Dear Doctor: White Coat Hypertension?
Q. I just took my dog to a new veterinarian for the first time, and he said she has high blood pressure. He wants to check it again in a few days. I’m concerned. She is only 3 years old and has never had high blood pressure before, but the doctor thinks it might just be white-coat hypertension — transient high blood pressure resulting from anxiety because she has never been to this office before. Can a dog really get white-coat hypertension?
Dear Ms. Rayson,
A. First, it’s not unreasonable of you to be concerned. High blood pressure, if sustained, can lead to a number of conditions, including damage to the heart and kidneys. In fact, the retinas of the eyes are very sensitive to high blood pressure, which can cause blindness over time (although that it more common in cats).
And your dog’s veterinarian is right to want to re-check your pet’s blood pressure before making a decision on what, if anything, should be done about it. Dogs, like people, can experience white-coat hypertension — blood pressure elevated in response to the anxiety of being in the doctor’s office. And the fact that this is a new doctor for your pet can certainly be the reason her blood pressure is “off” for the first time.
A study of retired racing greyhounds found that their blood pressure was significantly higher in the veterinarian’s office than at home. At home their blood pressure averaged 130/80 — close to the cutoff point for normal of 120/80 and certainly not high enough to do anything about. (The cutoff for people is essentially the same.) But in a hospital setting, the dogs’ blood pressure averaged 154/88 — clearly in the high blood pressure range.
A separate study of dogs of six different breeds — Siberian huskies, Labrador retrievers, Doberman pinschers, golden retrievers, Bernese mountain dogs, and German shepherds — found the same thing: for all the dogs, their maximum blood pressure at home was 145/88. In a clinical setting, the maximum was 158/95. This was true even though all the dogs were taken to a quiet examination room and given an acclimation period of 5 to 10 minutes. Their pressure was not taken until they appeared calm and relaxed, which just goes to show that outward demeanor does not necessarily correlate with the pressure at which the blood courses through the arteries. Even a gradually slowing heart rate does not necessarily correlate with gradually lower blood pressure; the two do not have to go hand in hand.
The best way for the doctor to get an accurate blood pressure reading is not only to give your dog several nice, calming moments in a quiet spot when she first arrives at the office but also to truly make visiting the vet a happy experience, with lots of cooing, treats, and gentle handling. In addition, he might want to take your dog’s blood pressure several times during the same visit. That will adjust your pet to having the cuff inflate around her — the more it happens, the less of a big deal it will be.