December 2, 2025
Why Dyspnoeic Cats Need Stabilisation First
Few patients prompt us to adjust our pace quite like the dyspnoeic cat. Instantly, the room grows quieter, movements gentler, as the cat focuses on the simple act of breathing. The ribcage moves sparingly; the posture is fixed; every second feels precarious. Even small movements can precipitate decompensation. And in the urgency to understand why the breathing is failing, it’s easy to move too quickly toward diagnostics before the patient has any physiological reserve left. The dyspnoeic cat ultrasound protocol exists to prevent exactly that.
At SA Veterinary Sonography, the first step is never a full echocardiogram; we work with the veterinary team to ensure the patient is stabilised before any demanding imaging is attempted. Our role is to adjust the imaging plan to what the cat can safely tolerate and to help the clinician make decisions without adding stress to an already fragile patient. A quick TFAST offers the minimum information required to redirect the plan safely. A brief check for pleural effusion can significantly alter the immediate approach, providing veterinarians with a clearer starting point while avoiding unnecessary handling. For busy SA clinics dealing with time pressure, anxious owners and critically unstable patients, this small preliminary scan often becomes the safest and most practical diagnostic foothold available.
How Stabilisation Works and How SA Vet Sonography Supports It
Stabilisation is performed by the attending veterinarian, but guided imaging and collaborative discussion often shape what happens next. The goal is to create enough breathing room, literally and clinically, for imaging to be safe and meaningful.
Stabilisation Steps Prior to Echocardiography.
| Step | Action |
Clinical Rationale |
How SA Vet Sonography Assists |
| 1 | Oxygen therapy | Reduces respiratory effort, allowing the patient to regain their reserve. | Advises whether immediate imaging is safe or if oxygen is needed before proceeding. |
| 2 | Mild sedation (e.g., butorphanol) | Eases anxiety and oxygen demand without compromising breathing. | Helps identify when gentle sedation will make imaging safer and more tolerable. |
| 3 | Diuretics (e.g., frusemide) | Reduces pulmonary or pleural fluid load when heart failure is suspected. | Early TFAST findings help determine if fluid overload is likely and whether diuretics are appropriate. |
| 4 | Allow time to stabilise | Improves handling tolerance and decreases risk of collapse during imaging. | Coordinates the timing so that the echocardiogram occurs when the patient is stable enough to yield meaningful results. |
| 5 | Proceed to a full echocardiogram | Once stable, the echo becomes safe and clinically meaningful. | Performs a targeted, comprehensive study to answer the diagnostic questions that guide treatment. |
Only once the cat has regained sufficient comfort and stability, as determined by the vet and supported by our preliminary imaging, do we proceed with the full echocardiogram. At that point, the study becomes safe, meaningful and central to determining whether the left atrium is enlarged, whether heart failure is likely and which treatment pathway is justified.
For borderline cases, a quick conversation between SA Vet Sonography and the veterinary team often resolves whether ongoing stabilisation can remain in-house or if emergency transfer is the safer option. Our goal is always to support the vet’s clinical decision-making, not complicate it.
Need Imaging Support?
If you’re managing a dyspnoeic patient and want guidance on whether stabilisation is sufficient to proceed, or if you’d like to arrange an urgent TFAST or echocardiogram, please reach out. We’re always happy to talk through the case and help plan the safest next step.
About the Author
Dr Jennifer Judd BVMS GCertSAUA MANZCVS (Radiology) is a visual thinker and ultrasound devotee with a knack for turning complex scans into practical answers. After a decade in general practice, she founded SA Veterinary Sonography to bring precision imaging into the hands of everyday vets.
Dr Jen is known for her calm presence, sharp eye, and collaborative style – helping clinics navigate tricky cases without sending patients offsite. When in doubt, she’s your diagnostic sounding board.
Mobile Veterinary Ultrasound Services
Advanced in-clinic ultrasound for accurate diagnosis and treatment planning, delivered through abdominal, thoracic, cardiac and reproductive imaging.
Abdominal
Comprehensive abdominal imaging assessing organs, effusion, masses, inflammation, and gastrointestinal changes.
Thoracic
Targeted thoracic ultrasound evaluating pleural effusion, lung changes, and masses, ideal for unstable or dyspneic patients.
Echocardiogram
Detailed cardiac imaging assessing structure, chamber size, function, and mitral valve disease staging for informed treatment.
Reproductive
Focused urogenital imaging assessing pregnancy, pyometra, prostatic changes, urinary tract issues, and suspected bladder stones.
Abdominal
Comprehensive abdominal imaging assessing organs, effusion, masses, inflammation, and gastrointestinal changes.
Thoracic
Targeted thoracic ultrasound evaluating pleural effusion, lung changes, and masses, ideal for unstable or dyspneic patients.
Echocardiogram
Detailed cardiac imaging assessing structure, chamber size, function, and mitral valve disease staging for informed treatment.
Reproductive
Focused urogenital imaging assessing pregnancy, pyometra, prostatic changes, urinary tract issues, and suspected bladder stones.
Frequently Asked Questions
Have questions? We’re here to support you. Below are answers to common queries about our veterinary ultrasound services.
What is the safest ultrasound protocol for a dyspnoeic cat in general practice?
The safest approach is a stabilisation-first protocol. Begin with a quick TFAST to check for pleural effusion without placing the cat under unnecessary stress, then stabilise with oxygen, mild sedation and diuretics such as frusemide. Only once the patient is breathing more comfortably should a full echocardiogram be performed. SA Veterinary Sonography supports this approach by providing in-clinic ultrasound, allowing unstable cats to remain in a familiar environment while you manage stabilisation.
When should I perform a TFAST on a dyspnoeic cat?
A TFAST is most useful early in assessment when the cat is too unstable for a full echocardiogram. It allows a quick, gentle check for pleural effusion or pericardial abnormalities without the handling required for a full cardiac study. This aligns with best practice for patients with minimal physiological reserve. SA Veterinary Sonography frequently assists SA clinics by confirming TFAST findings and helping determine whether the cat is stable enough to progress to a full echo.
What medications should be used to stabilise a dyspnoeic cat before an echocardiogram?
Stabilisation typically includes oxygen therapy, a mild sedative such as butorphanol to reduce anxiety, and frusemide when cardiogenic pulmonary oedema or effusion is suspected. These steps give the cat time to regain respiratory comfort before diagnostic handling. SA Veterinary Sonography performs echocardiography once stabilisation is achieved, allowing the vet team to focus on immediate patient care while imaging is safely planned.
When is it safe to proceed with a full cardiac ultrasound in a dyspnoeic cat?
A full echocardiogram should only be performed once the cat is stable enough to tolerate gentle restraint and a few minutes of imaging. Indicators include more regular breathing, reduced anxiety and improved oxygenation. At that point, the echo becomes safe and can answer key questions, such as left atrial enlargement or underlying cardiomyopathy. SA Veterinary Sonography offers mobile ultrasound services within your clinic, allowing the study to be conducted without relocating a fragile patient.
How do I differentiate primary cardiac dyspnoea from respiratory disease when the cat is too unstable for imaging?
In critically dyspnoeic cats, stabilisation takes priority over immediate differentiation. A quick TFAST can identify pleural effusion and guide early decisions without requiring a full echo. Once oxygen, sedation and frusemide improve respiratory effort, an echocardiogram becomes safe and is the most accurate way to determine whether cardiac disease is the cause. SA Veterinary Sonography can perform this in your clinic, reducing the stress and risk associated with transport.
Should I refer a dyspnoeic cat to emergency before arranging an ultrasound?
If the cat cannot maintain adequate ventilation despite oxygen, sedation and initial frusemide, emergency referral is appropriate. If the patient stabilises, SA Veterinary Sonography can perform an in-clinic echocardiogram, allowing diagnostics to continue within your practice. A brief discussion with us often helps determine whether ongoing stabilisation is appropriate in-house or whether emergency support is the safer option.