"Blood Pressure Measurement in the Palm of Your Hand"

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Why is blood pressure measurement so important?

What is the petMAP?

What does oscillometric blood pressure system mean?

How accurate are the petMAP blood pressure readings?

What studies have been done on the petMAP?

Why is it necessary to be so specific about cuff location, size, and fit?

Does it matter how the cuff is positioned on the limb?  Is there a sensor?

How high should I inflate the cuff to start with?

How long do the batteries last?

Is the 5.5 cm cuff the biggest you have? It doesn't look big enough for some of
my large dogs.

I don't think I need all of the cuff sized included in the system.  Can I buy the petMAP
with just a few of the sizes?

Will the petMAP work on ferrets, birds, rabbits, snakes, horses, monkeys, etc.?

Do you offer a free trial?

Q. Why is Blood Pressure Measurement so Important?

A. Blood Pressure must be maintained above a certain level to perfuse tissues, thereby ensuring:

_ Nutrient supply to organs and tissues

_ Exchange and excretion of metabolic waste products

_ Tissue oxygenation

However, the blood pressure must not be too high, since high pressure in the arteries damages them and/or
causes the heart to work too hard pumping blood against the pressure which is higher than normal.

The measurement of an animal’s blood pressure (BP) has a wide range of indications. BP measurement is clinically
significant in (early) diagnosis of a variety of diseases (particularly hypertension), in pain management, monitoring of
ICU patients and during anesthesia and also when certain medications are being used. BP measurement therefore
needs to be an integral part of EVERY veterinary practice and should routinely be used.

Routine Screening

_ General health check-ups

_ Geriatric screening programs

_ Non specific symptoms

_ Vaccination appointments

_ Diseases accompanied by hemodynamic changes, especially renal disease, hyperthyroidism, diabetes
mellitus, hyperadrenocorticism, and heart disease.

Emergency Medicine

_ Shock

_ Trauma

_ Pericardial effusion

_ Poisoning

_ Addisonian crisis

Intensive Care Monitoring

_ Postoperative monitoring

_ Hypertensive crisis

_ Protracted shock

Treatment Planning and Assessment

_ Cardiac patients

_ In all patients treated for hypertension and hypotension

_ When administering drugs that effect the blood pressure, especially ACE inhibitors, diuretics, calcium
channel blockers, beta blockers, vasodilators, sympathomimetics, seditives

Anesthesia Monitoring

_ Pre-anesthetic examination

_ Intraoperative monitoring

_ Postoperative surveillance

Egner, Carr and Brown: “Essential Facts of Blood Pressure in Dogs and Cats”

Q. What is the petMAP?

A. petMAP is a new class of oscillometric Blood Pressure (BP) device with multiple missions for the vet hospital.
We think the petMAP missions include anesthesia, since it works very well there, but it is especially helpful for
routine BP measurement of awake animals for the diagnosis of hypertension and for following up on its
treatment. This can be done in the exam room or perhaps even in the waiting room with the owner
holding/calming the animal, or in the animal’s carrier without the animal’s knowledge (“stealth BP”, watch the
video at www.petmap.com). Thus petMAP’s portability, ease of use, and accuracy in awake dogs/cats is
adding a dimension to BP measurement not easily achieved previously with Doppler and the larger oscillometric
devices.

Q. What does oscillometric BP system mean?

A. Oscillometric Blood Pressure is determined based on arterial wall pulsations. The re-entry of blood into the
arteries occluded by the cuff makes the wall of the arteries expand or “pulse”. These pulsations travel through
the soft tissue to the surface of the limb where they are detected by the cuff and analyzed by the microprocessor.
This analysis provides systolic, diastolic and mean arterial pressure readings along with heart rate.

Q. How accurate are the petMAP BP readings?

A. View abstracts on petMAP's accuracy.  petMAP Manual states “…….. has been optimized for accuracy by
comparison to intra-arterial BP measurements in dogs and cats…..”. BP is displayed within +/- 2 mmHg. This does
not mean however that every reading displayed by the petMAP will be within those limits of display accuracy. BP
changes more than that each time the animal breathes, but the optimizations built into petMAP for species and cuff
site have been developed to make the petMAP correlate with simultaneously measured intra-arterial BP better than
previous generations of BP devices. No device will ever read the BP perfectly since the BP is always
changing with each heart beat, particularly if the animal is not
totally relaxed.

Q. What studies have been done on the petMAP?

A. Dr. Maynard (Mike) Ramsey, M.D., Ph.D., the inventor of petMAP and a leader in blood pressure measurement
device development, has extensive animal research experience. During the development of the petMAP product, he
performed many animal BP comparisons in the laboratory of a well respected researcher at the University of Georgia
Vet School. Based on those cat and dog experiments, Dr. Ramsey developed algorithms for both species and cuff site optimization to provide petMAP the best possible correlation with directly measured intra-arterial blood pressure
(“the gold standard”). The result of these optimizations is that the BP measured with a petMAP will typically be 10-20% higher than those measured withother oscillometric devices and with Doppler devices. If the user wishes un-optimized readings, the BP can be displayed without optimization by pressing the mode switch repeatedly until both the species
and the cuff siteLEDs are extinguished. The readings thus displayed are un-optimized.
View abstracts on petMAP's accuracy.

Q. Why is it necessary to be so specific about cuff location, size and fit?

A. As suggested above, providing the user the ability to select the species (dog or cat) and the cuff site (forearm,
tail or hind foot) while using the petMAP is unique and significantly improves the accuracy when petMAP readings
are compared to direct intra-arterial pressure measurements. While taking BP in companion animals is both a
science and an art, having specific optimizations for species and cuff site strengthens the scientific side of the
requirements for accurate measurements. Being specific by setting both the species and cuff site location gives a
much improved correlation with intra-arterial BP and hence the BP displayed is useful for diagnosis or treatment
evaluation. We know getting good BP readings is difficult, so we want to make sure if the vet or tech is going to the
trouble of getting BP, it is as accurate as possible. The best accuracy is achieved by 1) using the proper cuff size,
2) the proper settings for species and cuff site, and 3) by using the nominal session BP function which combines
into one display, the BP reading most representative of the measurement session.

Q. Does it matter how the cuff is positioned on the limb? Is there a sensor?

A. The proper size cuff must be applied snuggly to the appropriate limb, preferentially on the forearm; the tail is next preference and the hind foot is least desirable. The inflated portion of the cuff is the area which provides the oscillometric signal. There is no sensor, per se, so making sure the cuff is the correct size and fits snugly is all that is required. One of the big advantages of the petMAP is there is no need to try to find “the artery” or to shave the limb or to apply ultrasonic coupling gel as must be done with the Doppler method.

Q. How high should I inflate the cuff to start with?

A. For starters, it is better to go substantially above the estimated systolic pressure, say 40-50 mmHg. In the clinic, animal’s BPs are often high due to stress, so inflating to 220-250 initially is a good place to start. After a few determinations, if the animal’s systolic pressure appears to be in the 160-180 range, pumping to 200-220 the next time should be sufficient. If in doubt, use a higher value for pump-up, since the small cuffs pumped to high pressures are not uncomfortable to most animals. When inflated smoothly with one continuous squeeze of the bulb over a 1-3 second period, most animals don’t even notice that the cuff is inflated. Human BP cuffs are substantially more uncomfortable than the small ones used on animals.

Q. How long do the batteries last?

A. Battery life is dependent on several factors such as LED brightness settings, use of automatic valve purge frequency, and use of automatic power shut off. In normal use, new alkaline batteries will last over 200 readings, fully charged NiMH batteries

will provide over 500 readings, and Lithium batteries will provide over 1000 readings. These numbers assume that the unit is powered off manually after a measurement session and that the LED brightness is roughly midway between bright and dim.

petMAP places severe drain on its batteries and testers do not test batteries under conditions of severe drain, and hence give a false indication of freshness. If in doubt, use new batteries.

Q. Is this 5.5 CM cuff the biggest you have? It doesn’t look big enough for some of my large dogs.

A. We have larger cuffs that are optionally available in 6.5, 8.0, 10.0, and 13.0 cm sizes.

Q. I don’t think I will need all of the cuff sizes included in the system. Can I buy the petMAP with just a few of the sizes?

A. No. The petMAP with 7 cuffs is a system designed to provide the best accuracy possible in a process we know can be difficult. We include all 7 sizes in order to make sure the user always has the correct size cuff. Extra or replacement CritterCuffs can be purchased individually.

Q. Will the petMAP work on ferrets, birds, rabbits, snakes, horses, monkeys, etc.?

A. Maybe. The petMAP was designed specifically for cats and dogs and all of our development was on those species. However, if the user can get a cuff to fit correctly on a limb, it may be possible to get BP readings using the mode button where neither the species or site LED lights up.

Q. Do you offer a free trial?

A. No, but we do provide a 30 day full refund return policy. Use the petMAP for 30 days and send it back if it does not suit your needs and your payment will be refunded.