Like humans, animals also suffer from heart and circulatory diseases, but these ailments have often not been given the priority afforded to other diseases, as they – simply put – just did not ‘appear’ to suffer from them. However, the development of new high-end ultrasound technologies has allowed veterinarians such as DrAndreas Kosztolich to investigate congenital cardiovascular disease in small animals, such as dogs, cats, rabbits and even ferrets.
Working from a practice in Vienna, Austria, Dr Kosztolich specialises in a branch of veterinary cardiology that is specific to small animals that have suspected heart disease. Much of his work comes from referrals and recommendations, and he carries out clinical and specialised examinations which range from standard and HolterECGs, blood pressure, laboratory examinations and ultrasound. At this stage, some animals have already undergone x-rays, CT or MRI scans by their referring physician, with whom Dr Kosztolich works closely in the treatment and therapy for the animal’s illness.
Heart problems in small animals, although common, are not always simple to diagnose. Dr Kosztolich describes it as a “chronic disease process, the clinical course of which is not always straightforward because of additional illnesses, such as orthopaedic complaints and neurological or internal problems in the aging patient.”. A suspected heart disease may present as “cardiac sounds, signs of impaired performance, respiratory problems, discoloration of the mucous membranes, circulatory problems and/or history of collapse.”
However, in some of the some of the animals Dr Kosztolich treats, there is a predisposition to heart disease. The Great Dane, Irish Wolfhound, Doberman and Cavalier King Charles Spaniel are among the breeds known to be affected, so technological developments in imaging diagnostics are very welcome indeed. Dr Kosztolich’s practice recently invested in an Artida Ultrasound System from Canon Medical and is the first veterinary specialist to use such high-end technology in a clinical environment for small animals. It’s a solution that allows him to take heart volume calculations from the animals before and during therapy, and is the only one which allows him to see and measure the motion of heart muscles through high quality 2-DE resolution.
“The referring physicians call for precise diagnostics and a therapeutic roadmap as a guideline,” he explains. “They do not want technical details, but a complete package that quickly gets to the point: What is wrong with an animal? How best to treat it and how can success be measured?” This means that clarity and accuracy of a diagnostic tool is essential. “The technical possibilities of the device allow me more security in diagnostic validity. I can, for example, make volume calculations using several methods and, depending on the current study situation, draw my conclusions from the results.”
Cooperation with human medicine was and is very important here. I have received a lot of input from radiologists, vascular physicians or cardiologists
As well as these particular diagnostic benefits, Dr Kosztolich is making progress with the Artida in other areas, such as monitoring of conditions. Detecting systolic and diastolic dysfunctions (poor contraction of the heart and stiffening of the heart's ventricles, respectively) has become easier, which is significant. “Especially for difficult patients, like cats, the resolution of our ultrasound system is unsurpassed.” But as you might imagine, in any clinical setting – human or animal – there are practical requirements to consider, such as speed of assessment. Clinical examination (just patient and physician) is still very important because, in the words of Dr Kosztolich, “our patients cannot speak” and “the credo is still to find a cost-effective way to maximum diagnostic safety.”
Equally, it’s important to have an effective digital workflow and peers with whom to discuss specifics. For Dr Kosztolich, this naturally came as part of the investment in the Artida: “cooperation with human medicine was and is very important here. I have received a lot of input from radiologists, vascular physicians or cardiologists, which I can also transfer to my field of work. This is the only way I can immediately and consistently provide the best for patients.” He adds “It is important to have a network of tech-savvy contacts. In addition to the results of current cardiological research on small animals, I am able to get the maximum out of certain issues.”
Future trends are hard to predict, but Dr Kosztolich feels certain to see further radical developments in technology. The fundamentals, however, he is certain will remain the same. “The inter-medical and pathophysiological basics of heart disease /or drug therapy must be the basis of a medical decision. Every clinical case is different, and after a certain routine, your own experience comes to the fore.
My motto is ‘per aspera ad astra’ (through hardships to the stars)!”