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Journal of veterinary internal medicine2023; 37(3); 1223-1232; doi: 10.1111/jvim.16674

Feasibility of a point-of-care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings.

Abstract: A point-of-care ultrasound (POCUS) protocol for evaluation of the cardiac and respiratory systems in horses does not exist. Objective: (a) Describe the windows of a POCUS protocol for cardiorespiratory assessment of horses (CRASH); (b) Estimate the number of acoustic windows that can be acquired by a sonographer-in-training; (c) Estimate the time required to complete the protocol for specific groups of horses; (d) Describe the sonographic abnormalities detected in horses presented with cardiovascular, respiratory, or systemic disease. Methods: Twenty-seven healthy horses, 14 horses competing in athletic events, and 120 horses with clinical disease. Methods: A pocket-sized ultrasound device was used to acquire 7 sonographic cardiorespiratory windows in various clinical scenarios. The duration of the examination was timed, and images were evaluated for diagnostic quality. Abnormalities in horses with clinical disease were determined by an expert sonographer. Results: The CRASH protocol could be performed in healthy and diseased horses in hospital, barn, and competition settings between 5.5 ± 0.9 (athletic horses) and 6.9 ± 1.9 min (horses with clinical disease). Thoracic windows were obtained most consistently, followed by right parasternal long-axis echocardiographic windows. Frequently detected abnormalities were pleural fluid, lung consolidation, B-lines, and moderate-to-severe left-sided heart disease. Conclusions: The CRASH protocol was feasible using a pocket-sized ultrasound device in various groups of horses, could be completed rapidly in a variety of settings, and frequently identified sonographic abnormalities when evaluated by an expert sonographer. The diagnostic accuracy, observer agreement, and utility of the CRASH protocol merit further evaluation.
© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2023-03-28 PubMed ID: 36975771PubMed Central: PMC10229348DOI: 10.1111/jvim.16674Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research aims to test the practicality of using a point-of-care ultrasound (POCUS) protocol for evaluating the cardiac and respiratory systems in horses in varying environments. The results showed the protocol can be rapidly completed in a variety of settings, often identifying diseases when evaluated by an expert sonographer.

Objective of the Research

The paper focuses on four key objectives:

  • To describe the specific points or ‘windows’ used in the POCUS protocol for the cardiorespiratory assessment of horses, a method dubbed CRASH.
  • To estimate the number of these windows that a trainee sonographer can acquire–the more windows, the more comprehensive the assessment.
  • To estimate the time required to complete the protocol for different types of horses–healthy, athletic, and diseased.
  • To document and describe the abnormalities detected in horses with cardiovascular, respiratory, or systemic disease using the CRASH protocol.

Methodology

  • The research was carried out using twenty-seven healthy horses, fourteen athletic horses, and one hundred and twenty diseased horses.
  • A pocket-sized ultrasound device was utilized to acquire seven sonographic cardiorespiratory windows in various clinical scenarios.
  • The duration of each examination was timed to estimate the speed of completing the whole protocol.
  • The sonographic images acquired were evaluated for diagnostics quality.
  • A sonography expert determined the abnormalities detected in horses with clinical diseases.

Results

  • The researchers found that the CRASH protocol could be performed both on healthy and diseased horses in hospital, barn, and competition settings, taking between 5.5 ± 0.9 minutes for the athletic horses and 6.9 ± 1.9 minutes for the horses with clinical disease.
  • The most consistently obtained windows were thoracic, followed by right parasternal long-axis echocardiographic ones.
  • The most common anomalies found were pleural fluid, lung consolidation, B-lines, and moderate-to-severe left-sided heart disease.

Conclusion

  • In conclusion, the CRASH protocol using a pocket-sized ultrasound device was found to be feasible for different horse groups and could be administered in multiple settings.
  • The researchers found that it could often identify sonographic abnormalities when evaluated by an expert sonographer.
  • However, they suggest further evaluation to determine the diagnostic accuracy, observer agreement, and overall practical utility of the CRASH protocol.

Cite This Article

APA
Bevevino KE, Cohen ND, Gordon SG, Navas de Solis C. (2023). Feasibility of a point-of-care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings. J Vet Intern Med, 37(3), 1223-1232. https://doi.org/10.1111/jvim.16674

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 37
Issue: 3
Pages: 1223-1232

Researcher Affiliations

Bevevino, Kari E
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas 77843, USA.
Cohen, Noah D
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas 77843, USA.
Gordon, Sonya G
  • Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas 77843, USA.
Navas de Solis, Cristobal
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania 19348, USA.

MeSH Terms

  • Horses
  • Animals
  • Point-of-Care Systems
  • Feasibility Studies
  • Ultrasonography / veterinary
  • Ultrasonography / methods
  • Point-of-Care Testing
  • Echocardiography / veterinary

Grant Funding

  • American College of Veterinary Internal Medicine Clinical Training Fellowship
  • Texas A&M University Department of Large Animal Clinical Sciences
  • Texas A&M University Link Equine Research Endowment

Conflict of Interest Statement

Authors declare no conflict of interest.

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Citations

This article has been cited 1 times.
  1. Balakrishnan A, Silverstein DC, Bedenice D, Bersenas A, Bourgeois JP, Carroll CL, Dunkel B, Greensmith T, Hopper K, Lascola K, Mangalmurti N, Rozanski E, Wilkins P, Yehya N. Acute Respiratory Distress Syndrome in Veterinary Medicine-The ARDSVet Definitions. J Vet Emerg Crit Care (San Antonio) 2025 Jul-Aug;35(4):327-338.
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