Feasibility of a Point of Care Ultrasound Protocol for Cardiorespiratory Evaluation in Horses

Abstract: Background: A point of care ultrasound protocol for sonographic evaluation of the cardiorespiratory system in horses does not exist.

Hypothesis/Objectives: 1) To describe the windows of CRASH, a POCUS protocol for cardiorespiratory assessment of the horse; 2) To determine the proportion of acoustic windows that can be acquired by a sonographer in training; 3) To determine the time required to complete the protocol for specific groups of horses; 4) To describe the sonographic abnormalities detected in horses presented with cardiovascular, respiratory, or systemic disease.

Animals: Twenty-seven healthy horses, 14 horses competing in athletic events and 121 horses with clinical disease.

Methods: A pocket-sized ultrasound device was used to acquire 7 sonographic windows to assess the cardiorespiratory system. The duration of the examination was timed, and all images were evaluated for diagnostic quality. Horses with clinical disease had images evaluated for the presence of abnormalities.

Results: The CRASH protocol could be performed in healthy and diseased horses in a hospital, barn, and competition settings within 5.5 to 6.9 minutes on average. Thoracic windows were obtained most consistently, followed by right parasternal long axis echocardiographic windows. Abnormalities detected most frequently with the CRASH protocol were pleural fluid, lung consolidation, B lines, and moderate-to-severe left-sided heart disease.

Conclusions: The designed CRASH protocol is feasible for use in various groups of horses and can be completed in a timely manner and frequently identifies sonographic abnormalities. The diagnostic accuracy and potential of the CRASH protocol to improve veterinary care of horses merits further systematic evaluation.