OFA Cardiac - Who Can Do It? (Long)

[TrishB]

Hi all,

There's been some questions about just WHO can do an exam for an OFA Cardiac cert. Some feel that they don't have access to a Veterinary Cardiologist, so they can't have the test performed. Apparently, YOUR vet may be able to do the test. I went looking on their website and found this description of the requirements and the test:

http://www.offa.org/cardiacphys.html

The Cardiac Exam

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The clinical cardiac examination should be conducted in a systematic manner. The arterial and venous pulses, mucous membranes, and precordium should be evaluated. Heart rate should be obtained. The clinical examination should be performed by an individual with advanced training in cardiac diagnosis.

Board certification by the American College of Veterinary Internal Medicine, Specialty of Cardiology is considered by the American Veterinary Medical Association as the benchmark of clinical proficiency for veterinarians in clinical cardiology, and examination by a Diplomate of this specialty board is recommended. Other veterinarians may be able to perform these examinations, provided they have received advanced training in the subspecialty of congenital heart disease.

Ascultation

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Cardiac auscultation should be performed in a quiet, distraction-free environment. The animal should be standing and restrained, but sedative drugs should be avoided. Panting must be controlled and if necessary, the dog should be given time to rest and acclimate to the environment. The clinician should able to identify the cardiac valve areas for auscultation. The examiner should gradually move the stethoscope across all valve areas and also should auscultate over the subaortic area, ascending aorta, pulmonary artery, and the left craniodorsal cardiac base. Following examination of the left precordium, the right precordium should be examined.
The mitral valve area is located over and immediately dorsal to the palpable left apical impulse and is identified by palpation with the tips of the fingers. The stethoscope is then placed over the mitral area and the heart sounds identified.

The aortic valve area is dorsal and 1 or 2 intercostal spaces cranial to the left apical impulse. The second heart sound will be most intense when the stethoscope is centered over the aortic valve area. Murmurs originating from or radiating to the subaortic area of auscultation are evident immediately caudoventral to the aortic valve area. Murmurs originating from or radiating into the ascending aorta will be evident craniodorsal to the aortic valve and may also project to the right cranial thorax and to the carotid arteries in the neck.

The pulmonic valve area is ventral and one intercostal space cranial to the aortic valve area. Murmurs originating from or radiating into the main pulmonary artery will be evident dorsal to the pulmonic valve over the left hemithorax.

The tricuspid valve area is a relatively large area located on the right hemithorax, opposite and slightly cranial to the mitral valve area.

The clinician should also auscultate along the ventral right precordium (right sternal border) and over be right craniodorsal cardiac border.

Any cardiac murmurs or abnormal sounds should be noted. Murmurs should be described as indicated below.

Description of Cardiac Murmurs

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A full description of the cardiac murmur should made and recorded in the medical record. Murmurs should be designated as systolic, diastolic, or continuous.

The point of maximal murmur intensity should be indicated as described above. When a precordial thrill is palpable, the murmur will generally be most intense over this vibration.

Murmurs that are only detected intermittently or are variable should be so indicated.

The radiation of the murmur should be indicated Effects of heart rate, heart rhythm, and exercise

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Some heart murmurs become evident or louder with changes in autonomic activity, heart rate, or cardiac cycle length. Such changes may be induced by exercise or other stresses. The importance of evaluating heart murmurs after exercise is currently unresolved. It appears that some dogs with congenital subaortic stenosis or with dynamic outflow tract obstruction may have murmurs that only become evident with increased sympathetic activity or after prolonged cardiac filling periods during marked sinus arrhythmia It also should be noted that some normal, innocent heart murmurs may increase in intensity after exercise. Furthermore, panting artifact may be a problem after exercise.

It is most likely that examining dogs after exercise will result in increased sensitivity to diagnosis of soft murmurs but probably decreased specificity as well. Auscultation of the heart following exercise is at the discretion of the examining veterinarian.

At this time the OFA does not require a post exercise examination in the assessment of heart murmurs in dogs; however, this practice may be modified should definitive information become available.

So if you want a Cardiac Cert from the OFA, print this off and give it to your vet. If they can't do it, I'm sure they know of someone in your area who does!

[BostonRott]

Yes, regular vets can perform it, but the Cardiac number specifies whether or not a cardiologist did the exam or not.


Being a peramedic and training majorly in cardiac disorders, I'd MUCH prefer a cardiologist's eval vs a general practioners. Matter of fact, as a bitch owner, I want to see the stud examined by a cardiologist, and NOT a general vet.

You can often find seminar and get the exam done for cheap. Do some searching online, or check the OFA website.

[Judi W]

Although we do not have a board cert cardio in our state or a vet school, my vet is the only one who has an echocardiogram and knows how to use it and is the closest thing. He does mine and I am perfectly confident in his eval. I certainly would not just use joe blow although it will be accepted.

[TrishB]

Originally Posted by BostonRott

Yes, regular vets can perform it, but the Cardiac number specifies whether or not a cardiologist did the exam or not.


Being a peramedic and training majorly in cardiac disorders, I'd MUCH prefer a cardiologist's eval vs a general practitioners. Matter of fact, as a bitch owner, I want to see the stud examined by a cardiologist, and NOT a general vet.

You can often find seminar and get the exam done for cheap. Do some searching online, or check the OFA website.

Clinics are listed here: http://www.offa.org/clinics.html

But they're all in the US. Here in Ontario, we only have one certified cardiologist at Guelph University. Other provinces don't have any. Never mind the great expense in getting examed by the only one in the province.

I can appreciate your requirements when breeding your dogs. All the power to ya! However, I'd rather have an exam and cert from a general practitioner than none at all. Even the general practitioner must have:

Other veterinarians may be able to perform these examinations, provided they have received advanced training in the subspecialty of congenital heart disease.

So Joe-Blow isn't an option either.

[frontierrots]

In my opinion, certifications done by anyone other than a board certified cardiologist hold no weight.

Hip and elbow xrays are certified by board certified orthopedic vets, eyes are certified by board certified opthamologists. Why on earth should a non board certified vet be allow to certify clear anything other than patellas?

There are cardiologist vets that travelfrom vet clinic to vet clinic doing cardiac work. That's how we get our cardiac exams done here. A cardiologist comes up from Mass almost every Wednesdays and does appts at 6am

There are clinics in nearly every state as well

Given my position, I have heard of a great many dogs that dropped dead of SAS who were screened clear by practitioner vets or were diagnosed late in the disease or not at all, by practitioner vets. They simply don't have the training needed for a cardiac clearance exam

[BostonRott]

I watch GP's screw up Cardiac diagnoses (my specialty as a paramedic) every day. I've had strong arguments with ED physicians regarding cardiac treatment, one even tried to tell me that using a certain med (amiodarone) was not in my protocols for rapid Afib. ...........GP's,even ER docs just don't know it all...........they are "jack of all trades, master of none." That is NOT a slam, simply an observation. If I want a cardiac opinion, I seek a cardiologist. Anything else is nothing better than I already know for myself as a paramedic.

[groupieindenial]

I have an apt for Vegas at the OVC with a cert cardiologist next month. The cost is $140 (CDN), and the ECC? (ultrasound test) is about $300 (CDN). They have 3 certified cardiologists of 4 in all of Canada. The other they said is in the Ottawa area. It's not OFA, it's just an OVC certification. I had a thread asking about all this a while back, no one responded with any insight.

[BostonRott]

If the auscultation is normal, you shouldn't need to pay for the echo-cardiogram.

[groupieindenial]

Well I would assume that if they chose to do the ECC it is because they definately hear a murmur, and the test gives them accuracy and specifics? So if it turns out normal, I shouldn't have to pay? Vegas has a slight murmur, hopin that he'll grow out of. I have delayed the apt at the OVC, and going to my vet to see if she thinks its gotten worse or not. If so, I will keep my apt with the OVC and take steps from there I guess.

[BostonRott]

Huh??? You always pay for a veterinary exam. Yes, the ECG gives specifics of structure, and can also show flow rates. Diane is better at explaining the "norms" of this exam than I am. Certain flow rates are indicative of SAS.

Innocent puppy flow murmurs disappear usually by 12 weeks.

[TrishB]

Originally Posted by BostonRott

If the auscultation is normal, you shouldn't need to pay for the echo-cardiogram.

I think what Gretchen is saying here (and please correct me if I'm wrong) is that if the initial exam is normal - you won't need the echo-cardiogram. Therefore, won't have to pay for it as it wouldn't be done.

[frontierrots]

Originally Posted by BostonRott

Diane is better at explaining the "norms" of this exam than I am. Certain flow rates are indicative of SAS.

If nothing is heard on the audible exam then the Drs don't do the echo, unless you want to have it done and request it.

Looking at the echo it will list the dog's blood velocity in milliters per second (m/sec) At 2.0 m/sec and above you are looking at a dog that most likely has SAS even if no structural issues are present. At 1.7 m/sec you are looking at a dog that would be suspect of having SAS, again even if no structural issues are present

Innocent puppy flow murmurs disappear usually by 12 weeks.

Some take up to 6 months, but they should be completely gone at 6 months, murmurs that linger beyond 5 months should be suspect of being SAS

[fbkeays]

Some of the puppies in Fizbin's litter had murmurs. I don't remember if Fizbin was one of them or not. Feb. 2003 there was a cardio clinic at a show where you could elect to have the EC done. I paid the $125 as I didn't want a shadow of a doubt about his heart. He was completely normal. I got a copy of the scans, the vet checked a box or two on the form and signed it. I sent it off to OFA and a month later got his OFA paper for cardio clear.
You can go to the OFA website, www.offa.org and down load the cardio form and have the vet sign it. I am sure they accept Canadian vets

[groupieindenial]

Thanks Diane, I'll jot that info down so I sorta know what to expect going in. Since Vegas is just over 5 mos, your saying at this point they should be able to give precise diagnosis of whats going on, SAS or not etc... If he's still got a murmur at this point, is there less likelihood of not growing out of it? 3 weeks ago I took him to another vet, who confirmed what my vet said, but he diagnosed it at barely a 1, and that most vets may not even hear it. My vet about 3 weeks before that, said it was between a 1 and 2. Are these just 2 opinions of their diagnosis, or is it getting better?

I'm taking him in to my vet next week. Would you all like to be updated on the situation?

FB, I get the feeling that OFA is too inconsistent. Since the OVC is minutes from my house, and they have the few certified cardiologists in Canada, I'll stick with the professionals. They are one of the best vet colleges in north america, best in Canada. I'm not slamming OFA, but of what I understand of the 2, one has too much room for error. If they make an error against your dog, it stays on record, period. There is no reversing the results once its made. If it fails the first time, and passes the next, it's still a fail on record.

[BostonRott]

Originally Posted by groupieindenial

FB, I get the feeling that OFA is too inconsistent. Since the OVC is minutes from my house, and they have the few certified cardiologists in Canada, I'll stick with the professionals. They are one of the best vet colleges in north america, best in Canada. I'm not slamming OFA, but of what I understand of the 2, one has too much room for error. If they make an error against your dog, it stays on record, period. There is no reversing the results once its made. If it fails the first time, and passes the next, it's still a fail on record.

OFA has nothing to do with a cardiac exam. OFA is a registry for cardiac data. The ONLY exams that OFA "does" are the evaluations of hips/elbows xrays. The Cardiologist does the cardiac exam, not OFA. OFA only records the results.