Abdominal Ultrasound

A cat lies on its back while gently held and a probe is on the belly

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Abdominal ultrasounds are a common, non-invasive diagnostic test used in veterinary medicine to explore potential issues within a pet’s abdomen, such as chronic vomiting or urinary problems. In this episode, Dr. Jessica Larson, an internal medicine specialist, joins us to discuss the process, benefits, and limitations of abdominal ultrasounds, including their role in diagnosing conditions, planning further tests or treatments. Take a listen to learn how an abdominal ultrasound can give answers to what is happening in your pet’s belly.

Table of Contents

Meet Dr. Jessica Larson: A Journey into Veterinary Internal Medicine

Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You to Know. Today, we’re going to be talking about a procedure that is very commonly recommended for getting some more information about what’s going on in your pet’s belly, and that’s an abdominal ultrasound. I’m joined today by Dr. Jessica Larson, an internal medicine specialist and fellow guide in the VetHive veterinary community. Dr. Larson and I work together, on VetHive, to help provide a community resource for veterinary professionals. If you are a veterinary professional that is out there listening, this is a really great space for asking questions, sharing cases, and getting support for some of those tricky cases where you’re not quite sure what is going on. Thanks so much for joining me, Dr. Larson.

[00:02:10] Dr. Larson: Good morning. Thank you.

[00:02:12] Dr. Lancellotti: So tell me a little bit about your background. How did you become a veterinary internist?

[00:02:17] Dr. Larson: I am a board certified veterinary internist, which means that I spend most of my time working with family veterinarians, pet owners, and their pets, because they have a more serious or chronic illness that requires additional testing and treatment. I have a very common story of wanting to be a veterinarian from a young age, and then I worked really hard through several rejections, getting into vet school, and not passing the difficult board exams right away, to get where I am today. I’ve done a number of things. I’ve worked in private specialty practice, industry, mobile specialty, and now I have opened my own business providing consultations, endoscopy, and education.

[00:03:05] Dr. Lancellotti: That’s great. I think it’s just a testament to how difficult this profession can be. It took me a couple of tries to get into vet school, as well. I have several colleagues that took a couple of tries to pass the board exam. It takes lot of education and training to be able to do what we do, so congratulations for sticking to it.

[00:03:25] Dr. Larson: Yes. Thank you. I’m very tenacious.

Wilson, a cat with chronic vomiting

[00:03:28] Dr. Lancellotti: So we’re going to talk about abdominal ultrasounds. When we think about this particular test, do you have a patient that comes to mind which could help explain what this test offers to owners?

[00:03:40] Dr. Larson: Yes. In fact, I see a lot of cats, in particular, with signs of what we call ‘chronic abdominal intermittent vomiting.’ This may sound very familiar to some of our pet owners. It’s these darn cats that puke every so often or more regularly, and our urge is to chalk it up to hairballs. Sometimes, that is the case, but many times, it’s actually not. Usually, the next step your family vet will recommend is an abdominal ultrasound. In this particular case, we were called in to see one of these kitties, Wilson, we did an ultrasound, and were able to tell that he had a mild thickening of the intestinal walls and some mildly enlarged lymph nodes in his belly. In that case, we worked with his family vet to change his diet, and to use some medications. He improved quite a bit, and the family was very happy for him.

[00:04:40] Dr. Lancellotti: Oh, that’s wonderful. I love that Wilson got better because you were able to tell what was going on in his belly. And that chronic vomiting is pretty common. They don’t just puke the way that some people think, “Oh, it’s just a cat. They just puke.” Earlier this year, I did a great episode with Dr. Christopher Byers on chronic vomiting and cats. If people want some more information on why a cat might be vomiting, episode 53 has a lot of really good discussion on that. But this is a great example of when we would want to do an abdominal ultrasound to get some more information.

What is an abdominal ultrasound for dogs and cats?

Dr. Lancellotti: Can you explain what an abdominal ultrasound is?

[00:05:18] Dr. Larson: Yes. It’s a very common and simple test, nowadays. Just like with ladies in pregnancy, this procedure is probably our most familiar example, which is otherwise known as a sonogram. It is a painless technique in which sound waves come through a special probe device, and then they bounce back to reveal the shape and the internal appearance of organs in the abdomen, or sometimes, in other parts of the body.

What happens when a dog or cat has an abdominal ultrasound?

[00:05:49] Dr. Lancellotti: We often describe this as a procedure that the pet is having. That term “procedure,” in and of itself, can sometimes make pet owners nervous. Can you walk our listeners through exactly what happens when their pet is having an abdominal ultrasound performed, and just address some of the common concerns that you hear?

[00:06:08] Dr. Larson: Yes, definitely. It does sound like a big step, but the usual order of events is that the pet may be given a mild sedative to help them relax, because they will need to lay on their back or side for about 15-30 minutes. They will often be placed in a soft padded tray to keep them comfortable, the area of the body is clipped (the fur on the belly is shaved) to help improve the sound wave passage, and then gel is used to allow the probe to slide around easily to look at the organs. Most of the time, we’re looking at all of the organs in the belly, but occasionally just a few organs will be examined. All the while, the technician or assistant with the doctor is making sure that the pet is comfy and then it’s done. It does not hurt at all, unless the pet is tender in the belly because of an internal problem. One important point here is to be a partner with your family vet when providing sedation. Many folks are very fearful of mild sedation for their pet, when it is actually the very thing that will keep them the most comfortable. The main struggle, when performing this test, is that the pet is too tense or wiggly. They don’t know what this is or why it is happening. And all that does is make the test take longer, limiting what we can see and how we can help.

[00:07:38] Dr. Lancellotti: That sedation can be really helpful, in terms of just making them nice and relaxed, making them so that they’re not anxious or afraid, and you can really get the job done as quickly and safely as possible.

Why is an abdominal ultrasound recommended?

Dr. Lancellotti: When a pet is having an abdominal ultrasound, what exactly are we looking for? In what situations is this test going to be helpful when we’re figuring out what’s happening for a pet and determining our treatment options?

[00:08:04] Dr. Larson: There are lots and lots of situations in which this kind of a procedure or test is very helpful. Most abdominal ultrasounds are recommended by your family veterinarian when your pet has been vomiting, seems painful in the belly, is not eating well, is having chronic diarrhea, etc. Other common reasons may be that your pet has abnormal kidney or liver values in their blood test results. Another common reason is for urinary signs, such as things like chronic urinary tract infections or blood in the urine. There are many other reasons why your veterinarian would add this test to be helpful.

[00:08:46] Dr. Lancellotti: There are a lot of different organs that are in the belly, so this is a great tool for us to be able to take a look at those different organs and see if they look normal. Is something going on there? What are we going to do with that information in order to help make the pet feel better?

What are some of the limitations of abdominal ultrasound?

Dr. Lancellotti: There are some limitations, in terms of what we can and cannot do, with an abdominal ultrasound. It gives us a lot of information, but certainly can’t do everything. What are some of the common misconceptions that you hear about what can and cannot be accomplished with abdominal ultrasound?

[00:09:16] Dr. Larson: I think it’s important to think of this as a test (or a step) in the process of figuring out what is wrong with your pet. Many times, it feels like a very exotic or very dramatic step to some pet owners, so they are reluctant, when it can be very helpful for all of the reasons we just discussed. One of the drawbacks is that it can be costly, depending on several factors, so that may be a limitation. It cannot fix the problem right then. Many times, it is a test that helps to guide the next set of tests, like a surgery or an endoscopy procedure (camera test). But keep in mind, it is a very helpful step and it’s much more available these days, so it is very common to use this type of tool in our pets.

[00:10:08] Dr. Lancellotti: Yeah, it’s a really helpful tool that gives us so much information, in terms of next steps, what’s going on with this pet, and how we can make them feel better.

What should pet owners know about abdominal ultrasound?

Dr. Lancellotti: What are some of the big takeaway points that you’d like our pet owners to remember about abdominal ultrasound?

[00:10:22] Dr. Larson: I would love for pet owners to just be more comfortable with understanding the basics of the procedure and how it can be so helpful to guide the next set of testing steps and treatment options. Remember Wilson? His story is very common, in that we make empiric treatment choices, especially if the next level of testing is not possible for many reasons- and it can really take away the mystery of why your pet is sick sometimes. On the other side, if there is a serious problem identified with ultrasound, then we can better understand our options and choices, even if the problem is very advanced. It helps to provide peace, and in some cases, closure. However, one other important point is that ultrasound can often help identify if there is something stuck in the intestines or the stomach, like a toy or something else that they ate, which can usually lead to a very successful surgery or scoping procedure where the toy or the object is removed. Those cases have a very happy ending.

[00:11:27] Dr. Lancellotti: Yeah. I have several internist friends who always send me pictures of things that they have pulled out of the stomach with their scopes. It’s always a very happy procedure when they’re able to get the thing that’s causing the animal some discomfort or an illness. So if they can find that with the abdominal ultrasound, that’s a great way to make the pet feel better.

Consult with a veterinary internal medicine specialist

Dr. Lancellotti: Dr. Larson, you do abdominal ultrasounds in your area. Can you tell us a little bit about your practice, in case there are pet owners listening who may want to have an abdominal ultrasound done with you?

[00:11:59] Dr. Larson: Yes. I just launched my own business in the Nashville, Tennessee area. In fact, I partner with family practice veterinarians and other people in the area who perform abdominal ultrasound as this step. I can help interpret those test results, which then lead to the next steps that we just talked about, which are sometimes scoping procedures or other testing. So that is a new venture for me.

[00:12:28] Dr. Lancellotti: And where can listeners find more information if they want to connect with you?

[00:12:34] Dr. Larson: www.musiccitypetim.com

[00:12:37] Dr. Lancellotti: Perfect. Many family veterinarians are starting to become trained in how to perform abdominal ultrasound, but the link to find a veterinary internal medicine specialist who has done advanced training in abdominal ultrasound (as well as veterinary radiologists) is available on the website under the resources tab, if you would like to consult with a specialist. You can also view the references for today’s show in the show notes on the website.

Scratching the Itch

[00:13:10] Dr. Lancellotti: I like to end each episode with a segment called Scratching the Itch. This is designed to highlight something, whether it’s a human interest story, a product, or a website. Essentially, it’s anything that provides relief or just makes you feel good. Hence, scratching the itch. Dr. Larson, do you have a ‘Scratching the Itch’ for us today?

[00:13:33] Dr. Larson: Yes, I’m on the board of a group called the Collaborative Care Coalition, and the focus of this group is to grow awareness around how family veterinarians and specialists can work together, break down some of the barriers, and just better understand how to support each other.

[00:13:49] Dr. Lancellotti: That’s great. And that’s www.collaborativecarecoalition.org if anyone wants to check that out and get more information there. Dr. Larson, I am so thankful for you coming on and breaking down what abdominal ultrasounds are, giving our listeners a little bit more information about this test, what we’re looking for, how we use it, and what happens to their pets. I think this is going to be a great resource for our pet owners out there. Thank you very much for your time and your expertise.

[00:14:17] Dr. Larson: Thank you. I hope this is very helpful to a lot of pet owners.

[00:14:21] Dr. Lancellotti: And for everyone out there listening, I look forward to your next visit with Your Vet Wants You to Know.

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