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 25-28 September, 2018 | Singapore
Postoperative complications
WSV18-0038
NUTRITION AND DIAGNOSTIC IMAGING (LECTURES GIVEN IN MANDARIN CHINESE)
NEW SONOGRAPHY TECHNOLOGY IN VASCULAR IMAGING
H.G. Heng1
1Purdue University, Department of Veterinary Clincial Sciences, West Lafayette, USA
MEASUREMENT IN ULTRASONOGRAPHY: DOES IT MATTER?
Hock Gan Heng, DVM, MVS, MS, Diplomate ACVR, ECVDI,
Purdue University, Department of Veterinary Clinical Sciences, 625 Harrison Street, West Lafayette, IN 47907, USA.
Organ sizeestimation using ultrasound is subjective. Interpretation of the ultrasound examination based on size alone is not advisable. When there is suspected change in the size of a certain organ, it should be interpreted with other signs of disease such as change of echogenicity and presence of clinical signs. The important practical aspect of size measurement
in ultrasound is for future comparison in follow up examinations. This could be useful to determine
whether there is a progression of disease or response
to treatment. There is no reliable way to measure the size of the liver. Rounding of the margins and excessive caudal extension of the liver suggest hepatomegaly. A small liver is suspected when there is poor visualization of the liver. The size of the spleen in dogs and cats varies depending on many factors. Sonographic determination of splenomegaly is often subjective. A more reliable way to measure the size of spleen is through radiography.
In cats, the spleen is always small and an enlargement
of the spleen is easier to recognize. Although a positive correlation of kidney length and volume with body weight has been reported, it is not widely used clinically due to the wide range of standard deviation. However, linear kidney measurement in cats is more reliable
as there is less variation of the body size. It is more difficult to determine mild enlargement of the kidneys when there is no alteration of the echogenicity and echotexture. Slightly smaller kidney size is commonly seen in older dogs and cats due to chronic renal disease. A mild increased size of the renal pelvis has been reported to be normal, secondary to intravenous fluid administration, or associated with disease condition such as pyelonephritis and ureter obstruction. Marked dilatation of the renal pelvis (hydronephrosis) is due
to obstruction of the ureter. The width of the pancreas
in dogs and cats is 1-3 cm and 1 cm respectively. A detectable pancreatic change of echogenicity or contour
43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS
The most significant complication encountered post-procedure is upper airway obstruction. This may be due to laryngeal oedema, inflammation and swelling resulting from biopsy or pre-existing lesion, accumulation of mucus/airway secretions or bronchococonstriction. In cases where upper airway swelling/inflammation is anticipated, intravenous dexamethasone may be administered IV (0.05– 0.2 mg/kg) before extubation. Additional doses of terbutaline may also be considered to counteract bronchoconstriction.
Conclusion
Bronchoscopy is generally considered a safe procedure, provided there is use of correct equipment for patient size, adequate patient risk assessment, close anaesthetic monitoring and adequate operator experience.
References:
1. Padrid P (2000) Pulmonary Diagnostics. Vet Clin North Am Small Anim Pract 30(6): 1187–206
2. Padrid P (2011) Endoscopic laryngoscopy and tracheobronchoscopy of the dog and cat. In: Tams TR, Rawlings CA. eds, Small Animal Endoscopy. 3rd edn. Elsevier Mosby, St Louis, MO: 331–59
3. Kuehn NF and Hess RS (2004) Bronchoscopy. In: King LG. ed, Textbook of Respiratory Disease in Dogs and Cats. WB Saunders, St. Louis, MO: 112–8
4. Dear JD, Johnson LR (2013) Lower respiratory tract endoscopy in the cat: diagnostic approach to bronchial disease. J Feline Med Surg 15(11): 1019–27
5. Caccamo R, Twedt DC, Buracco P et al (2007) Endoscopic bronchial anatomy in the cat. J Feline Med Surg 9(2): 140–9
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