It has not taken long to identify there are at least two very different camps with regard to who is qualified to evaluate a heart and its function (whether feline and human). Lahri's own cardiologist has no interest in even looking at the work of the sonographer who evaluated his echo. I fully understand, deeply appreciate her reasons and have very little confidence in the validity of the echo from the sonographer. Having witnessed at least five echos with the cardiologist, I am familiar with its interactive quality. For example, using only my own crude language: When she sees X, she looks for Y (maybe Z, Q, V, F...). When she can't find Y, she looks for something else. When she gets what she's looking for, she takes precise measurements, comparing those as she goes along with others that follow. Only then does she move on to what she knows to be the next location or level of concern, the evaluation of which may well send her back to an earlier location for reassessment.She interacts with the echo as if she were moving her hands and eyes inside the heart, the physical and functional aspects of which she understands in all of their subtleties. How can such finesse be achieved by a sonographer who receives a completed echocardiogram which precludes 'interacting with' the heart, considering different takes on it at various stages of its function, for example, as the heart itself is no longer available? Many more questions could surely be asked.
That said, I'm beginning to discover there are vets whose opinions differ. At the least, they site special training which enables echosonographers to know what to look for. I've had a number of sonograms done in my life and not one by the specialist herself. However, not a single sonographer has been able to tell me what she's seen. Protocol is surely a part of that, but I think it's also because a sonographer doesn't have the training which ensures the kind of understanding of a gynecologist, orthopaedist, urologist, etc. In my own uneducated words, sonographers can IDENTIFY parts and functions, but the depth and breadth of understanding available to a specialist in the area is beyond them.
I do feel taken in, but much less so now that I know there are vets who feel sonographers can do an adequate job of assessing feline hearts. Personally, though, I'm finding it impossible to be comfortable with such adequacy when it comes to the heart and its complexities. What can I do? All I know at this point is this. My intuition was strong that Lahri needed an echo and I needed not to spend the nearly $1K (maybe more) it was going to take with the previous cardiologist. I assumed that ONLY a cardiologist would be evaluating the echo and was not alert enough to ask why staff at the clinic never referred to the evaluater as a cardiologist even as I persisted in doing so. Some very valuable lessons here. It is my hope this message can help others avoid the situation I have gotten myself into.
That said, the sonographer did suggest the possibility of hypertension in Lahri. He got a BP test yesterday, about which all I could find out was that while his BP began at 150, it rose to 200. Tomorrow, he will be examined by a vet at the usual practice and I will find out what the latter really means with regard to hypertension, and perhaps what needs to be done to correct it.
The sonographer may well have done us a great favor through that suggestion.
Nothing written in stone, just reflections that may be useful to some of you.
Thank you very much for your understanding and support.
mb and lahri
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