Vertebral Heart Score: How and Why to Calculate One
A vertebral heart score (VHS) is a measurement used to determine if a patient’s heart is enlarged.
The VHS can provide valuable insight to complete your clinical picture, especially at times when you hear a heart murmur, for a general pre-anesthetic check, or to look for cardiac changes on breeds that are predisposed.
It’s a simple, non-invasive way to get more information and to monitor for changes over time.
How to calculate a vertebral heart score
Obtain a high-quality lateral thoracic radiograph. Be sure…
To collimate.
That the patient is straight and not twisted or at an angle.
That you can see enough detail, especially the thoracic vertebrae and the borders of the cardiac silhouette.
Make your first measurement along the longest axis of the cardiac silhouette, from the ventral border of the carina of the mainstem bronchus to the apex of the cardiac silhouette.
You don’t need to measure this in centimeters or inches—instead, just hold up a sheet of paper to your x-ray viewer and make a mark for your measurement, or use calipers. Or, with your digital x-ray system, use the VHS function to mark the measurement right on your screen.
Now, hold the measurement up to the vertebrae, starting with the cranial edge of T4—this is the 4th vertebra to have a rib connected. Count the number of vertebrae (including the vertebral body and the following disc space) that fall into the long axis measurement.
Measure to a decimal place of 0.1 (for example, let’s say your first measurement was 5.2 vertebrae).
Make your second measurement. This time, you’ll measure along the short axis, which is the widest part of the cardiac silhouette. It should be perpendicular (at a 90-degree angle) to your first measurement.
Repeat the process of transferring this measurement to the thoracic vertebrae, starting with the cranial edge of T4. For this example, let’s say your measurement was 4.5 vertebrae.
Add these two numbers together.
In this example, your VHS would be 5.2 + 4.5 = 9.7
How to interpret the results
For dogs, a normal vertebral heart score is less than 10.7 (with an average range of 8.5 to 10.5). For cats, an average VHS is 7.5 (with a range of 6.8 to 8.1).
Anything larger than that is considered abnormal.
Of course, this doesn’t tell you exactly what’s going on—you’ll need further information such as an echocardiogram to determine whether there is DCM, HCM, or some other issue causing the enlargement of the cardiac silhouette.
However, the VHS is a great screening tool to let you know to investigate further. And, if you have a patient who already has cardiac disease, a VHS can help you monitor their disease progression over time, and provide tangible information to a client who wants to know how their pet is doing on treatment.
Keep in mind that, as with any diagnostic tool, there is some individual variation. Some pets—especially certain breeds such as boxers—may fall outside the normal VHS range even if they’re completely healthy.
So, look at the overall clinical picture when assessing a patient. But with that in mind, a VHS is a quick, easy, valuable addition to your toolkit when it comes to evaluating and monitoring cardiac health.
Vetebral heart score tool video
Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.
Written by: Dr. Tammy Powell, DVM
Your Warranty and Service Coverage for Veterinary X-Ray
Today, every veterinarian recognizes the importance of incorporating digital X-rays into their animal hospitals.
A considerable number of them plan to transition from traditional film and chemical X-rays to digital systems this year.
While the initial concern typically revolves around the cost of acquiring a digital X-ray system, it is equally crucial to inquire about the warranty and its coverage.
Here are some pertinent questions to ask the prospective vendor when considering the purchase of a veterinary digital X-ray system:
1. What is the duration of the hardware warranty for my veterinary digital X-ray plate?
2. How long does the software warranty for my veterinary digital X-ray software last?
3. For how long will I receive software upgrades for the X-ray system used in my animal hospital?
4. How long will my veterinarian technicians have access to tech support, enabling them to seek answers to any queries that may arise during the daily implementation of digital X-rays in my animal practice?
5. What are the costs associated with continued phone support, software upgrades, and technical assistance after the warranty period ends?
6. Which entity is responsible for providing software and technical support? Who developed and owns the software?
7. Does the warranty cover labor and shipping expenses, as needed?
8. In the event that my X-ray plate requires repair, will a temporary replacement plate be provided?
It is common for vendors operating in the animal health sector to offer a minimum of a 1-year warranty.
Not all vendors possess ownership of the software that operates their veterinary digital X-ray plate, which holds significant importance. While a digital X-ray plate can remain functional for many years, the software it relies on may become outdated within a short span of time.
An example of this can be observed with Windows XP platforms. Unless companies continually update their software, it becomes incompatible with new computing platforms.
When veterinarians transition from computed radiography (CR) to direct radiography (DR), the predominant issue they encounter is not the failure of the CR system itself but rather the poor performance or lack of support for the software.
This issue is not limited to small companies alone. Renowned brands like Idexx and Sound have discontinued support for their older product lines by ceasing software upgrades.
Our aim is to offer you transparent service and support. Our animal health software has been developed in-house by JPI which has been manufacturing x-ray equipment, writing software, and providing telephone support for these products since 1994.
Here are the responses to the eight frequently asked questions:
1. What is the duration of the hardware warranty for my veterinary digital x-ray plate?
- The hardware warranty lasts for 5 years.
2. How long is the software warranty for my veterinary digital x-ray software?
- The software warranty is also valid for 5 years.
3. For how long will I receive software upgrades for my x-ray system to be used in my animal hospital?
- You will receive software upgrades for 5 years.
4. How long can my veterinarian technicians receive phone support for any questions they may have regarding the daily implementation of digital X-rays in my animal practice?
- Our tech support helpline will be available for your veterinarian technicians for 5 years.
5. What is the cost of continued phone support and software upgrades after the warranty period?
- The cost for continued phone support and software upgrades after the warranty period is $750.00 per year.
6. Who provides the software and tech support? Who developed and owns the software?
- Our Examvue Veterinary software is developed, supported, and owned by JPI. They have been offering industry support since 1994. For technical support, please call 516-513-1330, and select option 2. Our support team is based in New York.
7. Are labor and shipping costs covered under the warranty if needed?
- Yes, labor and shipping costs are included in the warranty as required.
8. Will a loaner plate be provided in case my X-ray plate needs repair?
- Yes, we will provide a loaner plate in the event that your X-ray plate requires repair.
Is the New Digital X-ray System Compatible with Innovet?
Many veterinarians invested in X-ray systems in the ’90s. Most purchased an Innovet Summit table and generator.
They used the table and generator along with cassettes enclosing film to capture X-rays and provide life-saving next steps for their pet patients.
Processing the film in the chemical rinse and developing the images in the darkroom enabled the practicing veterinarian to review the X-ray.
If the X-ray proved complicating or just interesting then the veterinarian would mail the X-ray to a specialist for a review or save the X-ray case for the next ‘radiology rounds’ in upcoming weeks and months.
During these radiology rounds, X-ray cases would be reviewed amongst veterinarian piers and sometimes even veterinary radiologist.
Even if the patient was deceased by the time of the review huge advances in pet medicine were and still are to this day applied.
If you're reading this you use to film with your old X-ray generator and table. You want to impact the neighborhood and village who depend on precise and timely diagnosis to treat their pets.
Digital X-rays can speed up the process not only of image acquisition but also provide clear diagnostic radiology rounds.
Most old tables and generators still can produce excellent X-rays.
Often times these old systems have new light bulb collimators and replaced fuses that enable the old workhorse to continue to provide the power for an X-ray.
Yes, you can use your old table and generator with two types of digital X-rays.
The first is computed radiography or CR which will work today with any generator as the image is captured on an erasable film cassette then scanned into the software where the digital image can now be interrupted, adjusted or emailed to pet owners.
The next is an AED cesium plate. Automatic exposure detection.
This allows the plate to prepare itself for the exposure to capture the image and send in second the inmate to the display monitor.
This is the newest way to capture X-rays.
Not having to wire the old X-ray system to the new digital X-ray system is a confinement advantage.
It removes an element of future failure in hardware by eliminating the interference box!
We can help answer more questions surrounding your old X-ray table and generator.
Reach out today and we would be happy to help.