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The 2024 ‘Italian Protocol’ for lung ultrasound scoring

I like this new article on lung ultrasound: J Vet Intern Med 2024 Jan-Feb;38(1):336-345Lung ultrasound score in dogs and cats: A reliability studyStefano Oricco, Daniele Medico, Ilaria Tommasi, Richard Marcello Bini, Roberto Rabozzi https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.16956 Obviously, lung ultrasound has been a fast-evolving area in recent years with new ideas coming and sometimes going again! This particular … Continue reading

06/03/2024 roger cardiology, Internal medicine, ultrasonography, Uncategorized

Septic thrombus of the renal vein and vena cava in a Pug dog with pyelonephritis

This Pug presented semi-recumbent and febrile with severe abdominal pain. On abdominal ultrasound, the dominant pattern of change involved hyperechoic peri-renal retroperitoneal fat on the left side and small pockets of peri-renal and peri-ureteral effusion. The left kidney was diffusely hyperechoic with reduced cortico-medullary distinction but of unremarkable overall size and shape. Neither renal pelvis … Continue reading

18/01/2024 roger Internal medicine, ultrasonography, Uncategorized

Is this dog with heart disease in congestive failure?

The more you know the more you realise how little you know. On the face of it, the principle of diagnosing congestive heart failure (CHF) is simple enough. Until you start seeing cases where, in practice, it’s not simple at all! It’s reassuring to find that human medics have the same problem. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375124/ ‘Diagnosing non‐secondary … Continue reading

13/01/2024 roger cardiology, Internal medicine, ultrasonography, Uncategorized

Practical small animal ultrasound bits and pieces: part II…. tracheal exudate sign

And the same in video: This is a useful finding: it implies airway exudate. If you see this in a coughing patient and transthoracic lung ultrasound is unremarkable, there is likely significant airway disease. Differential diagnoses associated with this might include, for example, eosinophilic bronchopneumopathy, infectious tracheo-bronchitis, bleeding due to coagulopathy, bronchial foreign body. Also … Continue reading

13/11/2023 roger Internal medicine, ultrasonography, Uncategorized

Practical small animal ultrasound bits and pieces: part I…linear foreign bodies

Linear FBs are sometimes difficult to visualise convincingly: even when everything is plicated to hell. OK, now see what happens if you fan the probe over the suspect loop of gut… …like magic! There it is. One more still from the same cat. We know the linear FB is there: … Continue reading

26/10/2023 roger Internal medicine, ultrasonography

Should we recommend CT angiography for all potential portosystemic shunts -or is ultrasound good enough? Part I: extra-hepatic shunts

In all images here cranial is to left of image. I’ve listened to two authoritative presentations on shunts by specialist surgeons in the last month. To paraphrase, both of them said they recommend CT angio and find ultrasound too user-dependent and too unreliable. My impression is that there’s a general drift in this direction. I … Continue reading

25/07/2023 roger Internal medicine, ultrasonography, Uncategorized

VPS advice to practices re liver biopsies

The decision-making process for liver biopsy is quite complicated: many factors are patient-specific. We’re always happy to discuss individual cases. If we need histopathology or assessment of copper levels then it’s important to consider risk factors for post-op bleeding. It’s not always a black or white decision. In many cases, there’s a grey area where … Continue reading

25/07/2023 roger Internal medicine, ultrasonography, Uncategorized

Lung ultrasound in cats and dogs: why does it get such a varied reception? Things become clearer

My impression, from a UK veterinary perspective, is that lung ultrasound (LUS) gets variable press. Specifically, most specialist cardiologists don’t much care for it. It’s useful to understand why this is. It’s no coincidence that LUS was discovered and developed primarily by human acute care physicians in intensive care units (ICUs) and emergency departments. Looking … Continue reading

06/05/2023 roger cardiology, Internal medicine, ultrasonography, Uncategorized

Sonography of canine interstitial lung disease: some examples

Firstly, a young CKCS with PCR +ve Pneumocystis pneumonia: this dog had a history of masticatory muscle myositis managed successfully with chronic steroid therapy until he recently developed severely increased respiratory effort. There are widespread lines perpendicular to the pleurae. As discussed in previous posts, the appearance of abnormal lung lines on ultrasound is … Continue reading

14/04/2023 roger cardiology, Internal medicine, ultrasonography, Uncategorized

New study reveals that almost half of UK pet cats may develop HCM in their lifetimes!

VPS’ Rita Pires reviews the slightly shocking recent literature Thanks to the RVC cardiology team, we now know a bit more about the natural history of hypertrophic cardiomyopathy (HCM) in a non-referral cat population. The picture of subclinical HCM presented in earlier publications tends to be biased as the studies were generally based on samples … Continue reading

09/02/2023 roger cardiology, ultrasonography, Uncategorized

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