- A 7-year-old F/S DSH cat was presented for ADR and general malaise.
- This was an initial visit with no previous medical history provided.
- Physical examination found the patient with a rather pot-bellied appearance, but her aggressive nature prevented a thorough palpation of her abdomen and no bloods could be sampled.
- A dash of Domitor and Torbugesic and voila! We now had a compliant and much less stressed patient. 🙂
- A 7-year-old F/S DSH cat was presented for ADR and general malaise.
- This was an initial visit with no previous medical history provided.
- Physical examination found the patient with a rather pot-bellied appearance, but her aggressive nature prevented a thorough palpation of her abdomen and no bloods could be sampled.
- A dash of Domitor and Torbugesic and voila! We now had a compliant and much less stressed patient. 🙂
- Radiographs are still our “go to” diagnostic for the moment, but I am hoping the doctors will be converts to obtaining an ultrasound first soon.
- Lateral whole body radiograph showed a massive amount of fluid occluding the entire abdomen.
- Ultrasound performed by a technician ( me 🙂 ) showed multiple pockets of free fluid in the abdomen along with a large mid-abdominal mass stemming from what appeared to be the liver. It had the same echogenicity as the liver and I thought I was in the right geographical location of the liver as well, but I am still learning how to scan.
- The mass encompassed the entire mid-abdomen with a flattened surface that was difficult to get my probe around.
- The owners opted for humane euthanasia after the doctor confirmed the presence of the large mass and the free fluid which was clear and watery when aspirated.
POST MORTEM NECROPSY
Large liver tumor. Wow! So what do you reach for first? The x-ray gown and gloves or the probe and some gel?
Comments
Very cool case and very
Very cool case and very impressive diagnostics Sonogirl! Perfect illustration of the efficiency of ultrasound as well as the value of spending the client’s money and our time on the appropriate diagniostics! I am truly impressed and envious of your skill.
I too (gently I admit) am trying to convince my boss to consider in-house ultrasound and a great technician (me with training!) to do the scanning. He seems stuck on the idea that he has to become skilled in ultrasound himself – and if we wait on that it will never happen.
Any helpful ideas out there to promote my cause? (other than this great case you presented of course which I will be sure to share with him!)
Very cool case and very
Very cool case and very impressive diagnostics Sonogirl! Perfect illustration of the efficiency of ultrasound as well as the value of spending the client’s money and our time on the appropriate diagniostics! I am truly impressed and envious of your skill.
I too (gently I admit) am trying to convince my boss to consider in-house ultrasound and a great technician (me with training!) to do the scanning. He seems stuck on the idea that he has to become skilled in ultrasound himself – and if we wait on that it will never happen.
Any helpful ideas out there to promote my cause? (other than this great case you presented of course which I will be sure to share with him!)
Abdominal ultrasound is
Abdominal ultrasound is definitly quicker and gives more information, with the added advantage of being able to see “thru” fluid and obtain FNA samples. Radiographs still helpful with gas and looking at boney structures around the abdomen and identifying possible GI tract foreign bodies.
As ultrasound takes time and practice it is better to get 1-2 people in a practice unto speed with the technique.
Abdominal ultrasound is
Abdominal ultrasound is definitly quicker and gives more information, with the added advantage of being able to see “thru” fluid and obtain FNA samples. Radiographs still helpful with gas and looking at boney structures around the abdomen and identifying possible GI tract foreign bodies.
As ultrasound takes time and practice it is better to get 1-2 people in a practice unto speed with the technique.
Exactly Dr.Lobetti, thank you
Exactly Dr.Lobetti, thank you for your input! Catlady, the convincing is to me a “no brainier” there are usually more techs on the treatment floor with 10-15 minutes available to scan a patient if trained properly. Doctors are forever tied up in appointments, in surgery, and buried in client call backs which makes their ability to scan a veritable impossibility solely due to time constraints. The old adage “use your technicians” comes into play here. The whole purpose and drive of a technician is to help, animals, doctors, clients, each other, etc. We want to help our doctors by filling in the blanks when they are busy which is usually all the time. We also LOVE to learn and would appreciate being able to apply those skills in our day to day work. Of course the added bonus to the clinic is a faster diagnosis which will help develop a treatment plan for the patient. A win-win scenario.
Exactly Dr.Lobetti, thank you
Exactly Dr.Lobetti, thank you for your input! Catlady, the convincing is to me a “no brainier” there are usually more techs on the treatment floor with 10-15 minutes available to scan a patient if trained properly. Doctors are forever tied up in appointments, in surgery, and buried in client call backs which makes their ability to scan a veritable impossibility solely due to time constraints. The old adage “use your technicians” comes into play here. The whole purpose and drive of a technician is to help, animals, doctors, clients, each other, etc. We want to help our doctors by filling in the blanks when they are busy which is usually all the time. We also LOVE to learn and would appreciate being able to apply those skills in our day to day work. Of course the added bonus to the clinic is a faster diagnosis which will help develop a treatment plan for the patient. A win-win scenario.
Singing to the choir
Singing to the choir ladies:).. and Remo of course. Need to have a viable probe on the floor in all hours of operation. Its that simple
Singing to the choir
Singing to the choir ladies:).. and Remo of course. Need to have a viable probe on the floor in all hours of operation. Its that simple
I think a clinic owner would
I think a clinic owner would be reluctant to purchase an ultrasound unit and invest in training a single staff member for fear that that staff member may someday leave. That’s a reason why a clinic owner/partner should learn how to use the ultrasound well if they are going to make the investment.
Imagine spending $20K – $40K or more on equipment, then a few thousand more on training, then the staff member who was trained takes that training to another clinic. It happens.
I think a clinic owner would
I think a clinic owner would be reluctant to purchase an ultrasound unit and invest in training a single staff member for fear that that staff member may someday leave. That’s a reason why a clinic owner/partner should learn how to use the ultrasound well if they are going to make the investment.
Imagine spending $20K – $40K or more on equipment, then a few thousand more on training, then the staff member who was trained takes that training to another clinic. It happens.
Ah yes that can happen, but I
Ah yes that can happen, but I think if you are a clinic whose ultrasound machine which was purchased for the doctor’s use is now either a really expensive “cysto machine” or simply collecting dust, training your techs would be the way to go. Hopefully the technicians you select for this type of continuing education are dedicated long-timers that have a passion for their clinic, a love for their patients, and a big interest in learning a ridiculously useful skill. 🙂
Ah yes that can happen, but I
Ah yes that can happen, but I think if you are a clinic whose ultrasound machine which was purchased for the doctor’s use is now either a really expensive “cysto machine” or simply collecting dust, training your techs would be the way to go. Hopefully the technicians you select for this type of continuing education are dedicated long-timers that have a passion for their clinic, a love for their patients, and a big interest in learning a ridiculously useful skill. 🙂
If I am not mistaken June
If I am not mistaken June Boon is not a veterinarian- and wrote the book on veterinary Echocardiography. Just need someone motivated to learn. I suspect a staff veterinarian could leave just as easily.
If I am not mistaken June
If I am not mistaken June Boon is not a veterinarian- and wrote the book on veterinary Echocardiography. Just need someone motivated to learn. I suspect a staff veterinarian could leave just as easily.