Tagged with " radiographs"

Ultrasound or Radiographs (x-rays) – What’s The Difference?

Feb 21, 2013 by     No Comments    Posted under: Personal Opinion, Tips & Advice

Unlike radiographs, ultrasound uses sound waves to generate a picture of the internal organs. Ultrasound is completely safe and painless and does not require anesthesia or sedation in most cases.

Ultrasound may be recommended after a physical examination, blood test or x-ray indicates an underlying problem. Ultrasound is commonly used in both veterinary and human medicine for a wide variety of problems, including diseases of the liver, kidneys, bladder, stomach, intestines, pancreas, heart, and other organs. As with people, it can be used safely during pregnancy.

Ultrasound can “see” many things that can’t be seen on x-rays. For example, if there is fluid build-up in the chest or abdomen, the organs can’t be seen clearly on x-ray because fluid and tissue have the same density. However, they appear quite clearly on ultrasound, because we can see through the fluid. In addition, while x-rays are helpful to see the shapes and sizes of the internal organs, ultrasound can get a picture of the internal structure.

If an x-ray shows an enlarged heart, we can’t tell from the x-ray if the walls of the heart are thick with narrowed heart chambers (where the blood flows) or if the walls are thin and weak with big chambers or if there is fluid build-up between the heart and the sac that surrounds it. Ultrasound can readily give us this information, which is critical, as these scenarios represent different types of heart disease, with different prognoses and treatments.

Ultrasound is not effective at seeing through air or bone, so it does not replace x-rays but rather is complementary. In some cases both x-rays and ultrasound are needed in order to get a complete picture of what is going on with a patient.

Ultrasound equipment is specialized and quite expensive, so not all veterinary hospitals have an ultrasound machine. Many hospitals have specialists that come to perform the examinations. Other hospitals refer their patients to a hospital that can provide this level of care. In some cases of complex heart disease, evaluation by a veterinary cardiologist may be needed.

Due to the specialized nature of ultrasonic exam and evaluation, it is critical to have a veterinarian who is experienced in obtaining and reading ultrasound images to perform the examination, and make this information apply to each patient in a meaningful way in terms of prognosis and treatment recommendations.

What happens during an ultrasound?

The hair over the area to be evaluated will be shaved, as hair will interfere with the images. A gel (water soluble and safe) will be applied to the skin to help the sound waves generate a good picture. A transducer (similar in size and shape to a TV remote control) is placed on the patient’s skin and slowly moved around over the area to be examined. The ultrasound is computerized, so it can be used to accurately measure the tissues as needed. In addition, images can be stored electronically.

In order to perform a thorough exam, the patient needs to stay relatively still, though some wiggling is fine. Although some cats may be slightly anxious initially, most relax and remain calm once they realize that nothing painful is happening. For cats that are very anxious, your veterinarian may recommend a sedative.

What should I do to prepare for the ultrasound procedure?

Please do not feed your cat for 8-12 hours prior to the examination. Water is permitted. In the case of an abdominal ultrasound, an empty stomach allows for proper imaging of the area near the stomach. There are some diseases/situations where food should NOT be withheld; contact your veterinarian for specific instructions. If your cat is having an abdominal ultrasound, please try not to let your pet urinate for the 3 hours prior to your appointment. This will help get a better picture of the bladder.

What will the ultrasound tell us?

An ultrasound examination will provide a lot of information about your cat’s health. Together with the internist, we look at information from lab tests, x-rays, examinations and medical history to make medical recommendations.

  • A specific diagnosis: often ultrasound can provide us with a diagnosis (or a reason for your cat’s illness).
  • A Partial diagnosis: While ultrasound shows us the shapes and consistencies of the internal organs, it cannot see microscopic changes. This means that while an ultrasound examination can identify abnormal tissue, including growths, it cannot always determine if the tissue is cancerous or what type of cancer it is. For some patients, this information will affect how they are treated and a biopsy may be recommended. In some cases, this biopsy may be performed as an ultrasound guided needle sample under light anesthesia. In other cases, a surgical biopsy is needed.
  • No Diagnosis/ Disease Exclusion: For some patients, the organ changes are not visible enough to pinpoint the problem. We are able to exclude (or rule out) certain diseases, but are left with a list of possible diseases that are causing your cat’s illness. This can be both relieving and frustrating. We will discuss options for therapies based on the available information and will recommend the best path for additional testing to obtain a diagnosis if indicated and desired.

If you have additional questions about whether ultrasound or x-rays are appropriate for your cat, please contact your veterinarian.

Dr Diana Lafer

Dr. Diana Lafer founded Cats Limited in 1995. She earned her bachelor’s degree in biology from Wesleyan University and her veterinary degree from Cornell University. Dr. Lafer has a cat (Sparky), and a dog (Lucy). She enjoys spending time with her daughters, horseback riding, skiing, hiking, participating in triathlons, and volunteering for the Lakeville Pony Club.

Cats Limited Hospital
1260 New Britain Avenue
West Hartford, CT 06110

Phone: (860) 561-9885
Email: cats@catslimited.com

Website: http://www.catslimited.com/
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Tissue and Fluid Samples: Why Are They Useful in Diagnosing Diseases?

Dec 13, 2012 by     No Comments    Posted under: Tips & Advice

Sampling of tissue and subsequent microscopic evaluation of tissue is described as collecting and interpreting a biopsy.  The preparation and evaluation of tissue is performed by a board certified pathologist.  Biopsies are used to evaluate masses and tumors, either inside the body, mouth or ears or on the external surface of the body (dermal or mammary tumors).  Biopsy samples can also be collected from tissue that is red or hairless or ulcerated as a means of differentiating cancer (neoplasia) from inflammatory, traumatized or infected tissue.

Analysis of fluid or a tissue sample is a diagnostic tool used in conjunction with blood and urine tests and imaging (radiographs, ultrasound, CT Scan or MRI) to narrow down a list of potential diseases in a cat.  Microscopic analysis of cells in fluid is referred to as cytology. Microscopic analysis of tissue (biopsy) is referred to as histopathology.  Samples of fluid are “aspirated” with a needle and tissue can be sampled with a small needle and syringe or by an incision that allows tissue to be collected. Fine needle samples of tissue can be collected with direct visualization if accessible to the eye or via one of the imaging systems mentioned above. When a tumor is removed, the entire mass can be submitted to the pathologist to ensure that all tumor cells were removed.  This is referred to as “checking margins” or making sure that “clean margins” are achieved , i.e. all of the cancer was removed.

Fluid samples are collected via a needle and syringe and often used to differentiate causes of abnormal free fluid accumulation in either the chest or abdomen of a cat.  Protein levels, bacterial isolation and microscopic evaluation of cell types are the usual tests done on fluid.  Some types of cancer will “shed” (exfoliate) cells into fluid and the exact cancer can be identified by microscopic evaluation of those cells. Lymphoma, the most common cancer in cats, usually exfoliates in the chest fluid if there is a lymphoma tumor in front of the heart. Feline Infectious Peritonitis (FIP) is a fatal viral (corona virus) disease that can cause abnormal fluid to accumulate in the chest or abdomen or both. FIP fluid has a characteristic yellow color, often contains a white blood cell type called macrophages and has high protein levels.  Congestive heart failure or non-exfoliating cancers like adenocarcinoma, will cause a clear watery fluid to collect in either the abdomen or chest that is free of cells.  Bacterial infection in the chest or abdomen (peritonitis) contains high levels of white blood cells (neutrophils or pus) called neutrophils and the causative bacteria can often be directly visualized inside the neutrophils or macrophages or may be grown on an agar plate (cultured) from the pus. Fluid extracted from around the brain or spinal cord  (cerebrospinal fluid) can be evaluated for inflammatory or cancer cells.

 

Dr Elyse Kent

Dr. Elyse Kent graduated from Michigan State University College of Veterinary Medicine in 1980 and completed an Internship at West Los Angeles Veterinary Medical Group in 1981.

In her early years in practice, Dr. Kent began to see a need for a separate medical facility just for cats, where fear and stress would be reduced for feline patients. In 1985, in a former home in Santa Monica, Dr. Kent opened the only exclusively feline veterinary clinic in Los Angeles, Westside Hospital for Cats (WHFC). Along with other forward-thinking feline practitioners from across North America, Dr. Kent founded the Academy of Feline Medicine in 1991. Through the efforts of these practitioners, feline medicine and surgery became a certifiable species specialty through the American Board of Veterinary Practitioners (ABVP). Dr. Kent became board certified in Feline Practice in the first group to sit for the Feline exam in 1995. She certified for an additional ten (10) years in 2005. There are now 78 feline specialists in the world. Dr. Kent served as the Feline Regent and Officer on the Council of Regents for 9 years. She is currently the immediate Past President of the ABVP, which certifies all species specialists. She also heads up a task force joining certain efforts of the ABVP with The American Animal Hospital Association (AAHA). She currently serves as a Director on the Executive Board of The American Association of Feline Practitioners.

The present day WHFC facility opened in 2000. It was the fulfillment of a vision for a spacious, delightful, state of the art, full service cat medical center that Dr. Kent had dreamed of and planned for over many years.

Westside Hospital for Cats
2317 Cotner Ave.
Los Angeles, CA 90064

Phone: 310-479-2428

Website: http://www.westsidehospitalforcats.com/
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