The 19 th Annual ECVIM Congress
Researches on the arterial hypertension
incidence in dogs
incidence in dogs
Brăslaşu M.C., Brăslaşu
Daniela Elena, Joiţa Silvia, Tudor
Poliana
Faculty of Veterinary Medicine, Bucharest , Romania
Clinical studies were realized during
a 4 month period. 1618 female and male
dogs from different breeds have been examined (47,71% males and 52,28%
females). The examination included: clinical examination, electrocardiography,
echocardiography and blood pressure evaluation.
Diagnosis of arterial hypertension was
established using the oscilometric method (VET HDO monitor – S+B medVET). Dogs
were placed in lateral recumbency and the determinations were made either on
the fore leg, or on the tail. Blood pressure determination was scheduled at the
end of the clinical examination, when the animals were quiet. 5 determinations
were made for each patient, and the arithmetical mean was calculated for the
values obtained (systolic, diastolic and medium blood pressure, pulse). Blood
pressure wasn’t evaluated in excited animals. Dogs with high values of arterial
blood pressure obtained at the first determinations, but with normal
physiological values in the last determinations, weren’t included. Although
mean values of arterial blood pressure specified by Vet Direct Services – the
producing company - are 135 mmHg
(Systolic pressure) and 75 mmHg
(Diastolic pressure), we diagnosed high blood pressure when values obtained
were above 150 mmHg (Systolic pressure) şi 90 mmHg(diastolic pressure).
167 dogs (10.32% from the entire group
examined) were diagnosed with high blood pressure. 52.69% were females and
47.30% males. We considered that a sex propensity can not be incriminated.
High blood pressure was diagnosed in the
following breeds of dogs: Mixed dog (medium breed) – 20.35%; German Shepard –
17.96%; Cocker spaniel – 13.17%; Boxer – 7.78%; Rottweiler – 6.58%; Caniche –
5.98%; German Brack – 5.38%; Setter –
3.59%; Pekinese – 2.99%; Foxterrier –
2.39%; Labrador Retriever 1.79%; Collie 1.79%;
Doberman – 1.79%; Great Dane, Amstaff, Dalmaţian, Romanian Shepard,
Airedale terrier, Schnautzer, Teckel, Caucazian, Aikito and Pitbull – 0.59 –
1.19% (for each breed).
Regarding blood pressure values, 16.76%
from all patients had systolic blood pressure above 200 mmHg and 33.53%
diastolic blood pressure over 115 mmHg.
The age of high blood pressure animals was
10.45±0.22 years (10 years and 4 month ± 2 month) (SD = 2.89). From the total
number of animals with high blood pressure, 18 were Rottweilers, Schnautzers,
Great Danes, Romanian Shepard, Caucasians and Aikito. In these breeds, the age
was 8.47±0.67 years (SD – 2.88).
Conclusively, in our study, the incidence of high blood pressure in dogs was 10.32%. The
age on animals diagnosed with high blood pressure was 10.45±0.22 years. No
propensity related to breed or sex couldn’t be incriminated in this condition.
Material and Method
The research was conducted in the Internal
Medicine Department of the Faculty of Veterinary Medicine Bucharest during 5
months period: 1st Nov 2008 – 31 st March 2009.
1618 dogs from different breeds and ages were examined from the cardiovascular
point of view.
Animals have been subjects of medical
check-ups for the following reasons:
1.
Cardiovascular
diseases
2.
Systemic diseases
along with cardiac signs: vascular ectasia, cavity effusions, ophthalmologic
signs et al.
3.
Old animals,
which were supported to undergo surgical procedures.
Medical check/up consisted in:
A. General
examination: anamnesis, inspection, palpation, auscultation, thermometry.
B.
Special exams:
ECG, thoracic Rx, echocardiography, arterial blood pressure determination,
hematological and biochemistry evaluations.
Routine check-up included a general
examination end electrocardiography. Animals with signs of cardiovascular
disease (dispnoea, tiredness, coughing, valvular murmur, cardiac rhythm
changes, lethargy) were checked using echocardiography, thoracic Rx, arterial
blood pressure determination and biochemistry evaluation.
In animals with epistaxis, limbs oedema,
ocular signs, lethargy, movement bad coordination or neurological symptoms with
sudden beginning, arterial blood pressure was checked constantly.
Arterial blood pressure determination.
a) Device.
- determination of arterial blood pressure
was done by oscillometric method using 2 device: Memo Diagnostic MDPRO Cat and
Dog Blood Pressure (HDO) (used in most of cases) and OMRON R-1 (for human use).
- systolic, diastolic and mean arterial
blood pressure was checked (Mean Arterial blood pressure - only with Memo
Diagnostic) and pulse frequency.
b) Arterial blood pressure determination
in dogs
- only awake animals have been checked
- dogs have been checked in lateral or
sterno-abdominal recumbency. The recumbence was smoothly imposed by the owner.
- in the rare situations when the dog
refused the recumbency or was afraid of adopting this position, blood pressure
was determined in standing position with the cuff of the device at the bottom
of the tail.
- blood pressure determination was done at
the end of clinical examination, when the animal has already got used with the
environment, with the doctor and with the examination technique.
- blood pressure was not determined in
nervous dogs.
c) Data interpretation
- on average of 5 determinations have been
made for each animal. When big differences were observed between values, 3-5
more determination were performed.
- the average of the values has been
calculated. In case a value was too high, usually during the first 2
determinations, high or too low, it was not considered.
- value correction has been done depending
on the place of blood pressure determination toward the heart base (in
recumbency, systolic adjustment if not standing, 1 mm Hg decrease per 1 cm
lower than heart level).
- although normal values of blood pressure can vary between 118 ± 17 and 149 ±
20 mm Hg (Labrador – Greyhound)(Angela Bodey – Waltham Focus, 1997) we consider
as hypertensive the animals with values higher than 150 mm Hg PAS and 90 mm Hg
PAD.
- animal with high blood pressure values
but with a normal clinical status (clinically healthy) have been double checked
after 5 – 7 days. If blood pressure values were normal, the subjects haven’t
been considered as hypertensive.
High values of blood pressure in nervous dogs without specific clinical signs
were considered a consequence of nervousness.
Results and
Debates
From the total number of animals examined
(cardiovascular system), 167 dogs (10.32%) have been diagnosed with arterial
hypertension (figure 1).
Incidence of
high blood pressure in dogs
(number animals)
We consider that
the prevalence of arterial hypertension in the studied population is normal,
the value being included in the limits described by other authors (Bodey şi
Michell, 1996; Remillard, Ross şi Edy, 1991, Stepien şi Henik, 2009). We emphasize the fact that this 10.32%
includes also the renal hypertension.
We consider the
animals that had values higher than 150mmHg – TAS and 90 mm HG TAD as having
HTA. We had some exceptions:
-
We didn’t
consider high values in excited animals as pathological, these animals being
not included in this group. In the situations where some clinical symptoms
suggested HTA (epistaxis, polyuria - polydipsia, oedema etc), the animals have
been re-examined at a 5 – 7 days interval. Some of these dogs have been
examined at home by the owner (arterial blood pressure determinations with
devices based on oscilometric principle and with muffs adequate to the breed).
-
When animals had
high values of arterial pressure, but the clinical signs suggesting a
cardiovascular or a systemic disease were absent (clinical evaluations, blood
biochemistry determinations), they were included in the batch considered in the
study only if: 1. Values were over 180 – 190 mm Hg – TAS and 2. High values
persisted at the following determinations.
In all situations a positive relationship
was observed between high values of PAS and PAD. In 19 situations, PAD had
normal values and PAS was out of range - 155 – 200 mm Hg. These 19 animals were
diagnosed with systolic arterial blood pressure.
PAS values in animals considered as being
hypertensive was 182.015 ± 1.53 mm Hg (Standard Deviation = 19.85).
Average value of arterial blood pressure
was 135.00 ± 1.31 mm Hg (Standard deviation = 15.98).
PAD values in animal was 113.53 ± 1.18 mm
Hg (D.S. = 14.28).
Repartition of animals on groups depending
on the arterial blood pressure (10 mm Hg) is presented in figures 2 – 4.
Repartition of
animals on blood pressure values- PAS groups
(no. animals/mm
Hg)
Repartition of
animals on blood pressure values- PAM groups
(no. animals/mm
Hg)
Repartition of
animals on blood pressure values - PAD groups
(no. animals/mm
Hg)
Regarding the incidence according to the
sex, 88 (52.69%) were females and 79 (47.30%) were males. These results would
indicate a female predisposition to HTA, but we consider this is not relevant
for the following reasons:
1.
Repartition of
the animals according to the sex criteria was of 52.28% females şi 47.71 %
males. There is a direct relationship between the number of animals/sex in the
study and the animals with HTA
2.
There is an
explanation for the higher number of females in the batch: the majority of
females that had to undergo a surgical procedure in the Obstetrical Department
had previously a cardiovascular control.
We consider there is no sex predisposition
on high blood pressure. Bodey A.R. şi Michell A.R. have pointed out in 1996 a
higher predisposition of males to develop high blood pressure.
Animals diagnosed with high blood pressure
were aged 1.8 – 17 years, with an average 10.45 ± 0.22 (Standard deviation = 2.89),
figure 5.
Age of dogs
with High blood pressure
In large breed dogs with high blood
pressure (Rotwailler, Aikito, Schnautzer, Dog german, Caucazian) the mean age
was 8.47 ± 0.67 (Standard deviation 2.88).
We have not observed:
-
correlations
between TAD, TAM or TAD values and Pulse value;
-
a incidence of
breed on high blood pressure (figure 6).
Incidence of
High blood pressure depending on the breed
1. Mixed breeds; 2. German shepherd; 3. Cocker
spaniel; 4. Boxer; 5. Rotwailler; 6. Caniche; 7. Brac; 8.
Setter; 9. Pekinez; 10. Fox terrier; 11. Labrador,
Retriever, Collie, Doberman pinscher; 12. Great Dane, Amstaff, Romanian shepherd;
13. Airedale terrier, Schnautzer, Teckel, Caucazian, Aikito, Pitbull.
Depending on blood pressure values and on
clinical signs, the animals were placed in 4 groups proposed by “Guidelines for
The Identification, evaluation and Management of Systemic Hypertension in Dogs
and Cats” (Brown S. and col., 2007). The cause of high arterial blood pressure couldn’t be established in
most of cases (difficulties in hormonal determinations et al.).
CONCLUSIONS
- Arterial
hypertension was diagnosed in 10.32% of examined dogs in a 5 month period.
Blood pressure determination was realized using the oscilometric method
and a Memo Diagnostic MDPRO Cat + Dog Blood pressure device. 5
determinations were done for each animal and the average was calculated.
- Diagnosis
was based on the increase of systolic mean and diastolic blood pressure
correlated with specific clinical signs: nervous signs (apathy,
uncoordinated movements, head shoving of the wall), ocular signs
(blindness, hemorrhage of the retina, detached retina), epistaxis, limbs
edema, heart failure failure signs
(fatigue, dispnoea, cough), renal signs (oedema, polyuria - polydipsia,
creatinine increase).
- Diagnosis
of high blood pressure was established at values higher than 150 mm Hg PAS
and 90 mm Hg PAD. High values obtained in excited animals were checked
using multiple determinations. When high values of blood pressure were
obtained, but there were no specific clinical signs, the animal was double
checked. Only in the situations when high blood pressure was obtained in
all determinations, the animal was considered hypertensive. According to
the values obtained, the animals were included in one of the 4 risk
grades, proposed by High blood pressure evaluation guide in dogs and cats.
- PAS values
(the total number of hypertensive animals), was 182.015±1.53 mm Hg
(Standard deviation = 19.85). Mean arterial blood pressure was 135.00±1.31
mmHg (Standard deviation = 15.98) and PAD = 113.53 ±1.18 mm Hg (S.D. =
14.28).
- Age of
hypertensive animals was 10.45±0.22 (S.D.=2.89). In large breed dogs, mean
age was 8.47±0,67 (S.D.= 2.88).
- There was
no correlation observed between the HTA (Systemic Hypertension) incidence and sex of the animals.
- Conclusively,
HTA is a condition that affects adult dogs and has repercussions on the
entire body. This fact recommends that blood pressure determinations
become a routine determination in clinical practice.
Bibliography
Bodey A.R., Michell A.R.,
1996 – Epidemiological study of blood
pressure in domestic dogs. J. Small Anim. Pract., 37, 3, 116 - 125.
Brown S., Atkins C.,
Bagley R., Carr A., Cowgill L., Davidson M., Egner B., Elliott J., Henik R.,
Labato M., Littman M., Polzin D., Ross L., Snyder P., Stepien R., 2007 – Guidelines for the Identification, Evaluation, and Management of Systemic
Hypertension in dogs and cats. J. Vet.
Int. Med., 21, 542 - 558.
Egner Beate, Carr A.,
Brown S., 2007 – Essential Facts of Blood Pressure in Dogs and Cats. A reference
guide. ed. IV. VBS VetVerlag, Babenhausen , Germany
Remillard R.L., Ross
J.N., Eddy J.B., 1991 – Variance of indirect blood pressure measurements and
prevalence of hypertension in clinically normal dogs. Am. J. Vet. Res., 52, 4,
561 - 565.
Stepien Rebecca L., Henik
Rosemary A., 2009 – Systemic
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