Portosystemic shunt imaging

Please note that the initial imaging technique of choice for patients with suspected portosystemic shunt is ultrasound rather than CT, as voted by imaging specialists at the EAVDI (European Association of Veterinary Diagnostic Imaging) annual conference in Wales in 2015 at which there was an expert panel discussion on portosystemic shunt imaging. This was based on the following factors:

1. requirement for immediate diagnosis (differentiation from juvenile liver disease) to allow appropriate immediate medical management

2. high sensitivity for accurate diagnosis of cPSS via ultrasound (95-99% in experienced hands – that’s me!)

3. the desire to avoid anaesthesia and risks of contrast administration on a repeated basis and at an early stage

4. the ability to then schedule portosystemic shunt surgery at a later time when the patient is medically stable to undergo anaesthesia, which will then only be required once (CT may well then be performed immediately prior to surgery if the surgeon requires)

This was their expert recommendation for imaging, and it also allows for retention of the patient in your own practice, until such a time as surgery is required. Great news for ultrasonographers and general practitioners alike!

Regular clinics for referrals 2018

NVi will be  performing regular ultrasound / endoscopy clinics at the following locations /dates during 2018. Please contact Paul to arrange a referral.

Orchard House Vets, Hexham every Monday morning

Blythman & Partners, Gosforth every second Monday afternoon

Westway Vets every Tuesday and alternate Thursdays

Vets4Pets, Sunderland every second Wednesday

Dunelm vets, Durham every fourth Monday afternoon

Simply Cats, Fencehouses every fourth Wednesday

Capontree Vets, Brampton every sixth Thursday

 

Please contact Paul if you wish to refer patients to these clinics, many thanks!

Urinary bladder mass biopsies..

A recent study has shown that trans-urethral ultrasound guided biopsy (not FNA) of urinary bladder masses to be highly diagnostic in female dogs.. using a new minimally invasive technique. We all know how frustrating bladder masses can be  – and exploratory surgery is often required to obtain that histopathology result – however using this new procedure this could well become a thing of the past, at least in female dogs! So if you have a case please give me a call, thanks!

Splenic biopsy – safe and highly diagnostic!

A recent published study has shown ultrasound-guided biopsy of splenic lesions to be safe and highly diagnostic.  I have avoided splenic trucuts in the past due to a lack of published studies to support the procedure, and a preconceived notion that splenic biopsy is associated with a high risk of haemorrhage at the biopsy site.  However this published study shows that an experienced sonographer with sensitive colour dopppler facilities can target solid lesions safely (Veterinary Radiology and Ultrasound 52:3, p317).  I am therefore currently performing guided biopsy of solid splenic lesions, 100% safely so far; please contact me if you have suitable cases, many thanks.

Small Intestinal obstruction

A recent study has supported the results of several preceding studies in that abdominal ultrasound is highly sensitive and specific for identifying small intestinal obstruction and can be used as a sole imaging modality for obstruction.  In addition the recent study has shown that abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence than radiography. (Veterinary Radiology and Ultrasound May/June 2011 p284)