AN INDIRECT METHOD FOR THE DETERMINATION

OF BLOOD PRESSURE IN THE UNANESTHETIZED

DOG’

A. C. KOLLS

From the Pharmacological Laboratory, Washington University School of Medicine,

St. Louis

Received for publication May 4, 1920

The determination of blood pressure in the dog or other ex-

perimental animal is beset by a number of difficulties. Some
years ago Pawlow (1) was able to train dogs to lie quietly during
the course of direct blood pressure measurements. He utilized
for this purpose a superficial artery of the leg which he prepared
and cannulated without the use of any anesthetic. It is, of
course, quite possible to perform the operation under anesthe-
sia and in this connection Brooks (2) and Turner (3) may be
mentioned.

Brooks made his measurements with a special cannula after

preparing the artery under ether and allowing the animal to re-
cover. Turner modified this. technique by preparing the artery
under local anesthesia, thus allowing determinations to be made
at once.
The operation is often an undesirable feature in experimental
work, vitiating the experiment. Often, also the blood pres-
sure would be of considerable value during the course of survival
experiments when previous isolation of the artery was over-
looked or deemed unnecessary. It is the author’s belief that a
simple accurate method which can be applied with the same
ease which is now the case with the large variety of clinical meth-
ods devised for man wOuld have distinct value in the laboratory.

1 Presented and demonstrated before the joint session of the Federation of

American Societies for Experimental Biology, Cincinnati, Ohio, December, 1919.
443
444 A. C. KOLLS

The indirect methods which have been described to date are,

with the exception of that by Gaertner (4) and its modification
by Trendelenburg (5), carried out only after an operation of
some type. Gaertner applied his tonometer to the tail of the
dog. Trendelenburg used the same apparatus On the fore leg
of the cat. Tonometric determinations of blood pressure in man
have been supplanted by more accurate methods which give an
insight into both the systolic and diastolic pressure, and it is
fair to assume that tonometric determinations in the experi-
mental animal are attended by the same objections as has been
the case in man. Erlanger (6) applied his sphygmomanometer
to the hindleg of the dog after an operation which was done in
order to convert the flattened leg into a cylinder. The exten-
sive operation alone would preclude this method from applica-
tion were it not also the fact that Erlanger experienced difficulty
in obtaining good pulsations with the sphygmograph in the re-
gion above the minimum level of the pressure, and I quote the
following paragraph from his publication, which refers to the
procedure just cited:

In none of these experiments were the recorded pulsations suffi-

ciently large to permit of an estimation of the maximum pressure by
noting the moment of the abrupt rise in ampliWde-method of V.
Recklinghausen.

Van Leersum (7) also adopted an operative procedure. His

method is essentially the indirect determination of the pressure
on the isolated carotid artery of the rabbit. The artery is pre-
viously brought up to the surface and surrounded by a skin flap.
A special cuff can then be placed about the artery. The method
is applicable to other species than the rabbit but it has, never-
theless, the same objection as the other methods. It will be
seen from this brief that
r#{233}sum#{233} no method has been described
to date which allows dependable pressure. determinations to be
made without surgical intervention. The palpation method
without operation used by Janeway (8) on specially selected
unanesthetized dogs, which is briefly described in an abstract,
is no more dependable than the above cited methods. By the
 INDIRECT DETERMINATION OF BLOOD PRESSURE 445

use of a modified Riva-Rocci cuff Janeway was able to approxi-

mate within J0-15 mm. the systolic pressure in the smaller
arteries of the fore leg of the dog.

THEORETICAL CONSIDERATIONS

The dog’s hind leg is commonly described as cone shaped.

This is far from being an accurate description, however, for, if
one shaves the leg, it becomes apparent that the thickness of

UI!L7
the thigh, i.e., the distance between the internal and external
surfaces varies but little when measured at the upper end and

FIG. 1. Cnoss SECTION OF DOG’S THIGH (LOWER DIAGRAM SHOWS THE

RELATION OF CUFF TO LEG)

lower third of the femur. Further examination will also reveal

the fact that the internal surface is nearly flat while the external
surface curves gently through its middle portion and at its bor-
ders curves more sharply to meet the internal surface (see dia-
grammatic section of leg in figure 1). The so-called “cone” is
formed by the acute angle made by the sharp anterior and
posterior surfaces. Therefore, if one should place over the ex-
ternal surface of the dog’s thigh, having previously shaved the
area, an inflexible cuff and apply pressure to the internal surface,
compression of the femoral artery should result without losing
a component of the force by dragging the cuff distally, or by
forcing the flattened leg into a true cone. Such a cuff is readily
446 A. C. KOLLS

constructed from sheet aluminum. The assumption that, under

the above mentioned conditions, collapse of the artery would
result without loss of force has been found to be correct and the
method to be described embodies this principle.

THE APPARATUS

Figure 2 is a drawing of the cuff with dimensions of the parts.

The aluminum portion is made in two pieces in order that it can.
be adjusted to conform with the size of the leg. The two pieces.
are not only curved at the outer edge but also curved slightly
where they come in contact with one another, thus increasing the

10

FIG. 2. DRAWING OF THE CUFF

depth of the cuff when the width is increased. Two thumb

screws at the back clamp the pieces rigidly together. The rub-
ber compression bag is indicated by the letter A. It is laid over
the internal surface of the leg, and held securely by a piece of
heavy inelastic cloth, B, or leather. The heavy cloth known as
moleskin has proven very satisfactory for this part of the appara-
tus. The cloth is clamped in strips of aluminum at each end.
One end is fastened by a small bolt on which it is freely movable,
the other end is fitted with a leather strap which passes through
a buckle on the back of the aluminum piece. The edges of the
compression bag which overlap the leg may be folded upon them-
selves or placed between the leg and the aluminum portion of the
cuff.
 INDIRECT DETERMINATION OF BLOOD PRESSURE 447

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448 A. C. KOLLS

The cuff just described has been found satisfactory for dogs
between 6 and 14 kilos body weight. When very large dogs
are used a somewhat larger cuff is necessary. These two cuffs
have been found to be adequate for any size of animal.
It is obvious from the experience of Erlanger which has just
been quoted that the ordinary sphygmograph is not sufficiently
delicate to record the pulsations. For this reason it became
necessary to devise a new type of recording instrument. Figure
3 shows this portion of the apparatus, which is a small inverted
piston. The thin brass barrel is attached to a compound lever,
which is counterbalanced by an adjustable weight and ,the lever
suspended by a fine spring. The two levers operate on small
steel pivots, and, although, jewel bearings for the pivots are
not essential they materially enhance the delicacy of the lever.
Gold plating the inner surface of the barrel and stationary
piston reduces the amount of friction between the moving sur-
faces. An accurate fit is not necessary owing to the fact that
some communication is necessary between the sphygmoscope
and the outside air in order to maintain the pressure within this
system identical with atmospheric pressure when gradual changes
in the size of the sphygmoscope bulb take place. The barrel
may, therefore, fit quite loosely on the piston. Below the piston is
a small adjusting screw with which further regulation of the size
of the external communication of the sphygmoscope may be
made. The diameter of the piston on the instrument shown
in figure is inch. Smaller ones further increase the amplitude
of the pulsations which may be desirable when working with
animals with very low pressures. The sphygmoscope is identical
with the one used on the Erlanger sphygmomanometer.
The apparatus is, when assembled, a sphygmomanometer
(fig. 4). For the sake of convenience and portability it has been
mounted on a wooden base on which a Harvard kymograph is
also fastened, and the whole placed in a wooden case when not
in use. The sphygmoscope and the manometer are connected
with the cuff by means of a stockcock obtained from a dismantled
Erlanger instrument. The manometric pressures as well as
the oscifiations of the sphygmograph are made to record on the
drum. The determination is then a matter of graphic record.
INDIRECT DETERMINATION OF BLOOD PRESSURE 449

FIG. 4. THE SPHYGMOMANOMETER

450 A. C. KOI.LS

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FIG. 5. RECORD OF A DETERMINATION ON A NORMAL 1.NANESTHETIZED Do

JIG. 6. COMPARISON OF DIRECT AND INDIRECT METHoDS ON THE ANESTHE-

TIZE!) ANIMAL
 INDIRECT DETERMINATION OF BLOOD PRESSURE 451

Determinations are readily made with the apparatus. The

dog’s leg is shaved and the cuff adjusted as has already been
described. The animal is allowed to lie on his side. An at-
tendant stations himself near the animal’s head and strokes him
if he is not quiet. The observer inflates the cuff and steadies
the leg with one hand while he attends to the instrument with
the other. Unless the inflation of the cuff is carried considerably
above the maximum arterial pressure the animal will, as a rule,
remain quiet while the determinations are being made. Some-
times an animal is encountered who shows considerable curiosity
over the cuff, but a little patience will convince him that no harm
will come of it. With the exception of a few vicious animals,
none have been encountered that did not lend themselves readily
to experimentation. A typical record of the approximation of
systolic and diastolic pressures is shown in figure 5.

CONTROL EXPERIMENTS

In order to test the accuracy of the method determinations

were made under ether anesthesia, while direct determinations
were made as nearly simultaneously as possible from the can-
nulated femoral artery of the opposite side by means of a maxi-
mum-minimum valve. The criteria employed for the estimation
of systolic and diastolic pressures were those customarily used,
namely, the spreading of the limbs of the pulse tracing for the
first mentioned and the sudden decrease in amplitude for the
last. In six such experiments the maximum differences between
the direct and indirect determinations did not exceed 5 mm.
Figure 6 is an example of one of these controls.

SUMMARY

An indirect method is described for the estimation of systolic

and diastolic blood pressures in the unanesthetized dog. The
apparatus is a sphygmomanometer equipped with a special type
of cuff which permits of compression of the artery without dis-
tortion of the leg, and a new type of sphygmograph of sufficient
delicacy to record the pulsations from an artery as small as the
femoral artery of the dog.
452 A. c. KOLLS

REFERENCES

(1) PAWLOW: Arch. f. d. ges. Physiol., 1878, xvi, 266; ibid., 1879, xx, 215.
(2) BROOKS: Heart, 1910, ii, 5.
(3) TURNER, MARSHALL AND LAMSON: Jour. Pharm. and Exp. Ther., 1915, vii,
129.
(4) GAERTNER: MUnch. med. Wochschr., 1900, p. 1195.
(5) TRENDELENBURG: Zeitschr. exp. Med., 1913, ii, 1.
(6) ERLANGER: Johns Hopkins Hosp. Rep., 1904, xii, 53.
(7) VAN LEERSUM: Arch. f. d. ges. Physiol., 1911, cxlii, 377.
(8) JANEWAY: Proc. Soc. Exp. Biol. and Med., 1919. vi. 108.