Study finds limits and promise in lingual BP monitoring for dogs
Bottom line
A new prospective study in the Journal of Small Animal Practice suggests that tongue-based oscillometric blood pressure monitoring may be a workable fallback for anaesthetised dogs when invasive monitoring isn't available, but with important limits. In 89 dogs under general anaesthesia, researchers collected 1,780 paired measurements comparing lingual oscillometric readings with invasive arterial pressure. Mean arterial pressure and diastolic pressure met American College of Veterinary Internal Medicine-style agreement criteria, but systolic pressure showed wide limits of agreement and a tendency to be underestimated as blood pressure increased. That means the technique may be useful for tracking trends, especially for MAP, but not for relying on systolic values alone. (pubmed.ncbi.nlm.nih.gov)
Why it matters: Blood pressure monitoring is a core part of anaesthetic safety, and invasive arterial monitoring remains the reference standard, though it isn't practical for every patient or procedure. For veterinary teams, the study adds evidence that cuff placement on the tongue could be a practical option in select cases, particularly when limb or tail access is limited, but it doesn't solve the broader accuracy problem seen with oscillometric devices in dogs under anaesthesia. Previous canine studies have also found that oscillometric MAP tends to perform better than systolic readings, and current monitoring guidelines still treat invasive pressure as the gold standard. (pubmed.ncbi.nlm.nih.gov)
What to watch: Expect follow-up discussion around which patients, devices, and cuff sites make lingual monitoring most clinically useful, and whether future validation work can narrow those wide systolic limits of agreement. (vaajournal.org)
Key facts
- Study type
- Prospective study
- Journal
- Journal of Small Animal Practice
- Population
- 89 dogs under general anaesthesia
- Measurements
- 1,780 paired blood pressure readings
- Comparison
- Lingual oscillometric versus invasive arterial pressure
- Main finding
- Mean arterial pressure and diastolic pressure met agreement criteria
- Limitation
- Systolic pressure had wide limits of agreement and was underestimated as blood pressure increased
- Takeaway
- May be useful for trend monitoring, especially MAP, when invasive monitoring is not available
A new study in the Journal of Small Animal Practice adds a larger clinical dataset to an emerging question in anaesthesia monitoring: can the tongue serve as a reliable cuff site for oscillometric blood pressure measurement in dogs under general anaesthesia? In 89 dogs and 1,780 paired observations, the answer appears to be yes for some values, but not all. The investigators found acceptable agreement for mean arterial pressure and diastolic pressure against invasive monitoring criteria, while systolic pressure remained too inconsistent for dependable standalone use. (pubmed.ncbi.nlm.nih.gov)
The idea isn't entirely new. A 2022 experimental study in eight anaesthetised Beagles found that tongue-based oscillometric monitoring compared favorably with pelvic limb and tail sites, and that MAP and diastolic readings were more reliable than systolic values. That earlier work suggested the tongue could be especially useful when assessing hypotension, but it was limited by a small, research-animal population. The new JSAP paper appears to extend that concept into a larger anaesthetised dog population, which is more relevant to clinical practice. (pubmed.ncbi.nlm.nih.gov)
The broader context is important because this is a long-running problem in veterinary monitoring, not just a question of cuff location. Across multiple studies in anaesthetised dogs, oscillometric devices have shown variable agreement with invasive arterial pressure, with MAP usually outperforming systolic pressure. Some devices and protocols meet validation thresholds for selected parameters, while others fail them outright, and wide limits of agreement remain common. That pattern helps explain why the new study's conclusion is cautious: lingual oscillometry may help teams trend MAP and diastolic pressure, but it shouldn't be treated as interchangeable with direct arterial monitoring. (sciencedirect.com)
Current professional guidance reinforces that caution. The 2020 AAHA anesthesia and monitoring guidelines identify blood pressure monitoring as part of routine anaesthetic care, and more recent 2025 small-animal monitoring guidance from the American College of Veterinary Anesthesia and Analgesia continues to describe arterial catheterization as the gold standard when real-time accuracy matters. Those guidelines also acknowledge the practical reality in everyday practice: noninvasive monitoring is often what teams have, especially for shorter or lower-risk procedures. In that setting, knowing which cuff site gives the most clinically useful trend data can make a difference. (pubmed.ncbi.nlm.nih.gov)
Industry and expert reaction specific to this new paper was limited in publicly available sources at the time of reporting, but the surrounding literature points in a consistent direction. Recent validation work in dogs and other species continues to show that lingual placement is promising, particularly for MAP, while systolic readings remain the weak point. A 2024 pig study and a 2025 canine monitoring paper both support the broader message that noninvasive blood pressure technology can be clinically helpful without being precise enough to replace invasive measurement in unstable patients. That's less a contradiction than a reminder to interpret oscillometric data as part of the whole anaesthetic picture. (pubmed.ncbi.nlm.nih.gov)
Why it matters: For veterinary professionals, the practical takeaway is straightforward. If a dog is under general anaesthesia and the tongue is the most accessible site, a lingual oscillometric cuff may provide useful trend information for MAP and diastolic pressure, especially when invasive monitoring isn't feasible. But the study doesn't support overconfidence in systolic numbers, and it doesn't change the standard that direct arterial pressure remains the best option for patients with expected haemodynamic instability, vasoactive drug use, major surgery, or rapidly changing perfusion status. In other words, the tongue may be a better workaround, not a replacement. (pubmed.ncbi.nlm.nih.gov)
There's also a workflow implication for general practice and referral settings. Tongue placement may be useful when limb access is restricted by positioning, draping, catheter placement, or surgical field constraints. Even so, teams will still need disciplined cuff sizing, consistent positioning, and an understanding that oscillometric values can drift with blood pressure range and device algorithm. The underestimation of systolic pressure at higher values in this study is especially relevant, because it raises the risk of missing hypertension or undercalling haemodynamic changes if clinicians focus on a single number rather than trends, pulse quality, anaesthetic depth, capnography, and perfusion markers together. (pubmed.ncbi.nlm.nih.gov)
What to watch: The next step will likely be more device-specific validation, along with studies that test lingual monitoring across breeds, body sizes, disease states, and real-world surgical settings. If those data hold up, tongue-based oscillometry could become a more accepted fallback site in anaesthesia protocols, but the bar for replacing invasive monitoring in higher-acuity cases remains much higher. (vaajournal.org)