Vertebral heart score (VHS) in dogs: how to measure it
Lateral thoracic radiograph of an adult dog in which the vertebral heart score (VHS) has been measured. The red lines mark the cardiac axes and the green ones their transfer onto the spine.
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Which statement about measuring the VHS is correct?
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A. Both axes are transferred to the spine starting from the first thoracic vertebra (T1)
The axes are counted from the cranial edge of the fourth thoracic vertebra (T4), not T1.
B. Long axis from the carina to the apex, short axis perpendicular at the widest point; both are added in vertebrae from T4
Correct. The long axis runs from the ventral border of the main bronchus (carina) to the apex, and the short axis is perpendicular at the widest part of the heart. Both are transferred to the spine from the cranial edge of T4 and added. The classic reference value in dogs is 9.7 ± 0.5 vertebrae.
C. It is only valid on the ventrodorsal view
VHS is measured on the lateral view (preferably the right lateral, and always the same one for rechecks).
D. The normal limit is the same for every breed: 8.5 vertebrae
There is a lot of breed variation: Boxers, Cavaliers and Labradors have higher normal values (up to ~11). Around 8 vertebrae is the guide limit in cats, not dogs.
lightbulb Key takeaway
More useful than the absolute value is the trend on serial radiographs of the same dog: a progressive VHS increase anticipates decompensation. Always use breed-specific reference values.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.