The cardiology team has recently expanded,
and we have welcomed Rachel Blake,
a European Veterinary Specialist in
Small Animal Cardiology.
Meet Our Cardiology Team
Rachel Blake MVB DipECVIM-CA (Cardiology) MScR AFHEA MRCVS
EBVS® European Veterinary Specialist in Small Animal Cardiology
Rachel graduated from University College Dublin in 2012
after which she completed an internship and subsequently a
cardiology residency at The University of Edinburgh. She joined
the Cardiology team at Pride Veterinary Centre and gained the
European Diploma in Veterinary Cardiology in 2019
Julie Todd BVMS CertVR CertVC MRCVS
Julie graduated from Glasgow Veterinary School and has worked
in small animal practices since then. She joined the team at
Scarsdale Vets in 2000 (subsequently Pride Veterinary Centre)
and has since gained the RCVS Certificate in Veterinary Cardiology,
having gained the Certificate in Veterinary Radiology in 1996.
Since the opening of Pride Veterinary Centre in 2011, Julie has
worked to build up the cardiology caseload for the hospital.
Emma Murphy RVN BA(Hons)
Emma joined the practice in 2009 first as an auxiliary nurse,
then as a student nurse. She qualified in 2013.
Previously Emma has worked in animal shelters in the UK and
USA, and has worked with horses as well as small animals.
Emma is currently working towards a VTS (Veterinary Technician
Specialty) in cardiology, having worked within the Cardiology
team at Pride Veterinary Centre
What Does A Typical Day In
Cardiology Look Like?
If patients have been in the hospital
overnight then these will be checked in
the morning before consultations start.
The day begins with consulting, which
includes appointments with new referrals
and rechecks of on-going patients.
The majority of patients will be seen for
a consultation, admitted for investigations
and sent home later that day.
In a typical new referral consultation,
the animal’s history will be reviewed, clinical
signs discussed including how well the
animal is exercising and whether there
have been any concerns with respiration.
In most cases blood pressure is checked
with a Doppler machine (we use the tail
which the team find most tolerate best).
This is often performed as the first diagnostic
test, when the animal is least stressed.
Echocardiography is then performed on
the majority of cases.
This can usually be done without sedation
so the animal is often returned to their
owner within a couple of hours.
If respiratory signs are a concern, the team
may take chest x-rays. In most cases these
are taken with no, or minimal sedation.
An ECG will be run if there are concerns
about an arrhythmia. In dogs where there
is a severe arrhythmia, or if the team are
investigating a case of collapse, a 24-hour
Holter (ambulatory ECG) monitor will be
attached. The dog will then be sent home
for the owner to record the dog’s activity.
After the investigations for cardiology
patients have been completed, the rest of
the day is spent doing heart scans for other
disciplines, writing letters to referring vets,
reporting results and giving telephone advice
to clients and vets. Emergency cases are also
seen throughout the day where possible.
Cardiology nurse Emma also runs blood
pressure clinics. She will take the blood
pressure with the owner present, and
spends time to calm the animal first, to
obtain as accurate a result as possible.
What Other Disciplines Do
Cardiology Work With?
The cardiology team work with the
majority of the other disciplines within
Pride Veterinary Centre as well as with first
opinion vets. If a case is in the hospital with
another medical or surgical condition but
has a heart murmur or arrhythmia, then the
cardiology team will investigate this if it is
thought to be clinically relevant or before
sedation or general anaesthesia. The team
work with the medicine department most
often. Their most commonly shared patients
are cats with hyperthyroidism, who have
an assessment for cardiac disease before
they are accepted for radioactive iodine
therapy. Cases presenting for investigation
of collapsing episodes can be difficult
to categorise so they are often jointly
investigated with the neurology team.
The cardiology team sometimes share more
unusual cases with other departments –
a recent example is a dog that was initially
referred to surgery with acute abdominal
pain but was found to have ascites due
to a pericardial effusion associated with
a right-atrial haemangiosarcoma.
Working in a multi-disciplinary team allows
cardiology cases with concurrent disease to
be investigated and treated under one roof,
and also provides the cardiology team with
a more varied and interesting case load.
What Type Of Cases Do
Cardiology See Commonly?
The most common routine cases are
asymptomatic heart murmurs whereby an
animal’s vet has picked up a heart murmur
at a booster vaccination/ health check that
the owner wasn’t aware of. Often these are
older animals with a progressive murmur
and a heart scan will help determine whether
medication should be given. The cardiology
team also investigate murmurs detected in
puppies and kittens using echocardiography
to determine if congenital heart disease
is present and if potentially life-saving
intervention is necessary.
The most common emergency seen
by the cardiology team is congestive
heart failure, often referred because
of respiratory difficulties, although in
some cases symptoms are more subtle.
A large proportion of the caseload is
made of rechecks of congestive heart
failure patients who require frequent
tweaking of medications to ensure
optimal control of their symptoms.
Other common emergencies include
pericardial effusions in dogs, arterial
thromboembolism in cats and both
tachyarrhythmias and bradyarrhythmias.
Keeping patients calm is very important
for the cardiology team. This is partly
because they are one of the disciplines
that do not heavily sedate animals for
procedures, but also because the condition
of patients with severe heart disease can
be worsened with extra anxiety. This means
they work hard to keep the environment
calm and quiet for all their patients which
in turn keep stress levels to a minimum.
Emma said: “We get to know our patients
very well as a lot of them come back
regularly. This means we know who is
anxious and the best way to keep that
particular pet calm. It’s nice to be able to
adapt what we do to the needs of the pet.”
What Would You Like Referring Clinicians To Know About Cardiology At Pride Veterinary Centre?
Rachel said: “We would like people to know
that they shouldn’t be afraid to contact
us for advice. We know cardiology can
be complicated sometimes, so we are
very happy to work with vets by sharing
advice with them over the phone.”
Julie said: “I enjoy seeing the long-standing
cases and getting to know the pet and
the owner. Educating the owner in how to
measure resting respiratory rate at home
is very helpful, as it is very different to
the examination in the hospital. Many of
our clients become very closely attuned
to their pet's condition and are able to
detect changes early, so we can work
together to fine-tune medication and often
give the animal a good quality of life for
far longer than is initially predicted.”
A Particularly Rewarding Case
One stand-out case was a cat with a heart
murmur and sudden onset blindness
who was referred to Ophthalmology and
Cardiology. He had retinal detachment,
hypertension and severe hypertrophic
cardiomyopathy with a very large left
atrium. With medication he regained
some vision and was able to live very
happily at home.
His owner was a lovely
lady, who the team came to know well,
and was very dedicated in monitoring and
treating him. The cat did not go into heart
failure for over two years. When he did, he
responded well to treatment, and did not
die of his heart disease. Sadly he had to
be euthanised eight months later, at the
age of eighteen, due to a mouth tumour.
It just shows how unpredictable heart
disease can be, particularly in cats, and that
animals can live happily for a long time with
the correct treatment regime for them.