several aspects of your dog’s medical care and treatment will be provided at no cost to you.

This includes your dog’s medical record fees at each study visit (normally $17.50 at each visit), your dog’s Cardiology examination fees at each study visit (normally $126.00 for the first visit and $52.50 at each recheck), two lung ultrasounds today and one at each recheck visit (normally $42.00 each), NT-proBNP tests (normally $134.00), and brief echocardiograms at recheck visits (normally $110.00). You will continue to be responsible for all other costs associated with the normal course of treatment (including the full echocardiogram performed on the first visit, blood pressure measurements, and all bloodwork other than NT-proBNP), the treatment of any complications that may arise, and unrelated medical conditions.

Contact: 

Dr Jessica Ward; 515-294-4900