PetSounds Mobile Veterinary Ultrasound

For Veterinarians

Practical Considerations

The ultrasound is very sensitive in differentiating normal from abnormal. In very few cases, however, is the ultrasound image of a lesion or suspected lesion diagnostic alone. In most cases other information such as radiographs, laboratory work and FNA's or biopsies obtained during the ultrasound exam are combined with the ultrasound images to narrow the list of differentials.

When a tissue sample is needed, one of two techniques is used: fine needle aspirate and/or Tru-Cut biopsy. The Tru-Cut biopsy carries a greater risk of post-biopsy bleeding and inadvertent puncture of non-target tissue, although it too is a relatively low risk procedure compared to surgical biopsy. A coagulation panel is recommended prior to biopsy. Animals with platelet counts as low as 50,000 are generally safe to biopsy if the clotting profile is within normal limits. Either an ACT or a PTT/APTT are acceptable as coagulation profiles. In most cases of liver disease a tru-cut biopsy is favored for diagnosis. Exceptions are confirmation of suspected Lymphoma or Hepatic Lipidosis which can be reliably diagnosed with fine needle aspirates.

Pregnancy exams, cystocentesis and echocardiograms on unstable patients are generally done without sedation or anesthesia. Sedation/anesthesia may or may not be advisable or necessary for abdominal exams depending on the need for motion control, the patient's temperament, the presence of painful conditions, the number of assistants available and other factors.
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There is increased risk in an effort to drain a suspected internal abscess. Generally, attempts to obtain a histopathological diagnosis of suspected bladder tumors with a FNA are not rewarding. Cystoscopy and biopsy through the cystoscope is recommended instead.

Supplies needed for ultrasound exam and ultrasound

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Chris D. Miller, D.V.M.