Veterinary Ultrasound & The General Practitioner

By: Lorne Caroll DVM

Veterinary ultrasound was once considered a diagnostic modality restricted to use in academic institutions and referral centers only. Since its insurrection in the 1970’s, veterinary ultrasound has advanced in a number of ways that now allows for its daily use in general practice. Advances in research and technology, education and competitive pricing have now made ultrasound easier, better and available to all general practitioners. The average pet owner now has expectations that their family veterinarian will have ultrasound diagnostic technology at their disposal should their animal ever require it. Ultrasound is more user friendly and less intimidating and great for use in any general practice technological advances such as:

  • Improved processing power & speed 
  • Reduction in machine size & footprints Windows-based intuitive software platforms
  • Probe frequency ranges & performance
  • 3 and 4 D advanced imaging
  • New modalities-cross beam & speckle reduction

The costs of newer and better veterinary ultrasound machines have become so much more affordable. Features such as, B-mode, M-mode, spectral Doppler with pulse wave and continuous wave and colour that used to be found only in academic and referral facilities are now found on smaller machines with better image quality often at a fraction of the price. The pricing of new ultrasound machines is designed to facilitate its daily use in veterinary practice, augment good veterinary care and generate revenue for the veterinary hospital. Hospitals utilizing ultrasound technology are effectively realizing an economic return similar to or greater than radiology due to ultrasound’s potential broader scope of use. Ultrasound provides valuable diagnostic information with virtually no risk and is non-invasive to the animal. Veterinary staff such as associate veterinarians and registered animal health technologists can receive appropriate training to utilize the benefits of ultrasonography. Veterinarians can now attain high levels of ultrasound training, education and confidence increasing the use of ultrasound in daily practice than ever before. With smaller, improved machines, reference texts, materials and continuing education. The general practitioner can achieve a high level of skill and confidence in a relatively short period of time. Some recommendations to aid veterinarians to become skilled sonographers more easily and quickly are:

  • Purchase the latest and most user friendly ultrasound machine with appropriate features and probe frequency range to perform the studies you are in (ie large or small dog/cat or abdominal versus cardiac)
  • Keep the ultrasound machine accessible to minimize efforts for its use. If the ultrasound machine is tucked away in a corner of the hospital gathering dust…
  • Familiarize yourself with the ultrasound features and navigate through the windows and menus options 
  • Have good reference texts and images readily available. Some veterinarians will keep these right on their ultrasound machine
  • Take as many CE courses as possible scil animal care company's education Schedule 
  • Use the ultrasound daily on all elective procedures such as spays to quickly bring familiarity of normal anatomy, organ location, tissue interfacing and echogenicity

"What is your diagnosis?"

 

Case Presentation:

10 year male, neutered Cocker Spaniel with coughing and lethargy.

Echocardiographic Findings:

Pulmonary Arterial Dilation (MPA:Ao > 1 = dilation) Tricuspid Regurgitation with peak velocity of 3.5 m/s Pulmonary Insufficiency velocity of 3 m/s
Right Atrial Enlargement
Right Ventricular dilation and hypertrophy
Flattening of Interventricular Septum with ↑Right Ventricular pressures with paradoxic motion Poor Left Ventricular filling (↓Preload) and relative Left Ventricular thickening (pseudo hypertrophy)

Diagnosis: Pulmonary Hypertension


"What is your diagnosis?"

Case Presentation:

7 year female spayed Miniature Schnauzer with vomiting, lethargy and abdominal discomfort

Increased lipase, amylase, an inflammatory leukogram and increased Spec CPL

Ultrasound findings:

Pancreatic enlargement with peripancreatic hyper echogenicity and an associated hypoechoic, fluid filled structured surrounded by a capsular membrane. Adjacent duodenal wall focal hyperechogenicity.
Fine Needle Aspiration Performed

Cytological Results:

RBCs, WBCs in a proteinaceous fluid with cellular debris. No organisms found.

Diagnosis: Pancreatic Pseudocyst