Feasibility of a point‐of‐care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings

BACKGROUND: A point‐of‐care ultrasound (POCUS) protocol for evaluation of the cardiac and respiratory systems in horses does not exist. OBJECTIVES: (a) Describe the windows of a POCUS protocol for cardiorespiratory assessment of horses (CRASH); (b) Estimate the number of acoustic windows that can be acquired by a sonographer‐in‐training; (c) Estimate the time required to complete the protocol for specific groups of horses; (d) Describe the sonographic abnormalities detected in horses presented with cardiovascular, respiratory, or systemic disease. ANIMALS: Twenty‐seven healthy horses, 14 horses competing in athletic events, and 120 horses with clinical disease. METHOD: A pocket‐sized ultrasound device was used to acquire 7 sonographic cardiorespiratory windows in various clinical scenarios. The duration of the examination was timed, and images were evaluated for diagnostic quality. Abnormalities in horses with clinical disease were determined by an expert sonographer. RESULTS: The CRASH protocol could be performed in healthy and diseased horses in hospital, barn, and competition settings between 5.5 ± 0.9 (athletic horses) and 6.9 ± 1.9 min (horses with clinical disease). Thoracic windows were obtained most consistently, followed by right parasternal long‐axis echocardiographic windows. Frequently detected abnormalities were pleural fluid, lung consolidation, B‐lines, and moderate‐to‐severe left‐sided heart disease. CONCLUSIONS: The CRASH protocol was feasible using a pocket‐sized ultrasound device in various groups of horses, could be completed rapidly in a variety of settings, and frequently identified sonographic abnormalities when evaluated by an expert sonographer. The diagnostic accuracy, observer agreement, and utility of the CRASH protocol merit further evaluation.