Basic Canine and Feline Electrocardiography

L.P. TILLEY

The Animal Medical Center, 510 East 62nd Street, New York, New York, U.S.A. 10021.

Electrocardiography has become 14) Basis for records and consultation The minimum electrocardiographic
established as an atraumatic, relatively 15) Serial electrocardiograms as an recording is a lead II rhythm strip-and
aid in the prognosis and diagnosis the six basic limb leads. This recording
inexpensive and extremely useful
in both the dog and cat is the primary
of cardiac disease.
technique for gaining information
basis for discussion here. The precorabout the heart. It is now generally
leads are discussed only in specific
to
the
Electrocardiogram
dial
Approach
of
the
caras
a
part
necessary
accepted
The complete electrocardiogram conditions.
diac examination of a. dog or cat
After the complete electrocardio(Table I). Electrocardiography can should include at least three to four
serve two purposes: (a) diagnosing complexes of each bipolar standard gram has been recorded, it must be
most cardiac arrhythmias, since the leads (I, II, III), three augmented uni- analyzed to determine whether it is
electrocardiogram can determine the polar limb leads (aVR, aVL, aVF) and normal or abnormal by measuring the
source of the rhythm and the fre- at least 30 to 45 cm of a lead II strip. various complex heights and interval
quency with which the impulse arises The unipolar precordial chest leads lengths and comparing them with the
and (b) providing informationt on the (CV5RL, also termed rV2; CV6LL or normal values.
Every electrocardiogram should
status of the myocardium, since the V2; CV6LU or V4; and VIO) can also be
P-QRS-T deflection of the electro- recorded for added electrocardiogra- have at least four features examined
cardiographic tracing are often altered phic accuracy in specific conditions. -systematically; heart rate, heart
by either pathological or physioligical
TABLE I
factors.
COMMON CLINICAL FINDINGS IN DOGS AND CATS WITH CARDIOMYOPATHY
More veterinary hospitals each year
Canine
Feline
are purchasing electrocardiographs,
thereby increasing the number of tracHypertrophic Form Dilated Form Hypertrophic Form
Dilated Form
ings taken by veterinarians and necesMale
Male
Male
Male
sitating a lecture course with a sim- Sex
death
Sudden
Cough
Shock
Dyspnea
Clinical
Signs
plifed approach toward accurately
Dyspnea
Thromboembolism
Hypothermia
interpreting these electrocardiograms.
Ascites
Anorexia
Sudden death
Some of the important indications
Weakness
Dyspnea
for taking an electrocardiogram are as
Anorexia
Thromboembolism
follows:
Syncope
Breed Siamese
1) Tachycardia, bradycardia, or
Breed: Large Breeds
Burmese
arrhythmia heard on auscultation. ElectroAtrial and ventric- Atrialfibrillation Third degree atrioVentricular
2) Acute onset of dyspnea
ular arrhythmias Ventricular prema- ventricular block
premature
cardiography
3) Shock
ture complexes
Intraventricular
complexes
4) Fainting or seizures
Left ventricular
conduction dis- Left ventricular
5) Cardiac monitoring during and
enlargement
turbances
enlargement
Sinus bradycardia Left ventricular
after surgery
and atrial
6) All cardiac murmurs
enlargement
7) Cardiomegaly found on thoracic
Cardiomegaly
radiographs
Cardiomegaly
Left atrial
Cardiomegaly
Radiology
Left atrial
Pleural effusion
enlargement
8) Cyanosis
enlargement
Cardiomegaly
9) Preoperatively in older animals
Pulmonary edema Pleural effusion
10) Evaluating the effect of cardiac
Pulmonary edema
drugs
Diuretics
Digoxin
Propranolol
Digoxin
disturbances
Treatment
11) Electrolyte
Propranolol (?)
Diuretics
Diuretics
Cage rest
12) Pericardiocentesis, for monitorPropranolol
Diuretics
Propranolol
ing purposes as well as for locatLQW sodium diet
Grave prognosis
ing the needle
Exercise restriction
Afterload reducers
the
affect
that
diseases
13) Systemic
Vitamin E
heart
Presented at the 32nd Canadian Veterinary Medical Association Annual Convention, Moncton, N.B. July, 1-980.

Can. vet. J. 22: 23-24 (January 1981)

23

rhythm, P-QRS-T complexes and

intervals, and mean electrical axis.
Following are the steps in analysis.
1) Calculate the heart rate
2) Evaluate the heart rhythm
3) Measure the complexes and
intervals.
a) P wave
b) P-R interval
c) QRS interval
d) S-T segment
e) T wave

f) Q-T interval
g) Basic limb leads (I, II, III, aVR,
aVL, and aVF)
4) Determine the mean electrical exis.
Recommended Reading
BOLTON, G. Handbook of Canine Electrocardiography. Philadelphia: W.B. Saunders Co. 1975.
ETTINGER, s. Cardiac arrhythmias. In Textbook
of Veterinary Internal Medicine, S.J. Ettinger,
Editor. Philadelphia: W.B. Saunders Co. 1975.
FREIDMAN. H.H. Diagnostic Electrocardiography

and Vectorcardiography, 2nd Ed. New York:

McGraw-Hill Book Co. 1977.
TILLEY. L.P. Basic Canine Electrocardiography.
Milton, Wisconsin: The Burdick Corp. 1978.
TILLEY. L.P. and V.T. SCIALLI. Digitalis, its Clinical
Indication and Practical Usage. Burroughs Wellcome. 1979.
TILLEY. L.P. Essentials of Canine and Feline Electrocardiography. St. Louis: C.V. Mosby Co.
1979.
TILLEY. L.P. Ed. Feline Cardiology, Veterinary
Clinics of North America. Philadelphia: W.B.
Saunders Co. 1977.

Diagnostic and Therapeutic Tips on Cardiology

1) An arrhythmia heard on auscultation in the cat is usually abnormal. Sinus arrhythmia is rare in
the cat while in the dog it is very
common.
2) P-pulmonale or tall and peaked
waves on the electrocardiogram
are often associated with tracheal
collapse in the dog.
3) The most common cause of pulmonary edema in the cat is hypertrophic cardiomyopathy.
4) Conduction defects on the electrocardiogram in the cat are most
often associated with hypertrophic cardiomyopathy.
5) In a cat that is hypothermic and
shocky, the dilated form of cardiomyopathy should always be a
major consideration.
6) Aortic thromboembolism is
almost always associated with
cardiomyopathy in the cat.
7) The maintenance dosage of
digoxin in most dogs should be
based on the following formulas:
Elixir (0.OSmg/) - 75% X lb X
0.0lmg = Total daily dose
Tablets 85% X lb X 0.01 mg =
Total daily dose
8) Older dogs always require less
digoxin: often a 25% to 50%
reduction.
9) The elixir form of digoxin should
never be used in the cat, as it is
most often not tolerated.
10) Beta blockage (or propranolol) in
both the dog and the cat most
likely prolongs the survival time
in the dilated form of cardiomyopathy.
24

11) The person best qualified to read

the electrocardiogram is the clinician in charge of the patient.
12) Memberships in the Academy of
Veterinary Cardiology can be
obtained for $10 with numerous
benefits for the veterinarian interested in veterinary cardiology.
(Write to Lawrence P.Tilley, 510
E. 62nd St., New York, N.Y.,
10021).
13) If vomiting, diarrhea, and/or
anorexia are observed in a dog or
cat on digitalis, the digitalis
should always be stopped for at
least one to two days.
14) Potassium supplementation is
rarely needed in the dog when digitalis and furosemide are used.
15) Vasodilators should only be used
in refractory end-stage congestive
heart failure and only used in conjunction with digoxin and lasix.
16) Atrial fibrillation rarely converts
to sinus rhythm with cardiac
drugs and is usually not necessary, but digoxin should always
be used for this arrhythmia.
17) The most common causes of small
QRS-complexes in the dog are:
large, wide chests or obesity.
18) The breed most often affected
with fainting from cardiac disease
is the Schnauzer breed.
19) Hyperthyroidism in the cat
should always be suspected when
there is weight loss, a tachycardia,
hyperactivity, and tall R waves on
the EKG..
20) Propranolol should never be used
during congestive heart failure: it

is a preventative drug.
21) Before giving digoxin for cardiac
decompensation to either a cat or
dog, a chest X-ray should always
be taken.
22) Sinus bradycardia in the cat is
most often associated with the
dilated form of cardiomyopathy.
23) A low sodium diet in the treatment of congestive heart failure
can be very helpful to prevent
pulmonary edema and ascites, as
well as reduce the need of a high
diuretic dosage.
24) Fainting in the dog or cat is most
often associated with underlying
cardiac disease.
25) Atrial fibrillation in a middle
aged, male and large breed dog is
almost always associated with
congestive cardiomyopathy.
26) The most common cause of sudden death in both the dog and cat
is most likely hypertrophic
cardiomyopathy.
27) The Siamese and Burmese breeds
of cats are very prone to the
dilated form of cardiomyopathy.
28) In both the dog and cat, the male
is more prone to cardiac disease.
29) Vasodilatory therapy:
a) to use in combination with
digoxin and diuretics,
b) use an arteriole vasodilator
(hydralizine) when an increase
in cardiac output is needed,
such as in mitral insufficiency,
c) a venodilator (nitroglycerin)
should be used when there is
pulmonary congestion,
d) to give both a venodilator and
Can. vet. J. 22: 24-25 (January

1981)