TRUVIEW Archives

Category: TRUVIEW

09/01/2025

Veterinary Cardiac Testing: Advanced Heart Disease Diagnostics Equipment

Based on clinical insights from Dr. Gary Oswald’s webinar, When the Heart Cries for Help. Using NT-proBNP in Canine Cardiac Disease*

Heart disease affects millions of dogs and cats, yet most cases go undetected until patients present in crisis. Studies show that many cardiac conditions remain hidden for months or years before becoming clinically apparent, often making their first appearance as sudden death or acute heart failure. The TRUFORMA® diagnostic system revolutionizes veterinary cardiac care by bringing advanced heart disease testing directly into general practice, enabling early detection and better patient outcomes through rapid NT-proBNP cardiac biomarker analysis.

The Hidden Epidemic: Heart Disease in Veterinary Practice

Heart disease represents one of the most challenging diagnostic areas for general practitioners, with traditional methods often failing until disease reaches advanced stages.

Common Diagnostic Challenges:

Physical examination may appear normal in early disease stages
Heart murmurs can be absent in many cardiomyopathy cases
Chest radiographs often show no changes until heart failure develops
ECG abnormalities frequently absent in subclinical patients
Patient stress during examination masks subtle signs

Clinical Reality: Many pets with significant heart disease show no obvious symptoms during routine wellness visits, leaving veterinarians without clear indicators to pursue cardiac evaluation.

The Cost of Late Detection

Patient Impact:

First symptom often sudden death or acute heart failure
Advanced disease requires more aggressive, expensive treatment
Shorter lifespan and reduced quality of life
Limited treatment options once heart failure develops

Practice Impact:

Emergency presentations requiring immediate referral
Client dissatisfaction when disease “appears suddenly”
Missed opportunities for preventive care
Higher liability risk from undiagnosed conditions

How to Diagnose Heart Disease in Dogs and Cats

Subtle Symptoms Pet Owners Report:

Exercise intolerance or tiring more easily during walks
Heavy breathing during normal activities
Restlessness at night or difficulty settling
Coughing episodes especially at night or early morning
Decreased appetite or reluctance to eat
Weight loss despite normal eating habits

Clinical Signs for Veterinarians:

Soft heart murmurs that may be intermittent
Increased respiratory effort during examination
Pale or slow capillary refill indicating poor circulation
Weak pulses or pulse deficits
Behavioral changes such as hiding or decreased activity

Traditional Diagnostic Limitations

Physical Examination Challenges: While cardiac auscultation remains important, many patients with significant heart disease present with normal or only subtle examination findings, particularly cats with cardiomyopathies and dogs with early dilated cardiomyopathy.

Radiographic Limitations: Chest X-rays frequently appear normal in subclinical cardiac patients. Even when abnormalities are present, distinguishing cardiac from respiratory causes can be challenging, especially in emergency situations.

The Diagnostic Gap: General practitioners need reliable tools to identify cardiac disease before clinical signs develop, allowing for early intervention and improved patient outcomes.

Advanced Heart Disease Testing: The NT-proBNP Solution

NT-proBNP (N-terminal pro-B-type natriuretic peptide) serves as the heart’s “cry for help,” providing objective evidence of cardiac stress when traditional diagnostic methods fall short.

How Cardiac Biomarkers Work: When the heart experiences stress from increased pressure or volume, cardiac cells produce a hormone called pro-BNP. This molecule is then split into two parts:

Active BNP: Helps the body manage cardiac stress by promoting blood vessel dilation and kidney function
NT-proBNP: Inactive fragment that remains in the bloodstream longer and can be easily measured

Clinical Advantage: NT-proBNP levels rise significantly before clinical signs appear, enabling early detection of heart disease in apparently healthy patients.

Why NT-proBNP Testing Transforms General Practice

Immediate Clinical Applications:

Emergency triage of patients with breathing difficulties
Pre-anesthetic screening for high-risk patients

Wellness screening in breeds prone to heart disease
Treatment monitoring for patients with known cardiac conditions

Practice Benefits:

15-minute results for immediate clinical decision-making
Objective data to support clinical findings

Client confidence in advanced diagnostic capabilities

Early intervention opportunities improving patient outcomes

Signs of Heart Failure in Pets: When to Test

Dogs Presenting with Breathing Difficulties: Emergency differentiation between heart and lung problems is critical for appropriate treatment. Traditional methods often leave uncertainty in diagnosis.

Common Emergency Presentations:

Labored breathing with or without coughing
Exercise intolerance or collapse during activity
Loud heart murmurs in breeds not typically affected
Distended abdomen potentially indicating heart failure
Anxiety or restlessness especially at night

NT-proBNP Reference Values for Dogs:

Below 900 pmol/L: Respiratory cause likely, heart failure unlikely
Above 2500 pmol/L: Congestive heart failure probable
900-2500 pmol/L: Consider pulmonary hypertension, pursue cardiac evaluation

Cat Heart Problems: Silent Disease Detection

Feline Cardiac Disease Challenges: Cats excel at hiding cardiac disease, often showing no symptoms until presenting in acute heart failure or sudden death.

When to Suspect Feline Heart Disease:

Any heart murmur detected during examination
Breathing difficulties or open-mouth breathing
Sudden onset of rear limb paralysis
Hiding behavior or decreased activity
Poor appetite or weight loss

NT-proBNP Reference Values for Cats:

Below 100 pmol/L: Heart disease unlikely
Above 300 pmol/L: Significant cardiac disease probable
Special consideration: All cats with heart murmurs should receive NT-proBNP testing

TRUFORMA® Diagnostic System: Revolutionary Point-of-Care Testing

The TRUFORMA diagnostic system brings laboratory-quality cardiac testing directly into veterinary clinics, providing rapid, accurate results that guide immediate treatment decisions.

Key Technology Features:

Bulk acoustic wave technology eliminates interference from hemolysis or lipemia
15-20 minute results for immediate clinical decision-making
Self-contained cartridges require no reagent preparation
Multiple test capabilities beyond cardiac biomarkers

Clinical Advantages:

Sample flexibility: Works with both plasma and serum
Minimal training required for operation
Compact design fits in any clinic setting
Proven accuracy with correlation >0.95 to reference laboratories

TRUFORMA System vs. Send-Out Testing

Breed-Specific Cardiac Screening Guidelines

High-Risk Canine Breeds

Dilated Cardiomyopathy-Prone Breeds:

Doberman Pinschers: Special consideration with lower threshold (700 pmol/L)
Great Danes: Standard screening protocols
Irish Wolfhounds: Annual screening recommended
Standard Schnauzers: Begin screening at 4-5 years
Boxers: Monitor for both DCM and arrhythmogenic cardiomyopathy

Breed-Specific Considerations: Labrador Retrievers, Newfoundlands, Greyhounds: May have elevated NT-proBNP values (>900 pmol/L) even with normal hearts. Pursue cardiac evaluation but normal echo findings are not uncommon in these breeds.

High-Risk Feline Breeds

Hypertrophic Cardiomyopathy-Prone Breeds:

Maine Coons: Begin screening at 2-3 years
Ragdolls: Annual testing recommended
Sphynx cats: High predisposition requires early screening
British Shorthairs: Include in routine wellness protocols
Persians: Consider screening all breeding animals

Universal Feline Screening: Given the difficulty in detecting feline heart disease through examination alone, many specialists recommend annual NT-proBNP screening for all adult cats as part of routine wellness care.

Ready to Transform Your Heart Disease Detection?

Don’t let cardiac disease hide in your patients until emergency situations develop. Implement advanced cardiac testing to provide early detection, accurate emergency triage, and comprehensive patient management throughout the disease process.

Visit zomedica.com to explore the TRUFORMA diagnostic system’s cardiac testing capabilities and discover how advanced heart disease detection can enhance your practice’s patient care standards while improving diagnostic confidence and practice profitability.

*Dr. Oswald was paid by Zomedica, Inc. for his webinar presentation

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08/20/2025

ecallenTRUVIEW

Modern Dermatology Labs: Essential Techniques for Today’s Veterinary Practice

Key insights from Dr. Robert Schick’s recent webinar on small animal dermatology diagnostics.*

Veterinary dermatology has evolved dramatically over the past four decades, and so have our diagnostic tools. In a recent webinar, Dr. Robert Schick, DVM, DACVD, shares critical insights on what’s changed—and what remains essential—in dermatology laboratory techniques. Just as modern cars require different tools than classic vehicles, today’s dermatology cases demand both traditional skills and cutting-edge technology.

The Modern Approach: Dr. Schick's Philosophy

Dr. Schick demonstrates that modern veterinary dermatology isn’t about choosing between old and new—it’s about strategically combining time-tested techniques with advanced tools to deliver superior patient care and diagnostic accuracy.

Success requires:

Mastering fundamentals while embracing innovation
Prioritizing consistency over perfect technique
Leveraging digital systems to reduce variability
Utilizing point-of-care testing for faster diagnoses
Proper sample handling regardless of testing method

Skin Scrapings: Dr. Schick's Refined Technique

Despite revolutionary parasiticides like isoxazolines dramatically reducing mite cases, Dr. Schick emphasizes that proper scraping technique remains crucial for accurate diagnosis.

Essential steps Dr. Schick teaches:

Gently squeeze skin before scraping
Scrape until capillary oozing occurs
Use skin spatulas instead of blades for safety (around $6)
Scan at 4X power initially

Monitoring treatment success: Dr. Schick explains that understanding mite life stages is key. Finding dead adults after 4 weeks indicates effective treatment, while continued eggs and larvae suggest therapy adjustment is needed.

Cytology: Dr. Schick's Most Valuable Diagnostic Tool

The Consistency Challenge
While diff-quick remains the gold standard, Dr. Schick emphasizes that consistency matters more than perfect technique.

Common pitfalls Dr. Schick identifies:

Using frosted tape instead of clear tape for preparations
Inconsistent staining protocols
Variable heat-fixing methods

Ear Cytology vs. Cultures: Why Dr. Schick Chooses Cytology

Dr. Schick strongly advocates for cytology over cultures in ear cases:

“I have not cultured an ear in so many years I couldn’t even tell you how many.” —Dr. Schick

Dr. Schick’s reasoning:

External ear cultures are often misleading
Sensitivity patterns based on blood levels don’t reflect topical concentrations
Multiple ear sites yield different culture results
Cytology provides immediate, actionable information

Digital Microscopy Revolution: Dr. Schick Champions The TRUVIEW™ Microscope

The Game Changer for Consistency: Traditional cytology faces a major challenge: technician variability in staining. Dr. Schick demonstrates how Zomedica’s fully automated digital microscope, TRUVIEW™, solves this problem.

Benefits Dr. Schick highlights:

Automated, consistent staining with 5-minute processing time
Standardized slide preparation eliminating human error
Superior documentation for medical records
Easy image sharing with clients and referring veterinarians
Remote consultation capabilities

“This takes all of that variability out,” Dr. Schick notes, highlighting how the system removes human error from the diagnostic process.

Point-of-Care Revolution: Dr. Schick's TRUFORMA® Platform Success Stories

Dr. Schick showcases how Zomedica’s TRUFORMA® diagnostic platform has transformed in-house diagnostics for dermatology cases:

Thyroid Testing Breakthrough

Accurate canine TSH levels (previously impossible in-house)
Total T4 and Free T4 testing with 30-minute results vs. overnight shipping

Adrenal Function Assessment

ACTH measurements for Cushing’s screening
25-minute results vs. 8-hour dexamethasone suppression tests

Real case impact: Dr. Schick shares how TRUFORMA diagnosed hypothyroidism in a Cocker Spaniel when the owner’s suspicion proved correct—elevated TSH and unmeasurable T4 confirmed the diagnosis, leading to successful treatment.

Dermatopathology Excellence: Dr. Schick's Biopsy Guidelines

Dr. Schick emphasizes that proper biopsy technique dramatically impacts diagnostic accuracy:

Critical Guidelines:

Never scrub lesions before biopsy
Use 6-8mm disposable punches (not 2-4mm)
Handle samples gently at the base
Request dermatopathology-trained pathologists

Dr. Schick’s Top Mistakes to Avoid:

Reusing disposable punches instead of using fresh ones
Grabbing biopsy centers with forceps causing tissue damage
Scrubbing away diagnostic surface material before sampling
Using inadequate punch sizes that limit diagnostic capability
Failing to request specialized pathologists for dermatology cases

Key Takeaways for Modern Practice

Dr. Schick’s comprehensive approach demonstrates that the practices that thrive will be those that maintain diagnostic fundamentals while leveraging technology to overcome traditional limitations like staining variability and lengthy turnaround times.

Essential points from Dr. Schick’s webinar:

Consistency in technique matters more than perfection
Digital microscopy eliminates human variability in cytology
Point-of-care testing provides immediate, actionable results
Proper biopsy technique is non-negotiable for accurate diagnosis
Modern dermatology combines proven methods with advanced technology

Dr. Schick’s bottom line: Today’s dermatology diagnostics combine proven techniques with advanced technology. Success comes from mastering fundamentals while strategically embracing innovations that solve real diagnostic challenges.

Ready to modernize your dermatology diagnostics? Visit Zomedica.com to learn more about TRUVIEW digital microscopy and TRUFORMA point-of-care testing solutions from Zomedica.

*Dr. Schick was paid by Zomedica, Inc. for his educational webinar.