Internal medicine

Sonographic manifestations of bleeding disorders in dogs: including a case of apparent gastric purpura

It’s been a while since my erstwhile mentor Dr Bob O’Brien published this nice article: Vet Radiol Ultrasound Jul-Aug 1998;39(4):354-6Urinary bladder mural hemorrhage associated with systemic bleeding disorders in three dogsR T O’Brien, E F Wood https://pubmed.ncbi.nlm.nih.gov/9710141/ …and ultrasound technology has moved on a bit in the meantime. This is a recent case of the … Continue reading

30/03/2021 roger Internal medicine, ultrasonography, Uncategorized

Which imaging modality is optimal for diagnosing cardiogenic pulmonary oedema and other lung pathology in dogs and cats?

Hot off the JSAP press we have just been reading the new and exciting: J Small Anim Pract 2021 Mar;62(3):178-186Diagnostic accuracy of a lung ultrasound protocol (Vet BLUE) for detection of pleural fluid, pneumothorax and lung pathology in dogs and catsL Cole, M Pivetta, K Humm https://onlinelibrary.wiley.com/doi/10.1111/jsap.13271 ‘Results: When using CT as the reference standard, … Continue reading

15/03/2021 roger cardiology, Internal medicine, ultrasonography, Uncategorized

Finding the Ileo-caeco-colic junction on abdominal sonography in dogs

This is a useful thing to be able to do. If you can find the ICCJ then that gives you a rock solid reference point: you can then identify the ileum, proximal colon and caecum with complete confidence. In pathological cases it’s not always easy to distinguish small and large bowel simply on inspection of … Continue reading

26/11/2020 roger Internal medicine, ultrasonography, Uncategorized

The significance of bright bits in the pancreas. Ultrasound elastography (USE) in pancreatitis

Ultrasound elastography, or elastosonography, is increasingly available on high-end ultrasound machines;. At the most basic level USE gives an indication of tissue stiffness. This may be either in response to mechanical pressure (strain imaging) or to ultrasound-generated compression (shear wave elastography). Mechanical pressure in strain imaging is exerted externally (manually) or by internal changes due … Continue reading

25/11/2020 roger Internal medicine, ultrasonography, Uncategorized

My CHF patient is on diuretics; but now he/she is azotaemic….what should I do?

I don’t know about you guys but I think I left vet school with the distinct impression that too much diuretic can lead to reduced arterial pressure and thus reduced renal perfusion and azotaemia. This simple picture does seem to have now been superseded. I like this up-to-date summary from the human literature: Change in … Continue reading

15/11/2020 roger cardiology, Internal medicine, Uncategorized

Canine heart medications: the evidence -late 2020 update

It pays to keep this situation under constant review. The more evidence emerges, the more there is to think about. The ACE inhibitor evidence in summary: IMPROVE study (1995): short term effects of enalapril over 21 days in heterogeneous group of dogs with CHF; conclusions rely quite heavily on subjective criteria. More benefit in DCM … Continue reading

08/11/2020 roger cardiology, Internal medicine

Why do we see concurrent pancreatitis and enterocolitis in dogs?…and other related issues

It’s been an interesting empirical observation that acute haemorrhagic diarrhoea syndrome (haemorrhagic gastroenteritis) is commonest in small breed dogs susceptible to pancreatitis. A related phenomenon is the prevalence of gastrointestinal episodes in dogs with diabetes mellitus. ‘ In the light of the current advance in understanding the basis of canine hemorrhagic gastroenteritis, the well-recognized association … Continue reading

05/11/2020 roger Internal medicine, ultrasonography

Ultrasound as the new stethoscope

This is an idea that’s been gathering pace for a while. It’s a few years since I was in general practice but, even then, I was starting to find that having ultrasound in the consult room was immensely useful for a lot of cases as a triage tool and extension of the physical examination. The … Continue reading

09/10/2020 roger cardiology, Internal medicine, ultrasonography, Uncategorized

Multiple acquired portosystemic shunts (MAPSS) in puppies and young dogs: a syndrome compatible with congenital ductal plate abnormalities

Recently I’ve seen two three-month-old dogs with multiple (numerous) small portosystemic shunts in the absence of inflammatory liver disease. The patient whose images are presented below was examined on account of acute encephalopathy with bile acids >130 umol/l and ALT > 600 (ref <100). The same in video: This flow courses via colic veins to enter … Continue reading

29/09/2020 roger Internal medicine, ultrasonography, Uncategorized

Putative uraemic colitis in the dog

The patient here is a 3 y.o. FN mini Schnauzer with bilateral ureteral calculi and plasma urea >40 mmol/L, creatinine 500umol/L. This patient very likely had pyelonephritis (UTI is present in something like 80% of dogs with ureteral calculi…much more so than in cats) although she lacked signs of sepsis. The interesting thing is … Continue reading

17/08/2020 roger Internal medicine, ultrasonography