+ Which machine is best for measuring blood pressure in cats?
Both Doppler and HDO provide accurate readings when used correctly. Staff training with consistent protocols for the equipment used is key. When using Doppler, headphones are recommended to reduce the sound that may disturb the cat and contribute to acute situational hypertension.
Additional information can be found on the Measuring Blood Pressure page.
+ What is the ideal patient position for obtaining an accurate BP measurement?
The cat can be positioned in ventral or lateral recumbency. The cuff needs to be at the level of the heart whenever possible. Cuff placement above the plane of the heart falsely decreases readings. Cuff placement below the plane of the heart falsely increases readings. In order to obtain accurate BP readings, it is essential to allow the cat to settle into a comfortable position where the cat will remain still. Ultimately, the cat will determine their most comfortable position.
+ Can I use a sedative prior to measuring BP?
Many sedatives will impact blood pressure, depending on their impact on the cardiovascular system.
+ Does the use of gabapentin prevent accurate measurements of blood pressure?
Using reasonable doses of gabapentin pre-appointment should not be avoided if it eases the cat’s anxiety and improves the patient experience. Document the dose given and the time the gabapentin was administered. Any evidence of TOD must be taken into consideration when interpreting readings. If hypertension is suspected, reevaluation on a lower dose of gabapentin can be helpful in making a determination. The impact of gabapentin on BP is not clear at this time.
+ Does the use of trazadone prevent accurate measurements of blood pressure before the veterinary visit?
Yes. In one study, trazadone was shown to significantly lower SBP in healthy cats.
+ We have a cat that does not respond to gabapentin and requires full sedation. Do sedatives such as butorphanol, ketamine, or dexmedetomidine affect blood pressure?
Yes. The patient should be monitored throughout the sedated procedure and trends monitored. If the patient remains at borderline high or high, the patient may actually be hypertensive, but this determination must be made carefully. It is important to discuss any clinical signs observed at home that can help determine if the cat is showing the signs of hypertension. Evidence of TOD is essential in assessing these cases in addition to signs at home.
+ What other measures can be used to help calm the feline patient?
Allow the cat time to acclimate to the room and explore (if cat desires) prior to obtaining blood pressure
Utilize feline friendly staff who have knowledge about reading feline behavior/facial cues and body language, utilizing feline-friendly handling, and understanding ways to reduce stress and to assess for each patient (sign up staff to learn about this through the Cat Friendly Certificate Program)
Ensure the cat is not near loud noises (i.e., barking dogs, high traffic areas with a lot of talking, washing machine, etc.)
Ensure the cat is not in a visual line of sight with other animals before and during the readings
Determine the preferred location for each cat (i.e., under a warm fluffy towel partially or completely covered, in a cat bed, in the bottom half of their carrier with or without being covered by a blanket, ventral or lateral recumbency, etc.)
Document what the cat prefers so it can be utilized during future visits
Speak in a low voice and avoid sounds that mimic hissing, such as “shhh”
Cats should feel safe and be given the opportunity to hide if needed
Remove “distressing” scents beforehand (i.e., cleaning/disinfecting tables/equipment, scent from another animal on scrubs, etc.)
Take a break if the cat’s fear or anxiety is escalating
Provide recommendations to reduce the stress prior to the cat arriving at the practice because the visit starts at home (i.e., carrier and vehicle acclimation, etc.)
+ How many readings should be obtained for accurate results?
A minimum of six readings should be taken, with the first reading discarded and the remainder averaged. The cuff should be inflated slowly to allow the cat to acclimate to the feeling of pressure on the limb and not over-inflated past the end number of the gauge used. It is important to avoid rushing when obtaining blood pressure as false elevations can occur. The Blood Pressure Assessment Form can be used to record results.
+ How long do I have to wait between readings?
Allow the cuff to deflate fully before proceeding to the next reading. The blood vessels do not require any ‘resting’ period between readings. If the cat is becoming stressed, anxious, or frustrated, consider taking a break.
+ How can you tell when blood pressure cuffs need to be replaced?
Discoloration, incomplete cuff closure, over-stretched areas on the cuff balloon, or needing to use tape or other methods to keep the cuff closed indicate a cuff should be disposed of. The cuff should stay closed by its own hook and loop self-fastener closure at all times and not peel away from itself when inflated. With regular use, a blood pressure cuff tends to have a shelf life of six months.
+ During general anesthesia, which limb should be used to monitor blood pressure?
The limb with no intravenous/arterial catheter should be used. If the limb with a catheter is used, pressure measurements may be affected, and backflow of fluids into the line can occur. The area farthest away from the incision/surgery site is ideal.
+ When should blood pressure be evaluated after starting medication?
While recheck frequency needs to be tailored for each individual patient, there are treatment templates that can be referred to for general guidance.
+ Can blood pressure be taken on pediatric patients?
Yes! Any critically ill kitten should have its blood pressure monitored just like an adult cat. Veterinary cuffs size 1-2.5 are available for pediatric patients.
