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Cardiology

Heart problems are common in older dogs and cats but can be seen in pets of all ages and with other medical issues.

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Veterinary heart experts providing treatment for dogs, cats and other pets​

We understand how concerning heart problems can be. That’s why we go the extra mile to provide a complete range of in-house services, from NSW’s largest team of Cardiologists, to ensure the best possible outcomes for pets and their families.

Heart problems are common in older dogs and cats but can be seen in pets of all ages, and in those with other medical issues. Our highly experienced veterinary Cardiology team are experts in the diagnosis and treatment of all kinds of heart problems, including:

  • Heart murmurs
  • Irregular heartbeats
  • Heart-related respiratory complaints
  • Weakness or fainting
  • Exercise intolerance

A cardiac examination may also be required for patients in the care of other departments at SASH, e.g., to check for any underlying heart problems before anaesthesia and surgery.

SASH is fortunate to have the largest Cardiology team in NSW, with the only two client-facing, full-time, Board certified veterinary cardiologists in NSW. Dr Inaki Prado Checa and Dr Arianne Fabella are available at SASH North Ryde for cardiology consults and procedures. Dr Inaki & Arianne joins our existing Cardiology team, with Dr Phil Brain, Specialist in Internal Medicine, with over 15 years of experience seeing cardiology cases.

Our cardiology team works closely with other on-site specialists in departments such as Diagnostic ImagingInternal Medicine and Surgery, to ensure that each patient receives fully integrated care in a timely manner, under the same roof. At SASH, we also have specialists in Critical Care and Anaesthesia who work hand in hand with the Cardiology team when patients with heart problems need high level care or surgery. This is especially important for cardiac patients, as they may have a higher risk of anaesthetic and post-operative complications.

This comprehensive, on-site, multi-disciplinary approach makes the SASH Cardiology service unique in Australia, and provides optimal conditions for patient care. Our mission is to provide a compassionate and supportive environment in which we use our advanced skills, expertise and facilities to give pets access to the same level of care that we or our loved ones would expect in a human hospital.

Puppy & Kitten Heart Murmur Screening Clinic​

Some pets have a heart murmur at or soon after birth. It may not be causing the puppy or kitten any problems but may be picked up during a routine health check, e.g., at vaccination.

A heart murmur doesn’t always require intervention or specialist care. However, for the welfare of the pet and the peace of mind of their family, it’s important to identify when immediate attention or further investigation is needed.

Heart murmur screening is to help with this situation. The service is available to pets that have a heart murmur but are otherwise healthy (have no clinical signs of heart disease) and are less than 12 months of age. Pets receive a physical examination and cardiac ultrasound (echocardiogram), performed by our board certified cardiologist. The cardiologist will then send a report to your regular veterinarian with recommendations for management or further assessment.

The SASH Puppy and Kitten Cardiology clinic is a simple and cost-effective option for accessing potentially life-saving information from one of Sydney’s only cardiologists.

If you have a puppy or kitten with a heart murmur, please ask your regular veterinarian about whether or not heart murmur screening is appropriate.

Cardiologist with puppy at Heart Murmur Screening Clinic
Cardiologist Dr Inaki at the Heart Murmur Screening Clinic

Cardiologist assessment

For pets referred to the Cardiology team, a cardiac assessment consists of a consultation with a cardiologist or cardiology vet, plus non-invasive testing as required. This usually involves cardiac ultrasound (echocardiography), ECG (electrocardiography), Holter monitoring (also known as “ambulatory ECG”) and blood pressure measurement. Chest x-rays and blood tests may also be required.

Aided by our highly skilled cardiology nurses, we strive to provide a relaxed environment, so that most pets can undergo these procedures without needing to be sedated. We aim to complete the tests on the day of consultation, so the pet can return home with their family. Based on the test results, the cardiologist makes recommendations for treatment or further investigation.

Diagnosis and management of heart problems can be complex. We take the time to listen and explain, to answer questions and ensure that families feel confident to make informed decisions about their treasured companion. We also communicate with referring veterinarians so that they can follow the patient’s journey and be aware of their ongoing needs after their care with us at SASH.

cardiologist scanning dog
Dr Phil Brain performing an echocardiogram

Cardiology diagnostic procedures and interventions

SASH North Ryde is fortunate to be one of the only veterinary hospitals in NSW to offer a comprehensive range of diagnostic procedures and interventions (interventional cardiology). When coming to SASH North Ryde, you can take comfort in knowing that your pet will be treated on-site in our state-of-the-art facility, access to the country’s broadest team of multidisciplinary specialists, without the need to be transferred to another hospital. This provides the best continuity of care and communication back to you and your regular veterinarian.

Echocardiography (Cardiac Ultrasound)
An echocardiogram is the main non-invasive technique that allows cardiologists and other specialists to examine a pet’s heart. This test causes the pet no discomfort. The examination is conducted with the patient lying on a padded table, usually with no or minimal sedation. The procedure produces a sonar image of the heart and associated large blood vessels. This allows the examining vet to evaluate the size and function of the heart, and to check for leaky valves or narrowing of the vessels leaving the heart.

Electrocardiography
Also known as an ECG, an electrocardiogram records the electrical activity of the heart. It allows vets to identify rapid, slow, or irregular heart rates caused by abnormal beats (arrhythmias) or abnormally conducted beats (heart block, bundle branch block). Identifying the nature of an abnormal rhythm is an important step in determining the best treatment for the pet.

Holter monitoring (ambulatory electrocardiography)
Sometimes a short in-hospital ECG does not provide enough information. For example, abnormal beats that only occur occasionally may be missed by the testing procedure. If this is suspected, a special device known as a Holter monitor, or continuous ambulatory ECG recorder, can be used to record the electrical activity of the heart from 24h up to a week. This is particularly useful for pets whose symptoms don’t occur all the time, and to assess the severity and frequency of abnormal beats. The Holter monitor is attached via chest electrodes, and the pet returns home carrying the system in a vest. When the recording has been made, the vest and recorder simply need to be returned to SASH – this can be done by post to avoid further travel for the pet and their family. The ECG is stored on a small memory card, which is transferred to a computer for analysis. From there, the cardiologist will look at the entire ECG recording and make recommendations about treatment.

Thoracic radiography (chest x-rays)

Chest x-rays are useful for assessing the size of the heart and the appearance of the lungs, e.g., to check for the presence of fluid or other abnormalities. This can help distinguish between cardiac disease and other types of illness.

Blood pressure measurement
Assessment of blood pressure in pets is a bit more challenging than in people but is valuable for evaluating certain disease processes. It is performed in a calm environment using a method that is similar to the technique used by human healthcare providers.

Blood tests
Blood testing can be used to measure markers that increase with certain types of heart disease. It also helps to assess the function of other organs in pets with cardiac problems.

Veterinary cardiologists in surgery
SASH Cardiology team performing an interventional cardiology procedure

Electrical cardioversion

Certain types of abnormally fast heart rhythms, such as atrial fibrillation or ventricular tachycardia, can sometimes be treated by electrical stimulation, via paddles applied to the chest.

Cardiac Catheterisation and Intervention 
Sometimes more invasive procedures may be required for both diagnosis and treatment of heart disease. When this happens, small catheters are inserted into blood vessels of anaesthetised pets and are guided through the heart using a moving x-ray technique known as fluoroscopy. Conditions that most commonly require an interventional procedure in pets include:

  • PDA (Patent ductus arteriosus) – Failure of a foetal blood vessels to close as it should after birth. We can insert a device to close this vessel and restore normal blood flow.
  • PS (Pulmonic stenosis) –  Thickening and/or fusion of the valve between the heart and the vessels going to the lungs. We can insert a balloon which tears this valve and helps to increase the flow of blood through it.
  • Cardiac pacemaker – With abnormal heart rhythms a pacemaker may be needed. Pacemakers provides an artificial electronic impulse that helps drive the heartbeat when the patient’s own “pacemaker” does not work properly, e.g., with third degree AV block (complete heart block) or sick sinus syndrome.

 

As these procedures are minimally invasive, patients are often only in hospital for a day or so and are left with a very small surgical wound (less than 1 cm).

Our Cardiology Team