Prediction of systolic blood pressure using peripheral pulse palpation in cats.

Abstract

OBJECTIVE To evaluate the ability of peripheral pulse palpation to predict systolic blood pressure (SBP) in cats presenting as emergencies. DESIGN Prospective observational study performed over an 8-month period. SETTING University veterinary teaching hospital. ANIMALS One hundred two cats presenting to the emergency service. Eligibility for inclusion in the study included a physical examination and a SBP via Doppler technique performed prior to treatment. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Femoral and metatarsal pulses were digitally palpated and the quality of the pulses was assessed as either strong, moderate, poor, or absent. A concurrent SBP was also recorded. The median SBP for all cats was 92.5 mm Hg (range, 30-240 mm Hg). Femoral pulse quality was found to strongly correlate with the admission SBP (P < 0.001, rho = 0.6755). The median SBP for each femoral pulse quality category (strong, moderate, poor, or absent) was significantly different (P < 0.05). For metatarsal pulses, the median SBP for cats with either absent or strong pulses was significantly different (P < 0.001). Cats with absent metatarsal and femoral pulses had a median SBP of 30 mm Hg (range, 30-105 mm Hg), whereas cats with strong metatarsal pulses had a median SBP of 135 mm Hg (range, 58-210 mm Hg). Absent metatarsal pulses correctly identified cats with a blood pressure of 75 mm Hg or less 84% the time (area under the curve: 0.89, confidence interval 0.81, 0.97). CONCLUSIONS In cats, peripheral pulse quality assessment by emergency room veterinarians correlates with SBP. With progressive decreases in blood pressure, metatarsal pulses will disappear and it is only with severe hypotension that femoral pulses are absent. An assessment of both dorsal metatarsal pulse and femoral pulse quality during triage may be useful in identifying abnormalities in blood pressure.