HOLTER MONITORING SERVICE

 

                        

Intermittent collapse is a common presenting sign in small animal practice however the investigation of this problem is notoriously difficult due to the intermittent nature of clinical signs and extensive differential diagnosis list.  A careful history is required to determine whether the animal has exhibited syncope, a seizure or has fallen over.

Classical features of these three syndromes are shown in the table below however it should be noted that not all dogs will fulfil all criteria and sometimes have to be classified on the basis of “best fit”.

 

 

 

Indications for Holter Monitoring

Obviously if the dog collapses whilst wearing the monitor, it should be possible to rule in or rule out cardiac disease as a cause of the collapse. However, even if the dog does not exhibit clinical signs whilst wearing the monitor, useful information can still be obtained as many dogs with intermittent dysrhythmias require a prolonged period of the dysrhythmia to exhibit collapse but will still have short paroxysms of the dysrhythmia throughout the day.

Other indications for Holter monitoring:

· Monitoring the efficacy of anti-arrhythmic drug treatment

· Screening for pre-clinical dilated cardiomyopathy in Boxers and Dobermans

The trace below shows paroxysmal ventricular tachycardia (VT) with a rate of 300bpm in a young boxer. This trace showed that the dog was a risk of sudden death and this patient has responded well to beta-blocker administration