Effect of body condition score on the interobserver variability of vertebral heart scale assessment in dogs

Karin Bruining-Staal, Ilse Tiemessen, Johannes C M Vernooij, Niek Beijerink

Background
The vertebral heart scale (VHS) is a commonly used radiographic method for assessing canine heart size and identifying cardiomegaly. Obesity, a prevalent condition in dogs, can create intrathoracic fat deposits that may obscure the cardiac silhouette and potentially increase variability in VHS measurements among observers. This study investigated whether body condition score (BCS) affects the interobserver variability of VHS assessment.

Methods
This prospective observational study analyzed thoracic radiographs from 56 client-owned dogs, categorized by BCS into normal (4/9–5/9) and overweight (6/9–9/9) groups. Three trained observers measured VHS using the standardized Buchanan method. Differences in measurements were statistically evaluated using Bland-Altman plots and linear mixed models, with factors including BCS, observer, sex, and age.

Results
-No statistically significant differences in interobserver variability of VHS were observed between normal and overweight dogs.
-Variability did not differ significantly by observer, sex, or age category.
-The geometric mean of VHS variability in overweight dogs was estimated to be marginally higher than in dogs with normal BCS but was not significant.
-Overall, the intraclass correlation coefficient was high (0.954), indicating strong agreement among observers.

Limitations
-The sample size for extremely overweight dogs (BCS 7/9–9/9) was limited, potentially introducing a type II error.
-The study did not correlate VHS measurements with echocardiographic findings, leaving accuracy in obese dogs unverified.
-Single-observer BCS scoring might have introduced subjectivity.

Conclusions
BCS does not significantly impact the reliability of VHS measurements among trained veterinarians. Despite potential challenges from intrathoracic fat, the VHS remains a reliable and objective tool for assessing cardiomegaly. Future studies could explore the accuracy of VHS against echocardiographic findings, particularly in obese dogs.

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