Reviving ECG & Holter Monitoring in Everyday Practice

ECG and Holter monitoring have been part of veterinary medicine for decades, yet their use in general practice has quietly declined. While imaging and lab tests are routine, rhythm assessment is often overlooked, even though many dangerous arrhythmias are invisible without it.

ECG remains the gold standard for diagnosing arrhythmias, conduction disturbances and drug‑related effects. It is quick, inexpensive, nurse‑friendly and provides real‑time insight that physical examination or echocardiography cannot. Many arrhythmias are intermittent, stress‑related or nocturnal, meaning a brief ECG may appear normal despite significant underlying disease.

Holter monitoring fills this gap by capturing the heart’s rhythm during normal life. It detects paroxysmal arrhythmias, evaluates arrhythmia burden, monitors therapy, and is essential for predisposed breeds such as Dobermanns and Boxers. In cats, its value is even greater: in one study, all 13 cats showed arrhythmias on Holter despite most having normal resting ECGs.

Underusing these tools has real consequences. Syncope is often misdiagnosed as neurological disease, especially in cats. Intermittent arrhythmias may go unnoticed until collapse or sudden death. Anaesthetic risk increases when silent arrhythmias remain undetected. A 2024 Veterinary Record study found that nearly one‑third of clinically healthy dogs had ECG abnormalities, and 15% required changes to their anaesthetic protocol.

Beyond clinical benefits, ECG and Holter services represent a high‑value, low‑cost revenue opportunity. They integrate easily into routine workflows, pre‑anaesthetic checks, geriatric screening, collapsing dogs, cats with vague episodes and breed‑related screening.

Modern telecardiology removes the final barriers by providing free‑loan equipment, rapid specialist interpretation and clear case guidance. Rhythm diagnostics are now accessible to every practice.

If ECG and Holter monitoring aren’t part of your routine toolkit, your patients — and your practice — are missing out.