Bradyarrhythmia can be a challenge to identify, when considering if an animal has high vagal tone, consider if it’s HR fit with its general appearance. For treatment, be sure to treat any underlying cause e.g. correction of hyperkalaemia. If there are no or limited clinical signs treatment is likely not required (sudden death is very rare). In cases of sick sinus syndrome, advanced type 2 AV block and type 3 AV block an artificial pacemaker is often the only effective treatment.