July 17, 2017
Radiographs give us a good overall picture, showing the general size and shape of organs, as well as their position relative to one another. Ultrasound gives us a detailed look inside of each of these organs. It is important to gain as much information as possible when trying to make a diagnosis, and using these two modalities together allows us to do that.
We see a good number of cases of intestinal foreign objects that do not show up well on radiographs. Most of our cloth foreign bodies (underwear, socks, rags) have the same tissue density as intestines and can be difficult to see. Ultrasound will usually allow us to easily determine something in the intestines because it allows us to see inside the intestinal lumen.
Sometimes, we do not get enough information from radiographs alone. We may need more detail to find something that cannot be seen with radiographs. An example would be a pet with some abnormal liver enzymes on a routine blood panel. Radiographs may show a liver of normal size and in the proper location, but ultrasound may find a tumor within the liver, or an obstruction within the biliary tract that would not be visible on radiographs.
Care First Animal Hospital has both digital radiography and ultrasonography in-house. This allows us to use the most advanced technology to get a clear picture and the most accurate diagnosis. Having these services in-house means a patient never has to wait for critical tests or be transferred to another facility. Sometimes, minutes count with critically ill patients. A dog with a ruptured splenic mass, for example, could have life-threatening bleeding in the time it takes to transfer to another location for testing. A rapid, in-house diagnosis would get this patient into a life-saving surgery quickly.
Just recently, I had a case with a dog who had eaten a corn cob which became lodged in her intestines. The radiographs did not pick up the corn cob, since it is a very similar density as the intestinal tissue. Ultrasound allowed us to see that something was not quite right in the small intestines and was possibly obstructing her. We followed up with a test called a barium study, where we gave the patient some liquid medication that shows up bright white on a radiograph. Through a series of radiographs, we were able to watch the barium move through the intestines until it reached the obstruction and could no longer pass through. At that point, we knew we had to get her to surgery to remove the obstruction.
We are always more than happy to share these images with you. Most of our locations have computer screens right in the exam rooms to help you see radiographic images.
Ultrasound can be a great diagnostic tool for preventive medicine as well. Many patients may have abnormalities developing but may not be showing outward signs of disease. This can be especially critical in cases of heart disease. Patients can sometimes be developing significant heart disease with no outward signs of any problem. Sometimes, these patients will have abnormalities such as a heart murmur that can be detected on an annual checkup, but some cases of heart disease give us no signs until it is too late. Preventive testing, such as ultrasound, can help us detect these diseases earlier and use surgery or medication to treat the disease before it is too late.
