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Oddly enough, we have found that, at the authors' own cardiology clinic at Texas A&M, they advise the owners of their cavalier patients to skip echocardiograms and to rely upon annual auscultations (stethoscopic examinations) and annual x-rays to detect heart enlargement instead of echos

10.1186/1475-2840-12-1 [DOI] [PMC free article] [PubMed] [Google Scholar] Urva S., Quinlan T., Landry J., Martin J., Loghin C

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When dosed correctly at 400-500mcg five days per week, we consistently see 2-3 inch waist reductions over 12 weeks." Medi-Spa Director, 2026 Understanding realistic expectations prevents disappointment and helps maintain consistency with protocols