How to prepare for an ultrasound exam

Dear client,

Your pet is being referred to the diagnostic imaging department at VCA Canada Central Victoria Veterinary Hospital for an ultrasound exam.

HOW TO PREPARE FOR AN ULTRASOUND EXAM

Ultrasound is a non-invasive diagnostic tool used to image the internal structures of the body. The most common study performed is an abdominal exam. To perform this procedure, the patient is positioned on his/her back on a large cushion to keep him/her comfortable. The hair on the abdomen (or other area of interest) is shaved and a small amount of ultrasound gel and alcohol is applied to the skin. An ultrasound probe is used to apply light pressure against the skin to visualize the organ(s) of interest on a nearby screen.

Ultrasound is also frequently used to help target sample collection from particular organs or tissues. The most common diagnostics that can be performed with ultrasound guidance include:

• Cystocentesis – Inserting a small needle into the urinary bladder to obtain a sterile sample of urine.
• Abdominocentesis – Inserting a small needle into the abdominal cavity to obtain a sample of fluid.
• Thoracocentesis – Inserting a small needle into the thoracic cavity to obtain a sample of fluid.
• Fine-needle aspirate – Inserting a small needle into an organ or mass to obtain cells that are then evaluated under a microscope.
• Ultrasound-guided biopsy – Similar to a fine needle aspirate, but instead of a small needle, a larger specialized biopsy device is used to obtain a larger sample of tissue.

USE OF SEDATIVES OR ANESTHESIA

An ultrasound exam requires that your pet remains still for a period of time. Because of this we often require sedation that will reduce the stress for your pet and allow the radiologist to obtain higher quality images.. Sedation is also very helpful in cases of fine needle aspirates or biopsy. Sedation involves the administration of medications that often provide pain relief and cause your pet to become drowsy and relaxed, but remain conscious.

During the admission process, we will be happy to answer any questions you might have regarding the procedure. We will also ask that you sign a consent form for it, including your permission to allow the administration of sedation or anesthesia and the performance of some additional procedures if indicated.

THE ULTRASOUND PROCESS

• All food, including treats, should be withheld starting at 10:00 p.m. the night before the examination; free access to water is allowed.
• Your pet will arrive at the hospital at the designated time and will be admitted to stay in the hospital during the day. When checking in your pet, please make sure our staff knows how to contact you in the event of a question, scheduling change, or emergency.
• Your pet will undergo a physical examination by our Hospitalist, Dr. Ailish Lynch, in preparation for the procedure and sedation.
• An intravenous catheter will be placed in a leg vein for the administration of sedative or anesthetic agents. Note: Preparation for the catheter requires hair clipping at the site.
• The hair from the abdomen (or area of interest) will be clipped and ultrasound gel will be applied to acquire the images.
• After the exam, your pet will be brought to a recovery room, where it will wake up from sedation. Shortly thereafter, your pet will be ready to go home.
• The ultrasound examination will be performed and interpreted by one of our board-certified veterinary radiologists, Dr. Mason Wanamaker and Dr. Lynn Griffin. In the case of echocardiograms, the images will be sent to a cardiologist for interpretation. The written report will be sent to your referring veterinarian within the next 24 hours.
• The normal duration for an average ultrasound exam is approximately 30 minutes, although this could vary if additional procedures are indicated. Recovery time can fluctuate pending on the individual patient and if sample collection was necessary. You should plan on leaving your pet with us between 4-8 hours.

FORESEEABLE RISKS

Depending on your pet’s medical condition, sedation and diagnostic procedures may involve some risks. This will be discussed with you in detail during the admission process and during discharge from the hospital.

Ultrasound examination is an extremely safe procedure. The most common complication is due to irritation or nicks to the skin from shaving (or bruising in pets that have bleeding disorders). There are additional risks associated with aspirates or biopsies that might be performed during the ultrasound procedure. While complications are uncommon we will be monitoring closely for:

• Significant bleeding when performing biopsies or aspiration of masses located within the chest or abdomen.
• Bleeding or urine leakage into the abdomen during cystocentesis. If this occurs, it is usually mild and does not require treatment.
• Introduction of bacteria or other contaminants into the body that can cause infection. This risk is minimized by shaving the fur and disinfecting the skin at the needle puncture site(s).
• Air leakage (Pneumothorax) when aspirating inside the chest.
• Accidental puncture of tissues not intended for sampling (uncommon).
• In patients with certain tumors, it is theoretically possible that needle aspirates could result in tracking of cancer cells through the abdomen and skin when the needle is removed.

Because these types of aspirates are guided by ultrasound, we assess for complications immediately following sample collection. If a complication has occurred, it will be addressed appropriately and you will be contacted.

INCONCLUSIVE RESULTS AND UNREMARKABLE SCANS

Please note that an ultrasound examination may be unremarkable (no abnormal findings) or that performing an ultrasound examination will not always lead to a conclusive diagnosis.. In these cases, the advantage of undergoing the procedure is that we will be able to quickly rule out many of the more common problems, allowing your veterinarian to focus on diseases that may not be visible with this type of imaging.

Since fine needle aspiration is a non-invasive technique that collects only a small sample of tissue, another potential “risk” is that this procedure might not yield a firm diagnosis, thereby requiring additional diagnostic tests or surgical intervention.

If you have any additional questions, feel free to contact our specialty service department at 250-475-2495.