Point-of-care N-terminal pro B-type natriuretic peptide assay to screen apparently healthy cats for cardiac disease in general practice

Background: Point-of-care (POC) N-terminal pro B-type natriuretic peptide (NT-proBNP) ELISA test has been evaluated for screening cats for cardiac disease in the referral veterinary setting but less is known about its use in general practice (GP).

Objectives: To evaluate the diagnostic utility of a POC NT-proBNP ELISA in cats seen in GPs.

Animals: Two hundred and seventeen apparently healthy cats from 21 GPs.

Methods: This was a prospective, cross-sectional study. Cardiac auscultation and POC NT-proBNP ELISA were done by veterinarians at their GPs. After enrollment at GPs, cats were sent to a cardiology referral hospital for cardiac auscultation and echocardiographic diagnosis. Results were interpreted based on whether cats had normal or abnormal echocardiographic findings.

Results: Point-of-care NT-proBNP ELISA results differentiated cats in the abnormal group from those in the normal group with a sensitivity of 43%, specificity of 96%. In cats with a heart murmur at GPs, POC NT-proBNP ELISA results differentiated cats in the abnormal group from those in the normal group with a sensitivity of 71% and a specificity of 92%.

Conclusion and clinical importance: In apparently healthy cats in GPs, positive POC NT-proBNP results are associated with heart disease, warranting an echocardiogram, but negative results do not reliably exclude heart disease. These results suggest POC NT-proBNP is not an effective screening test for apparently healthy cats in GPs, although its performance is improved if it is used only in cats that have a heart murmur.