160 Bear Christiana Rd 
Bear, De 19701       

302-322-6488 


Dr. Jim Berg 


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Vomiting

Dear Dr. Berg,

 

I took my dog to my vet because he had been vomiting for about 3 days after he ate and didn’t seem to feel very good.  My vet asked if he had eaten anything unusual and I couldn’t think of anything, but he does tend to chew on things.  My vet took an x-ray which he said was “OK”, but he also recommended that I take my dog to another hospital to have an ultrasound test done.

 

When I called the other hospital about having the test done, they said that it would cost about $250.00 and that they’d have to shave his belly.  Do I really need to have the ultrasound done when the x-ray didn’t show anything?.  Can’t my vet just do another x-ray?

 

 R. B., Newark.

 

 

Dear R. B.,

 

Radiographs and ultrasound exams are wonderful tools that allow veterinarians to check the insides of an animal without having to do surgery, and each has its particular use.  X-rays have been used for many years to check most structures, and are particularly good at assessing things like lungs or broken bones.  Ultrasound works best if it is used on a solid or fluid-filled structure, such as an abdomen or kidney, but will not work very well to check air-filled areas like the lungs.

 

When a veterinarian finds something suspicious on an x-ray, they may suggest further examine using ultrasound.  Ultrasound gives us the ability to assess characteristics about density and cell structure that may not be visible on a radiograph and, by moving instrument around, offers the ability to check out a structure from different angles as well.  Both radiographs and ultrasound yield valuable information that is often complimentary and will help to confirm a diagnosis quickly.

 

To perform an abdominal ultrasound, the examiner will usually shave a patch of hair over the area to be examined; many ultrasound exams are of the abdomen and a patch approximately 8 inches square will be shaved.  A small “head”, which looks something like a smooth-ended marker with a cord attached will be lubricated using a special jelly, then it will be moved slowly over the skin while the examiner watches the ultrasound screen.  If something significant is seen, the examiner can freeze the monitor picture and print out a hard copy to keep in the record.

 

Many ultrasound units also have something called “Doppler” built in, allowing measurement of fluid flows within the body.  Looking somewhat like a weather radar screen, different flow rates are assigned different colors, making it easy to spot obstructions or irregularities in flow.  This means that we can actually see such things as a heart valve leaking, and can also accurately measure improvement as medications are introduced.  Ultrasound has greatly improved modern treatment of many diseases, but is especially significant in the diagnosis and treatment of heart conditions.

 

Ultrasound is also commonly used to accurately guide a needle within the body to obtain a biopsy, making large incisions and major surgery unnecessary in some cases.

 

One word of caution, however, regarding ultrasound.  Ultrasound is a wonderful tool, but this is one test where it really matters who is doing the procedure.  Before being able to diagnoses problems with ultrasound, one must have a solid knowledge what the “normals” are.  It takes many months for most veterinarians to become proficient in differentiating the normal from abnormal, usually more so that with radiographs.  Subtle difference in structure and density can be very significant and need to be skillfully interpreted.

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