Precious Paws - Mobile Veterinary Ultrasound

14/06/2024

7.5 yo, MN, chihuahua presented with a painful, tense caudal abdomen; sticking bum up in air, unable to get comfortable, not eating. Radiographs were done – showed enlarged prostate with internal calcifications.

Ultrasound Findings:
UROGENITAL: The urinary bladder wall has a normal thickness. The urinary bladder contains a small volume of echogenic sediment. A minuscule 2 mm calculus is also present within the urinary bladder. The prostate is mildly to moderately enlarged and heterogenous with multiple pinpoint calcifications.

Conclusions:
1. Enlarged mineralized prostate. This is most consistent with neoplasia such as adenocarcinoma. BRAF testing could be considered for screening purposes prior to pursuing a biopsy.
2. Sediment within the urinary bladder as well as a minuscule cystic calculus. This could represent a small volume of hemorrhage, crystals, casts, or proteinaceous debris.
3. Otherwise unremarkable abdomen, without evidence of metastatic disease.

BRAF testing was conducted and the results were positive for transitional cell carcinoma.

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**cine clips in comments

29/12/2023

Cat | Domestic Short Hair (DSH) | 14 years and 1 day | Male (Neutered)

Weight loss, hungry, T4/T4ED normal Elevated WBC (neutrophils)

HEPATOBILIARY: Moderately sized, approximately 1.89 cm cystic masslike lesion within the right division of the liver.
Multiple other cystic lesion is seen within the right liver.

GASTROINTESTINAL TRACT: Colon contains normally formed f***s which creates a distal shadow. There is moderate muscularis thickening of the small bowel. Mesentery is slightly hyperechoic. There is a distended region within the small bowel which measures approximately 3.29 cm in width and this appears to be within the lumen. No hard shadowing is seen there is Doppler signal on this structure in one of the images. Another region, the material
within the lumen does appear to distally shadow.

**see cine clips in comments

Conclusions:
1. Moderate diffuse thickening of the muscularis layer of the small bowel. Differentials include neoplasia (e.g., lymphoma) and less likely benign etiology (inflammatory bowel disease).
2. Within a loop of small bowel, there is material which creates a hard distal shadow adjacent to or nearby and intraluminal masslike lesion which has Doppler signal. A partial mechanical obstruction secondary to infiltrative disease, possibly associated with #1, is suspected.
3. The cystic masslike lesions within the liver are suggestive of benign etiology (e.g., biliary cystadenoma on the right and simple cysts on the left side) and less likely malignancy (biliary cystadenocarcinoma).

27/09/2023

4.5 yo MN Lab presented with blood in stool; Anorexia x 5 days, lethargic; weight loss of about 10 lbs in 5 days per owner

Ultrasound Findings:
There is dilation of sections of bowel containing echogenic and associated material with a plicated and corrugated appearance. There is thickening of the wall in this region. On the sagittal plane images there is a linear component to this material that is extensive. Other sections of small bowel are identified that are normal, without evidence of dilation. Multiple enlarged mesenteric lymph nodes are identified, measuring up to 1.3 cm in thickness. No free fluid is identified.

*video in comments

Conclusions:
1. Gastrointestinal foreign material with a linear component involving a large section of small bowel. Exploratory surgery and removal is indicated.
2. Reactive mesenteric lymphadenopathy secondary to #1.

After following up with the veterinarian, there was a linear foreign body – string which was caught in the stomach at the anterior end and extending into the small intestine.

The patient improved after surgery and is back to normal.

20/06/2023

12 yo MN yorkie presented with weight loss, ascites (2 days previously ~1L of fluid drained from abdomen), decreased total protein and albumin/globulin, protein losing enteropathy

R/O IBD, alimentary neoplasia, primary lymphangiectasia

Ultraound Findings:
A moderate volume of free fluid is seen throughout the peritoneal space.
Left kidney is slightly reduced corticomedullary distinction and smooth margins. The right kidney is similar appearance to the left.
The pancreas is enlarged and heterogenous.
The duodenum is thickened with intact wall layering, primarily affecting the mucosa with multifocal echogenic speckling. The jejunum has a similar appearance.

Conclusions:
1. The appearance of the small bowel is most consistent with a protein-losing enteropathy and lymphangectasia. A full-thickness biopsy can be considered for further support of a diagnosis.
2. Peritoneal effusion likely represents hypoproteinemia or less likely inflammatory or hemorrhagic effusion.
3. Appearance of the pancreas likely represents previous pancreatitis and fibrosis or incidental fat deposition. Active pancreatitis is considered relatively unlikely.
4. Bilateral mild renal degenerative changes.

27/05/2023

9 yo MN Rottwieler presented with chronic vomiting x 5 days, decreased appetite, seems depressed, increased WBC, positive cPL

Findings:
Severe asymmetric but circumferential thickening of the gastric wall at the level of the pylorus with reduced wall layering definition in this region. A portion of the gastric wall is hyperechoic with resultant distal shadowing.
The pancreas is heterogenous and primarily hypoechoic, with mildly hyperechoic surrounding mesentery.

Conclusions:
1. Presumed ulcerative gastritis. The loss of wall layering can be seen in relation to pancreatitis, however infiltrative neoplasia such as lymphoma or adenocarcinoma must also be considered. Granulomatous disease is less likely.
2. The appearance of the pancreas is consistent with active pancreatitis.

**See video clips in comment section**

19/04/2023

Practice makes perfect! … When your own animals become your “volunteers” 😆

31/03/2023

When your own cat is ADR and needs an ultrasound…and you find some pathology…
14 yo FS feline presenting with decreased appetite for a month, weight loss and history of hyperthyroidism (currently on meds).

First few pictures are the right lobe of the liver. There is a hyperechoic and cavitated/cystic mass that does not distort the capsular margin and measures approximately 2.03 cm x 1.58 cm. Next, you can see the pancreas which is mildly hypoechoic with mildly increased echogenicity to the pancreatic fat. And last, she has a bilobed gallbladder which is a common anomaly although the gallbladder wall is mildly thickened with a small amount of adherent echogenic sediment along the mucosal margin.

Bloodwork confirmed active pancreatitis and low T4.

The report from the ultrasound says:
-Hyperechoic and cystic mass within the liver. This is consistent with a cystadenoma.
-The appearance of the pancreas is suggestive of mild active pancreatitis.
-Mucinous hyperplasia and inspissated bile associated with the gallbladder, commonly seen in the incidental finding.

BUT I am happy to report that with her treatment plan of an appetite stimulant and pain meds for the pancreatitis, decreased dosage of thyroid medication for the time being and yummy a/d food, she is starting to eat more and putting on a little of the weight. I am also giving her subQ fluids every day (which she purrs while I administer them) and her T4 levels will be rechecked in a few weeks to also determine if her thyroid medication dose will change.

20/03/2023

Just a beautiful picture of the canine pancreas 😍

The right lobe and part of the body are seen here (you can also see the pancreatic angle) along with a slightly dilated pancreatic duct. The pancreas was seen as mildly hypoechoic and this may represent mild or resolving pancreatitis.

06/12/2022

https://www.heskavet.ca/article/a-technicians-role-in-ultrasound/

In human medicine, ultrasound is becoming an integral part of the physical exam, and veterinary medicine is not far behind. [...]Read More...

25/11/2022

26/10/2022

Canine presented with hematuria. Ultrasound reveals stones inside urethra within prostate.

26/10/2022

Feline with decreased appetite and weight loss. Ultrasound reveals multiple thickened loops of intestine which is consistent with intestinal lymphoma.

26/10/2022

🐶 🐱

31/08/2022

Feline with hematuria. Ultrasound demonstrates bladder with multiple blood clots. These were mobile and contained no vascularity. Last picture demonstrates a normal urinary bladder on a different patient.

31/08/2022

The magic of ultrasound! As visualized in this image of the spleen - we have the power to find nodules within the body as small as 1 millimetre. We can determine if that tiny little nodule is cystic or solid and if it has benign or malignant characteristics.

31/08/2022

Same patient, both images are of different sections of the colon. First image shows normal appearing colon, second image demonstrates very irregular thickening / mass effect within the wall. As a sonographer, you must be able to assess each organ and find the pathology. Capturing the images for the radiologist comes second!

31/08/2022

Just a beautiful kidney 🐈