Establishment of reference values of the caudal vena cava by fast-ultrasonography through different views in healthy dogs

Elodie Darnis, Soren Boysen, Anne-Christine Merveille, Loïc Desquilbet, Serge Chalhoub, Kris Gommeren, Elodie Darnis, Soren Boysen, Anne-Christine Merveille, Loïc Desquilbet, Serge Chalhoub, Kris Gommeren

Abstract

Background: Clinical assessment of intravascular volume status is challenging. In humans, ultrasonographic assessment of the inferior vena cava diameter, directly or as a ratio to the aortic diameter is used to estimate intravascular volume status.

Objectives: To ultrasonographically obtain reference values (RV) for caudal vena cava diameter (CVCD ), area (CVCa ) and aortic ratios using 3 views in awake healthy dogs.

Animals: One hundred and twenty-six healthy adult dogs from clients, students, faculty, or staff.

Methods: Prospective, multicenter, observational study. Two observer pairs evaluated CVCD by a longitudinal subxiphoid view (SV), a transverse 11th-13th right hepatic intercostal view (HV), and a longitudinal right paralumbar view (PV). Inter-rater agreements were estimated using concordance correlation coefficients (CCC). For body weight (BW)-dependent variables, RVs were calculated using allometric scaling for variables with a CCC ≥ 0.7.

Results: The CCC was ≤0.43 for the CVC/aorta ratio at the PV and ≤0.43 in both inspiration and expiration for CVC at the SV. The RVs using allometric scaling for CVCa at the HV for inspiration, expiration, and for CVCD at the PV were 6.16 × BW0.762 , 7.24 × BW0.787 , 2.79 × BW0.390 , respectively.

Conclusions and clinical importance: The CVCD , measured at the HV and PV in healthy awake dogs of various breeds has good inter-rater agreement suggesting these sites are reliable in measuring CVCD . Established RVs for CVCD for these sites need further comparison to results obtained in hypovolemic and hypervolemic dogs to determine their usefulness to evaluate volume status in dogs.

Keywords: FAST echography; allometric scaling; caudal vena cava; intravascular volume status.

Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Figures

Figure 1
Figure 1
Placement of the transducer under the SV. CR, cranial direction
Figure 2
Figure 2
Placement of the transducer to locate the porta hepatitis (HV). CR, cranial direction
Figure 3
Figure 3
Measurement of the CVCamin‐HV‐B, Aomin‐HV‐B (HV B‐Mode). CVC, caudal vena cava; Ao, aorta; PV, portal vein
Figure 4
Figure 4
Placement of the transducer under the last rib (PV). CR, cranial direction
Figure 5
Figure 5
Measurement of CVCmin‐SV‐B (SV B‐Mode). Plain line CVC, caudal vena cava diameter
Figure 6
Figure 6
Measurement of the CVCmax‐HV‐M, CVCmin‐HV‐M (HV M‐Mode), ①CVCmin‐HV‐M, and ② CVCmax‐HV‐M
Figure 7
Figure 7
Measurement of CVCD‐PV‐B and AoD‐PV‐B (PV B‐Mode)
Figure 8
Figure 8
Measurement of CVCD‐PV‐M and AoD‐PV‐M (PV M‐Mode)
Figure 9
Figure 9
Maximal CVC area in B‐Mode for hepatic view (CVCamax‐HV‐B) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown in plain lines
Figure 10
Figure 10
Minimal CVC area in B‐Mode for hepatic view (CVCamin‐HV‐B) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown for this variable in plain lines
Figure 11
Figure 11
Maximal Ao in B‐Mode for hepatic view (Aomax‐HV‐B) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown for this variable in plain lines
Figure 12
Figure 12
CVC diameter in B‐Mode for PV (CVCD‐PV‐B) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown for this variable in plain lines
Figure 13
Figure 13
CVC diameter in M‐Mode for PV (CVCD‐PV‐M) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown for this variable in plain lines
Figure 14
Figure 14
Maximal Ao in B‐Mode for PV (AoD‐PV‐B) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown for this variable in plain lines
Figure 15
Figure 15
Maximal Ao in M‐Mode for PV (AoD‐PV‐M) versus BW after logarithmic transformation for the 126 dogs (dots). The regression line and the 95% prediction interval are shown for this variable in plain lines

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