Point-of-Care Ultrasound Techniques for the Small Animal Practitioner

4 Chapter 4 Figure 4.1. Longitudinal and transverse orientation shown on anatomical plan... Figure 4.2. Examples of image planes for the kidney. In (A) the kidney is sh... Figure 4.3. Standard ultrasound screen orientation, longitudinal (sagittal) ... Figure 4.4. Electronic ultrasound probes and their characteristic B‐mode ima... Figure 4.5. Angle of insonation. The angle at which the ultrasound beams str... Figure 4.6. Rocking. The position of the probe is not moved on the patient a... Figure 4.7. Fanning. The position of the probe is not moved on the patient a... Figure 4.8. Rotating. The probe remains on the same focal point of the patie... Figure 4.9. Sliding. The probe is moved across the body in the longitudinal ... Figure 4.10. Sweeping. The probe is moved across the body in the transverse ... Figure 4.11. Pressure/Compression. Neither the probe position on the body ... Figure 4.12. Labeling the image. The same image in (A) and (B) of a liver ma... Figure 4.13. Probe head damage. The damage to the surface of this probe was ...

5 Chapter 5 Figure 5.1. Wet and part the hair. In (A) the area is wetted without parting... Figure 5.2. Air trapping. In (A) the probe head is placed on a wetted mat of... Figure 5.3. Best practice is the head of the patient and machine in the same... Figure 5.4. The helper hand and probe hand make a difference. In (A) the hel... Figure 5.5. Anatomy generally better recognized in longitudinal (sagittal) o... Figure 5.6. Short‐axis and long‐axis lines for echo views. If on... Figure 5.7. V trough your patient with your nonprobe helper hand. Your nonpr... Figure 5.8. When extending the foreleg, don’t touch the paw! Gently extend t... Figure 5.9. “Kickstand” your probe hand to prevent drifting. Hav... Figure 5.10. Paying attention to the direction of the beam. If the sonograph... Figure 5.11. Be aware of the probe marker. Every probe has a marker or notch... Figure 5.12. Focus cursor and depth. In (A) there are four focus cursors ( up ... Figure 5.13. Depth setting and the centimeter scale. The image is the same a... Figure 5.14. Splenic mass and estimating size from the centimeter scale. The... Figure 5.15. An algorithm for trouble shooting image acquisition with some c... Figure 5.16. Time gain compensation (sliders) and the overall gain (wheel). ... Figure 5.17. Slice‐thickness artifact at the AFAST CC view. (A) and (B...

6 Chapter 6 Figure 6.1. AFAST on a dog in right and left lateral recumbency. In (A) AFAS... Figure 6.2. AFAST and its five views performed in right lateral recumbency i... Figure 6.3. AFAST and its five views performed in left lateral recumbency in... Figure 6.4. Modified lateral‐sternal recumbency. The AFAST views are p... Figure 6.5. Never use dorsal recumbency without doing a Global FAST to asses... Figure 6.6. Correlation of AFAST acoustic windows with a dog in right latera... Figure 6.7. Longitudinal orientation for AFAST. (A) Kidney in longitudinal o... Figure 6.8. The DH view in a dog. In (A) is shown where the probe is placed ... Figure 6.9. Images showing various anatomic features at the DH view. None of... Figure 6.10. Variety of typical positive studies at the DH view. In (A) free... Figure 6.11. The “cardiac bump” at the DH view. In (A) the apex ... Figure 6.12. Variety of typical CVC images with other relevant structures. (... Figure 6.13. Mirror image artifact at the DH view. Mirror image artifact occ... Figure 6.14. Showing B‐lines along the pulmonary‐diaphragmatic interface.... Figure 6.15. Pitfalls at the DH view related to the gallbladder, hepatic ven... Figure 6.16. Additional examples of pitfalls at the DH view. (A) and (B) are... Figure 6.17. The SR view in a dog. In (A) is the external location where the... Figure 6.18. Examples of typical negative studies at the SR view. In (A) the... Figure 6.19. Examples of typical positive studies at the SR view. In (A) the... Figure 6.20. Edge shadowing artifact off the left kidney. (A) and (B) are th... Figure 6.21. Both kidneys in view at the SR view. In the cat and the small d... Figure 6.22. Pitfalls at the SR view and linear stripes are not free fluid. ... Figure 6.23. The CC view in a dog. In (A) the direction of the probe is show... Figure 6.24. Examples of typical negative studies at the CC view. In all the... Figure 6.25. Examples of typical positive studies at the CC view. In (A), (C... Figure 6.26. Relevant artifacts at the CC view. (A) A mirror image artifact ... Figure 6.27. Calculi versus intestinal tract. The sonographer will readily a... Figure 6.28. Various abnormal intraluminal urinary bladder findings. (A) An ... Figure 6.29. Pitfall of the thigh or a mass or other. In (A) and (B) are ide... Figure 6.30. HRU view in a dog. In (A) and (B) the direction of the probe is... Figure 6.31. Examples of typical negative studies at the HRU (SRU) view. The... Figure 6.32. Examples of typical positive studies at the HRU (SRU) view. In ... Figure 6.33. False positives at the HRU (SRU) view. In (A) and (C) are the a... Figure 6.34. HR5th view on a dog. In (A) two different approaches are shown ... Figure 6.35. AFAST‐focused spleen. The spleen represented by the banan...

7 Chapter 7 Figure 7.1. AFAST‐applied abdominal fluid scoring system. Calculating ... Figure 7.2. The “measurement” modification of the AFAST‐applied abdominal fl... Figure 7.3. Modification of the AFAST‐applied AFS. The figure shows ho... Figure 7.4. AFAST‐applied AFS and the small‐volume versus large‐volume bleed... Figure 7.5. AFAST‐applied AFS system and the small volume versus large volum... Figure 7.6. Clotted blood adjacent to the left kidney at the SR view. In pen... Figure 7.7. Evaluating for blood flow of the left kidney at the (SR) view. I... Figure 7.8. Example in a cat using the modified AFS system. (A) AFAST in rig... Figure 7.9. Composite showing comparison of abdominal radiographic serosal d... Figure 7.10. Normal and edematous gallbladder wall and sonographic striation... Figure 7.11. Gallbladder wall edema in dogs with anaphylaxis. Three differen... Figure 7.12. Integrating gallbladder wall edema with characterization of the... Figure 7.13. The racetrack sign of PCE with integration of the CVC character... Figure 7.14. Relative positioning of gallbladder to diaphragm to caudal vena... Figure 7.15. Measurements at the AFAST CC view for estimating urinary bladde... Figure 7.16. AFAST goal‐directed template.

8 Chapter 8 Figure 8.1. Comparative echogenicity of the liver to the cortex of the right... Figure 8.2. Liver margination and comparative echogenicity to the falciform ... Figure 8.3. Hepatic venous congestion. The differentiation between hepatic v... Figure 8.4. Normal gallbladder and variations. (A) The normal gallbladder wa... Figure 8.5. Nodular hyperplasia. (A) Small hyperplastic nodule as demarcated... Figure 8.6. Hepatic cyst and biliary cysts. (A) Hepatic cyst ( arrow ) with di... Figure 8.7. Various liver masses. Benign and malignant liver masses cannot b... Figure 8.8. Liver and splenic masses. The origin of large masses can be chal... Figure 8.9. Liver masses. (A) Image of a dog with target lesions of the hepa... Figure 8.10. Diffuse homogeneous hypoechoic and hyperechoic liver. (A) Hepat... Figure 8.11. Gallbladder wall abnormalities. (A) Thickened gallbladder wall ... Figure 8.12. Degrees of gallbladder sedimentation (sludge). (A) A mild amoun... Figure 8.13. Gallbladder stones or choleliths. (A) Two small choleliths in a... Figure 8.14. Gallbladder mucocele. (A) Gallbladder mucocele in a dog. Note t... Figure 8.15. Biliary tract distension. (A) Cat with bile duct tortuosity whi...

9 Chapter 9 Figure 9.1. Normal splenic hilus. (A) The “Y” shape of the splenic vein, als... Figure 9.2. Subjective size evaluation of the spleen. Splenic enlargement as... Figure 9.3. Echogenicity of spleen relative to liver and cortex of kidney. (... Figure 9.4. Normal appearance of spleen. Spleen by itself showing its homoge... Figure 9.5. Splenomegaly. (A) Splenomegaly or splenic enlargement as evidenc... Figure 9.6. Splenomegaly with spleen extending to urinary bladder. This seve... Figure 9.7. Splenomegaly with normal echogenicity. Infectious diseases can c... Figure 9.8. Splenomegaly with splenic hyperechogenicity (brighter than norma... Figure 9.9. Splenomegaly with splenic hypoechogenicity (darker than normal). Figure 9.10. Splenic nodular hyperplasia and myelolipomas. (A–C) Examples of... Figure 9.11. Splenic hematomas and infarcts. (A) The spleen has a hypoechoic... Figure 9.12. Splenic hemangiosarcoma (HSA) and its variability. (A) A spleni... Figure 9.13. Target lesion. Target lesions suggest metastatic neoplasia and ... Figure 9.14. Lymphosarcoma (LSA). The “Swiss cheese” or “moth‐eaten” appeara... Figure 9.15. Splenic torsion parenchymal lesion. (A) Note the hypoechoic (da... Figure 9.16. Splenic torsion vascular lesion. (A) Image of the splenic hilus... Figure 9.17. Splenic thrombus. (A) The splenic vein near the hilus appearing...