petMAP graphic User manual

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Blood Pressure Measurement Device
 Digital display of systolic,
diastolic, mean arterial
pressure and heart rate.
 Real-time display of the
oscillometric “envelope”.
 Graphical trend of
measurement session values.
 Real-time calculation and
display of the NSV.
 Tabular list of measurement
session values.
Developed by:
Manufactured,
Distributed and
Serviced by:
www.petmap.com
[phone] [phone]
Patents Pending
Ramsey Medical, Inc.

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Blood Pressure Measurement in Animals
Measuring accurate blood pressure (BP) on animals is not trivial, (it
is much more difficult than in humans) and lots of experience and
attention to every detail is important: limb selection, proper cuff size,
snug fit of the cuff, position of animal so that no weight or pressure is
on the measurement limb or cuff, a relaxed and still animal (let the
owner hold it in a comfortable position), an experienced and VERY
PATIENT measurement person and possibly a patient assistant as
well. And, multiple BP measurements MUST be made during the
BP measurement session.
Experts in the field of animal BP measurement stress the important
elements of the blood pressure determination process are the skill,
experience, and patience of the person measuring BP. The most
important element taught is the patience of the person measuring the
BP and their rapport with the animal.
Instructors teach that readings on at least 25-50 animals should be
completed before practitioners consider themselves experienced and
skilled in taking BP. The measurement process is an art, a skill, and
a science all in one . . . when done well.
The best way to learn to use the petMAP is to practice taking
readings on your finger. This will allow you to get comfortable with
the device prior to using it on patients. Even after practice, it may
take 10 - 25 minutes to get the 4-8 good readings (minimal animal
motion during the reading and the determination completed in
under 45-60 seconds) needed to accurately assess the animal’s BP.
The use of petMAP’s unique “Nominal Session BP Value”
(NSV) is recommended as the charted BP for the session since it
eliminates “outliers” which can distort an ordinary average of the BP
values and hence is a more robust measure of the animal’s true
pressure during the session.
Remember that research has shown that if an animal is upset
or agitated due to handling or due to the measurement procedure
itself, it will take 8-10 minutes, after the animal is calmed and
relaxed, for the animal’s blood pressure to return to normal.
Measurements on an agitated animal are not an indication of their
normal BP and are usually worthless clinically when diagnosing a
hypertensive animal.
Manual Copyright © 2005-2009 by Ramsey Medical, Inc. All rights reserved. No part
of this publication may be reproduced or distributed in any form or by any means,
without the prior written permission of Ramsey Medical, Inc.

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Table of Contents
Description 3
Applications / Advantages 3
Controls and Indicators 6
General Information and Helpful Tips 10
Operating Instructions 11
Blood Pressure Values 17
Battery Considerations/Replacement 18
CritterCuff™/RamseyCuff™ Information 20
Maintenance 22
Troubleshooting 22
Specifications 24
Warranty 25
Repairs 25
Product Information 26
Explanation of Symbols
Power/Page Button
Multi-Function Button

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petMAP™ New Technology for Better Accuracy
The Ramsey Medical, Inc. petMAP is a battery powered
veterinary blood pressure measuring device which has been
optimized for accuracy through correlation to intra-arterial BP
measurements in dogs and cats at three different cuff sites.
Based on our development studies in dogs and cats, this
optimization for both species and cuff site is necessary for
improved accuracy and the best possible correlation with directly
measured intra-arterial pressures, the “gold standard” for BP.
This unique accuracy enhancing feature (PPO—petMAP
Proprietary Optimization) is proprietary to Ramsey Medical, Inc.,
and is only available with petMAP and other Ramsey Medical BP
measurement devices.
petMAP utilizes the oscillometric method which simplifies the
measurement of blood pressure in companion animals. petMAP
measures all of the blood pressure parameters (systolic,
diastolic, mean arterial pressure, and heart rate), enabling
accurate diagnosis and management of hypertension. The
petMAP is also useful for monitoring BP and heart rate during
surgical and dental procedures on animals under anesthesia.
petMAP provides another unique and proprietary feature, the
“Nominal Session BP” (NSV) which enhances the veterinarian’s
ability to accurately diagnose, trend, and manage hypertension in
animals over time. All of the session readings are analyzed by
the petMAP and a “Nominal Session BP” is displayed. This
“Nominal Session BP” is not an average of the BP readings, but
a substantially more robust statistical measure of the animal’s
nominal BP during the BP session since it eliminates BP outliers.
Applications & Advantages
The petMAP offers major advantages over previous veterinary
blood pressure (BP) measuring devices and methods. It is small,
fits comfortably in the hand, is quiet (so the animal remains
calmer and less stressed, enhancing accuracy), and can be
carried easily in a pocket.

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The sensitivity of petMAP permits BP measurement in cats
and dogs, as well as in larger and smaller animals. The
accompanying CritterCuffs™ are specifically designed to
be soft for animal comfort, and sensitive to enhance
measurement accuracy. Additionally, PPO enhances the
accuracy achieved by allowing the user to select the specific
species (dog or cat) and the specific cuff site (forearm, tail, or
hind foot). PPO is unique and significantly improves the
correlation to direct intra-arterial pressure measurements. Also
unique and proprietary to petMAP is the automatic computation
of the “Nominal Session BP” (NSV) as the measurement
session progresses.
Using petMAP, the BP can be measured in conscious or
anesthetized animals. In conscious animals, the petMAP is
less stressful to the animal as compared to the Doppler method
since there is no need for clipping of fur, no application of
ultrasonic coupling gel, and no need to position a transducer
over the animal’s artery. Also, since petMAP is quiet, it does
not alarm the animal like the unfamiliar sounds from the Doppler
unit’s speaker box.
In summary, the petMAP’s advantages over prior
veterinary BP devices are many. In addition to
improved accuracy with PPO and the automatic
computation of the NSV, advantages are:
Small size, hand held, easily carried in a pocket, battery
powered using two ordinary and easily replaced AAA
batteries and there is:
No clipping of fur . . . time consuming and frightens the animal.
No messy gel . . . required using Doppler . . . and is . . . messy.
No transducer to connect, position, hold, readjust, and break.
No speaker box to connect, position, and frighten the animal.
No speaker, alarms, or startup noises to disturb the animal.
No long, thick, and cumbersome hose to deal with.

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Features and Benefits
petMAP graphic is a technologically advanced oscillometric BP
measurement device designed for use in the broadest range of
patient sizes and blood pressures. Compare its features and
benefits in the chart below:

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Controls and Indicators
Power/Page Button: Button has three functions:
1) Turns the device On.
2) Once on, changes screen views from the measurement page
to the graphic results page to the tabular results page.
3) Pressing and holding the Power/Page button for 4 seconds will
turn petMAP Off. This is also possible by pressing both the
Power/Page and Multi Function buttons simultaneously.
Multi-Function Button:
1) Species and Cuff Site selection:
Repeated quick presses and releases incrementally
selects species (Cat or Dog) and cuff sites: forearm, hind foot,
or tail. A setting for “none” is also available. Always setup for
the appropriate species and site before measuring and
recording the BP.
2) Changing Display Brightness:
Pressing and holding down the Multi- Function button
adjusts the brightness of the display.
Power/Page
Multi-Function
Battery Change Screw
Systolic/Diastolic
(MAP)
Cuff pressure
(yellow)
Power ON LED
Cuff pressure scale
& manometer
(Determination descriptor codes - used by remote support)
Low battery LED
(red)
Low gain channel
(magenta)
High gain channel
(Green)
Species & cuff
site optimization
Heart rate

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Power ON Indicator: Iluminates green when the unit is
powered. (In order to conserve battery life, the petMAP will
automatically shut off after 10 minutes of “no use”).
Low Battery Indicator: The low battery indicator may
flash occasionally during a determination. This is a warning
for battery replacement. When the light remains illuminated,
battery replacement is required. Always replace both AAA
batteries at the same time to ensure proper performance.
Observe the proper orientation of the batteries, since the unit
will not function, and may potentially be damaged, if the
batteries are not inserted properly (See Section on Battery
Considerations).
Species & Cuff Site Settings: Used to select and display the
species (dog/cat) and cuff site (forearm, hind foot, tail).
petMAP may be used in the optimized mode or the
non-optimized mode as described below:
Optimized Mode: PPO for species and cuff site is
unique to petMAP. This feature provides determination
values with the best possible correlation to intra-arterial
pressures. These petMAP settings are called the
“Optimized” modes.
Previous generation BP measurement devices are not
specifically optimized to better correlate with direct
intra-arterial measurements in cats and dogs and for cuff
site. Consequently, they will typically read lower BPs
than the readings obtained with the petMAP, assuming
that the petMAP is set appropriately for the species and
the cuff site on which the BP measurement is being
made.
Non-Optimized Mode: If a user is more comfortable with
the lower readings because of what they have seen in
the past with older generation devices, the petMAP can
be set to display “non-optimized” values. This petMAP
mode will correlate better with the lower readings the
user is accustomed to seeing, but the values will not
correlate as well with intra-arterial pressures.

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Inflation Bulb:
Use to inflate cuff.
Deflate Trigger
locked up (valve closed) Deflate Trigger locked down (valve open)
This non-optimized mode should be used when:
1. The user wants values that better correlate to
other oscillometric devices and/or Doppler values.
2. The use is measuring on a species other than a
cat or a dog.
Deflate Trigger: When locked in up position (valve
closed), cuff is ready for inflation.
When locked in down position (valve
open), purges air from the cuff.
Cuff Connector: Attach cuff
connector securely to device
connector.

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Systolic/Diastolic
(MAP)
Cuff pressure
(yellow)
Power ON LED
Cuff pressure scale
& manometer
(Determination descriptor codes - used by remote support) Low battery LED
Low gain channel
(magenta)
High gain channel
(green)
Species & cuff
site optimization
Heart rate
Measurement Page
Graphic Results Page
Tabular Results Page
NSV Values for systolic,
diastolic, heart rate and
(MAP)
Session’s values plotted
with elapsed time
Session’s Results
Column 1: Approx. time (min)
since Power ON
Column 2: Systolic/diastolic
Column 3: (MAP)
Column 4: heart rate

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General Information & Helpful Tips
IMPORTANT: For accurate BP readings with petMAP, only
Ramsey Medical, Inc. CritterCuffs and RamseyCuffs should be
used.
Improper cuff size and improper cuff fit will result in inaccurate
(or no) BP readings. petMAP requires a cuff whose width is
approximately 42 - 50% of the circumference of the forearm,
the hind foot, or the tail of the animal. The index line on the cuff
should fall within the “optimum region” shown by the dotted
lines on the cuff, but NEVER outside of the solid boundary
lines. For proper fit, the cuff must be snug, but not painfully
tight (see CritterCuff information).
Measuring blood pressure in companion animals requires:
1. A cooperative animal that is not moving
2. A patient, well trained veterinarian or technician
3. Accurate measuring equipment
4. The right size cuff properly applied to the limb.
Veterinarians who teach BP seminars point out the most
important requirements are the skill, training, and patience of
the person taking BP. Also, a calm animal is essential.
petMAP is specifically designed to allow the user to get good
determinations while also calming the animal. Even so, many
animals will require extra time and patience. If an animal is
restless, giving them 8 to 10 minutes to calm down may help
and should restore their BP to their usual level.
Accurate BP readings, even on a relaxed animal, require
proper cuff size and a “snug-tight” fit. Use the “optimum”
lines (see CritterCuff information).
If you have trouble getting good determinations, try:
1. Calming the animal so that they are not moving
2. Checking cuff size for “optimum” fit and snugness
3. Gathering more operator patience.
Cold Animals: If the animal is noticeably cold, it may require
5 to 6 attempts in order to achieve any BP reading.
Trembling Animals: It will be very difficult to get accurate BP
readings on a trembling animal since the rhythmic motion of the
cuff can mimic the rhythmic beat of the heart.

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OPERATING INSTRUCTIONS:
1. The animal should be in a comfortable position; noise and
stress should be minimized. Having the owner present and
holding the pet is often the best way. There should be no
weight bearing or pressure on the limb on which the cuff is
being used. Do not attach cuff to petMAP yet.
2. Refer to “CritterCuff™ Information” section to explain
selection of proper Cuff Size and Cuff Fit. Place the
appropriate size cuff on the animal at one of these sites:
1. forearm 2. tail or 3. hind foot. To achieve the most
accurate and consistent readings, it is recommended that
the forearm or the base of the tail be used on cats (either
works well). For dogs, the base of the tail is the preferred
site, followed by the forearm. The hind foot is the least
accurate and should only be used if the forearm and/or tail
cannot be used.
3. The cuff should fit “snug tight”, tight enough to get all of the
air out of the cuff and tight enough so that it will not fall off,
but it should not be so tight that it hurts the animal or is so
tight it functions as a tourniquet when not inflated. The
proper size cuff for the limb chosen, and its “snug tight”
application are absolutely essential if good results are to be
achieved.
Forearm cuff site
(Below elbow joint)

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4. Turn the petMAP ON. If there is a “Nominal Session
BP” (NSV) from the previous BP measurement session, it
will be displayed until the cuff pressure is raised over 30
mmHg. At that time that NSBP will be erased and
“forgotten forever” so make sure it has been recorded
before starting a new BP session.
In addition, the user may view the previous session’s
values on both the graphic display screen and the tabular
display screen.
5. Press and release the Multi-Function button to select the
proper species and site. If the user does not desire
optimized readings, use “none”. (See Species & Cuff Site
Settings, in the Controls and Indicators section).
6. Attach the cuff hose to the petMAP securely, and verify
that the deflate trigger is in the closed (up) position.
7. Cuff Inflation: One steady firm (but gentle) squeeze of the
inflation bulb will inflate most cuffs (be careful not to open
the deflate trigger while inflating). As you increase cuff
size more than one bulb inflation may be required. Inflate
the cuff 35 – 40 mmHg higher than the expected systolic
pressure. (Typically for older cats, utilize an initial
inflation pressure of 200-220 mmHg and slightly lower for
young cats and most dogs.) DO NOT OVER-INFLATE.
Over-inflation (pressures beyond 260 mmHg) may cause
damage to the petMAP and harm the animal.
Tail cuff site
(Approximately 1/2”
from base of tail)
Hind foot cuff site
(Between dewclaw and heel)

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8. Automatic Deflate:After cuff inflation, leave the deflate trigger
in the closed (up) position. The petMAP’s internal electronic
valve will automatically deflate the cuff pressure in a series of
steps. The petMAP can be placed on the surface upon which
the animal is resting so that the operator has both hands to
pet and calm the animal during the determination. This will
minimize animal movement.
The user may view the display to follow the progress of the
readings. A good determination will appear as follows:
Please refer to the examples at the end of this section for
further information about interpreting the display. If the user
concludes that a determination is not progressing correctly
(i.e. too much motion artifact), the user may terminate the
reading by opening the deflate trigger. The user will then get
the following screen display:
Once the animal is calm, the user may initiate another reading
by closing the deflate trigger and squeezing the bulb.

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9. When the BP determination is complete, the air is purged from
the cuff automatically or by using the deflate trigger. The petMAP
will display BP and Heart Rate as follows:
10. To obtain another reading, just re-inflate the cuff. This may be
done from any of the display screens.
11. To view the session’s values graphically, including the NSV,
press the Power/Page button once. petMAP computes the NSV
from a minimum of 2 readings and up to the last 10 in a session.
12. To view a tabular listing of the session values, push the Power/
Page button again.
Systolic
Mean Arterial
Pressure
Diastolic
Heart rate

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BP determinations that are showing ragged oscillometric
envelopes like the BAD and the UGLY examples should be
terminated while in process; the patient should be calmed to
reduce motion before a new determination is started.
The GOOD, the BAD, and the UGLY . . .
GOOD BAD UGLY

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Addressing BP Measurement Difficulties:Determine and
correct the reason for the BP measurement difficulty. Often
the problem is one or more of:
1) movement during the determination (calm the animal)
2) cuff is not proper size or snugness (check size/fit)
3) initial cuff inflation is too low (pump cuff higher)
Remember that measuring accurate BP on animals is
not trivial and attention to every detail is important. For
example, steps to improve the measurement process after a
failure might include one or more of the following: (1) resize
or tighten the cuff (2) reposition the animal so that there is
no weight bearing on the limb on which the cuff is being
used (3) calm the animal by petting it to reassure it until it is
again relaxed and not moving, waiting 8-10 min for animal
to re-establish its normal BP after calming it (4) change cuff
to another site if repeated failures.
Experts in the field of animal BP measurement stress
that the most important elements contributing to the success
of the blood pressure measurement session are the skill,
experience, and patience of the person measuring the
pressure. They also suggest that it will typically take 10-25
minutes to get the 4-8 GOOD readings needed to accurately
measure the animal’s pressure. Remember, if the animal is
upset, it will take 8-10 minutes for the animal’s blood
pressure to return to normal once the animal is calmed.
CAUTION: Do not keep the cuff inflated on an animal
for more than a minute. Animal distress, blood
circulation interference, and even injury to the animal
could potentially occur. Protracted determination
times are generally caused by excessive animal
movement and should be terminated by deflating the
cuff fully and then starting again.

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Blood Pressure Values in Cats and Dogs
Blood pressure (BP) is most accurately measured directly using an
intra-arterial catheter. Knowing an animal's BP is often required
for diagnosis and treatment. However, since intra-arterial
pressures are often impossible or impractical to measure, a variety
of indirect measurement devices (Doppler and oscillometric) have
been developed to permit estimation of an animal's BP. It is
important to note that the different methods and different brands
of indirect BP devices will likely produce different BP values in the
same animal, as each estimates blood pressure in a somewhat
different way. Further, all indirect methods are dependent on the
state of the animal and, to some extent, the experience and skill of
the user.
petMAP has been designed to better correlate with intra-arterial
pressure readings through its optimizations for species and cuff
site. The result of this better correlation with intra-arterial
readings is that petMAP’s readings will almost always be 10-20%
higher than Doppler or other oscillometric devices. If correlation
of petMAP BP readings with other BP devices (other than direct
intra-arterial readings) is desired by the user, petMAP should be
used in the non-optimized mode (described in the Controls and
Indicators section).
"Normal” BP in companion animals varies with the species, age of
the animal, method used for BP determination, and the emotional
state of the animal as a result of animal handling and other
circumstances. "Normal” systolic values can range from 110 to
160 mmHg and most diastolic values range from 55 to 100 mmHg,
if the animal is undisturbed and at rest. Normal BP is different for
cats and dogs and can also vary by breed within species.
Hypertension is generally characterized as pressure
>170/110 mmHg in relaxed animals; hypotension is pressure
<90/50 mmHg in the awake animal. However, much of the BP
data that has been used to establish these ranges has been

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measured with indirect devices and, as previously mentioned,
most of these devices (Doppler and oscillometric)
underestimate the intra-arterial systolic pressure by 10-20%.
The study of hypertension and its treatment is an evolving
subject in veterinary medicine. It is suggested that
veterinarians refer to the literature, including the ACVIM
Consensus Statements, published on this topic.
Battery Considerations
In order to maximize battery life, petMAP is designed to turn
the display completely OFF following a determination when the
unit is motionless for more than 12 seconds. If the unit is not
re-pressurized for a new determination within 10 minutes,
petMAP will turn OFF. Battery life for petMAP will vary
depending upon the type of batteries used and the number of
determinations made.
Three types of AAA batteries may be used to power the
petMAP:
1) disposable alkaline batteries (Energizer Alkaline and
DuraCell Coppertop, for example)
2) rechargeable NiMH (nickel metal hydride) batteries (850 –
1000 mAh)
3) disposable lithium batteries.
Disposable zinc-carbon (Heavy Duty/ General
Purpose) batteries and NICAD batteries are not
recommended.
Fresh alkaline batteries and fully charged NiMH batteries yield
approximately equal battery lives; however, NiMH batteries are
rechargeable and may be reused many times, making them
the most affordable long-term option. Lithium batteries yield
almost twice the life of alkaline batteries, but are approximately
twice as expensive. Zinc-carbon batteries yield approximately
one-third the life of alkaline batteries and, therefore, are not
recommended for petMAP.
The LoBat (red LED) signal is activated well before the
batteries are completely depleted. Up to one hour of
continuous usage may remain on alkaline batteries once the
NOTE:

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Battery Replacement
Loosen the battery change screw and remove the battery cover.
While observing polarity, replace the depleted batteries with fresh
ones. To reinstall the cover:
1) press it firmly down against the battery compartment
using two fingers (one on each side of the screw)
2) retighten the screw firmly (Do not over tighten)
 Always replace both batteries
 Do not mix types, brands, or models of batteries in petMAP
 Be certain the batteries are installed according to the polarity
symbols marked on the battery compartment.
Warning: Improper installation of batteries will prevent
petMAP from working and may damage the device.
Use new AAA batteries (Alkaline, Lithium, Nickel Metal
Hydride (Rechargeable), no NICAD or “Heavy Duty”)
WARNING: IMPROPER INSTALLATION OF BATTERIES WILL
PREVENT THE petMAP FROM WORKING AND MAY CAUSE
DAMAGE TO THE DEVICE!
Negative
Terminal Up
After replacing
batteries, turn
petMAP ON to
confirm proper
operation.
Battery
Change Screw
Battery
Cover
Positive
Terminal Up
LoBat signal activates. However, if either lithium batteries or
NiMH rechargeable batteries are being used, a much shorter
period of continuous use following the LoBat signal is to be
expected.