Focused ultrasound of the caudal vena cava in dogs with cavitary effusions or congestive heart failure: A prospective, observational study

PLoS One. 2021 May 28;16(5):e0252544. doi: 10.1371/journal.pone.0252544. eCollection 2021.

Abstract

Introduction: Ultrasonographic indices of the inferior vena cava are useful for predicting right heart filling pressures in people.

Objectives: To determine whether ultrasonographic indices of caudal vena cava (CVC) differ between dogs with right-sided CHF (R-CHF), left-sided CHF (L-CHF), and noncardiac causes of cavitary effusion (NC).

Materials and methods: 113 dogs diagnosed with R-CHF (n = 51), L-CHF (30), or NC effusion (32) were enrolled. Seventeen of the R-CHF dogs had pericardial effusion and tamponade. Focused ultrasound was performed prospectively to obtain 2-dimensional and M-mode subxiphoid measures of CVC maximal and minimal size (CVCmax and CVCmin), CVCmax indexed to aortic dimension (CVC:Ao), and CVC collapsibility index (CVC-CI). Variables were compared between study groups using Kruskal-Wallis and Dunn's-Bonferroni testing, and receiver operating characteristics curves were used to assess sensitivity and specificity.

Results: All sonographic CVC indices were significantly different between R-CHF and NC dogs (P < 0.001). Variables demonstrating the highest diagnostic accuracy for discriminating R-CHF versus NC were CVC-CI <33% in 2D (91% sensitive and 96% specific) and presence of hepatic venous distension (84% sensitive and 90% specific). L-CHF dogs had higher CVC:Ao and lower CVC-CI compared to NC dogs (P = 0.016 and P = 0.043 in 2D, respectively) but increased CVC-CI compared to the R-CHF group (P < 0.001).

Conclusions: Ultrasonographic indices of CVC size and collapsibility differed between dogs with R-CHF compared to NC causes of cavitary effusions. Dogs with L-CHF have CVC measurements intermediate between R-CHF and NC dogs.

Publication types

  • Observational Study, Veterinary
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Dogs
  • Female
  • Heart Failure / diagnosis*
  • Heart Failure / pathology
  • Heart Failure / veterinary
  • Male
  • Pericardial Effusion / diagnosis
  • Pericardial Effusion / veterinary
  • Prospective Studies
  • Ultrasonography
  • Vena Cava, Inferior / diagnostic imaging*

Grants and funding

This study was supported by an Iowa State University Veterinary Clinical Sciences Research Incentive Grant (awarded to JLW, YYC, SDM, MAT). A grant number was not provided for this internal award. Website of the ISU VCS Department is https://www.vetmed.iastate.edu/vcs. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Hill Country Veterinary Specialists provided support in the form of salary for author GRL, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of all authors are articulated in the ‘author contributions’ section.