Clinical findings associated with N-terminal pro-B-type natriuretic peptide measurement in dogs and cats attending first opinion veterinary practices.

Peter‐John Noble,Melanie Hezzell,Elena Arsevska,Sarah O'Shaughnessy,India Crawford,David Singleton,David Hughes

doi:10.1002/vetr.945

Abstract

Clinical findings associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement in dogs and cats in primary practice, and their relevance to published measurement indications, have not been described. Using electronic health record data collected by the Small Animal Veterinary Surveillance Network, appointments in which NT-proBNP was measured were identified using keyword-based text filtering. For these appointments, clinical findings were manually identified from each patient's clinical narrative (CN) and their frequencies described. CNs of 3510 appointments (357 dogs and 257 cats) from 99practices were evaluated. The most frequently recorded clinical findings in dogs were: heart murmur (n=147, 41.2% (95% confidence interval (CI)=36.1%-46.3%), coughing (n=83, 23.2% (95% CI=18.8%-27.6%)) and panting (n=58, 16.2% (95% CI=12.4%-20.0%)) and in cats: heart murmur (n=143, 55.6% (95% CI=49.5%-61.7%)), suspected thromboembolism (n=88, 34.2% (95% CI=28.4%-40.0%)) and weight loss (n=53, 20.6% (95% CI=15.7%-25.5%)). Dyspnoea and tachypnoea were infrequently reported in dogs (n=29, 8.1% (95% CI=5.3%-10.9%) and n=21, 5.9% (95% CI=3.5%-8.3%), respectively) and cats (n=26, 10.1% (95% CI=6.4%-13.8%) and n=36, 14.0% (95% CI=9.8%-18.2%), respectively). Clinical findings referable to cardiac disease were recorded contemporaneously with NT-proBNP measurement and suggested both published and other indications (coughing (in dogs and cats), and serial measurements and thromboembolism (in cats)) for testing.

Highlights

Cardiac disease is an important cause of morbidity and mortality in dogs and cats and is prevalent in certain breeds
N-terminal pro-B-type natriuretic peptide (NTproBNP) is a biomarker of a myocardial stretch, and circulating concentrations increase with the increasing cardiac filling pressures that occur in most cardiac diseases, including myxomatous mitral valve disease (MMVD), dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM).[4,5,6,7,8]
The available clinical history of each animal in which at least one NT-proBNP measurement was performed was extracted and manually analysed, including access to all records and fields from every recorded appointment for which the animal’s owner did not opt-out of data provision. This allowed valuable additional information to be collected in the following circumstances: (1) where a separate appointment was made for blood to be drawn for NT-proBNP testing and (2) where a specific cardiac diagnosis had been made before NT-proBNP measurement

Summary

Introduction

Cardiac disease is an important cause of morbidity and mortality in dogs and cats and is prevalent in certain breeds. Clinical findings associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement in dogs and cats in primary practice, and their relevance to published measurement indications, have not been described. Methods: Using electronic health record data collected by the Small Animal Veterinary Surveillance Network, appointments in which NT-proBNP was measured were identified using keyword-based text filtering. For these appointments, clinical findings were manually identified from each patient’s clinical narrative (CN) and their frequencies described. Conclusion: Clinical findings referable to cardiac disease were recorded contemporaneously with NT-proBNP measurement and suggested both published and other indications (coughing (in dogs and cats), and serial measurements and thromboembolism (in cats)) for testing

Objectives

Methods

Conclusion