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Swanstein H, Boysen S, Cole L. Feline friendly POCUS: how to implement it into your daily practice. J Feline Med Surg 2024; 26:1098612X241276916. [PMID: 39254308 PMCID: PMC11418624 DOI: 10.1177/1098612x241276916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
PRACTICAL RELEVANCE Cats are great pretenders; they often hide illness until they are critical. This makes patients of this species challenging to assess and manage in the emergency setting where quick and stress-free diagnosis and treatment are necessary. Veterinary point-of-care ultrasound (POCUS) is a rapid, evidence-based, non-invasive, repeatable, cage-side ultrasonographic examination designed to answer clinically driven questions without compromising feline wellbeing. Integrating feline friendly POCUS as an extension of the physical examination to streamline diagnostic and therapeutic interventions, thereby limiting stress and improving overall patient care, is advocated by the authors of this article. EQUIPMENT Given the multitude of ultrasound machines and probes available that are portable, meaning they can be moved around the clinic and used patient-side, it should be possible for most practitioners to integrate POCUS into daily practice. The authors' preferred equipment for feline POCUS is a microconvex probe and a portable machine with a fixed pre-set. This set-up allows the clinician to complete all POCUS (abdominal, lung and pleural space, and heart) without needing to move the patient, change probes or restrain the patient in a particular position, ultimately saving time, personnel and cost while maintaining patient comfort and safety. AIM This review aims to serve as a valuable resource for veterinarians seeking to improve their feline patient care through the judicious utilisation of POCUS. In this article, the complex challenges posed by cats are addressed, and the different POCUS techniques, applications and clinical recommendations are discussed. EVIDENCE BASE This review draws on the published literature, as well as the authors' own collective experience when providing recommendations.
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Affiliation(s)
| | - Søren Boysen
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
| | - Laura Cole
- Royal Veterinary College, Hawkshead Lane,Hatfield, UK
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Piskovská A, Kraszewska K, Hauptman K, Jekl V. The Rat Thoracic Ultrasound protocol: scanning technique and normal findings. Front Vet Sci 2024; 11:1286614. [PMID: 38440385 PMCID: PMC10909930 DOI: 10.3389/fvets.2024.1286614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Respiratory diseases (especially pneumonia) are very common disorders in pet rats. The suspected diagnosis is mostly based on the clinical signs, thoracic auscultation, and thoracic radiography. However, auscultation is insensitive in determining the severity of the disease, and radiographs are often unremarkable. Non-cardiac thoracic ultrasonography is increasingly used in veterinary medicine; however, it has not been described in detail in rats. Thoracic ultrasonic examination was conducted on 400 client-owned conscious pet rats. The rats were examined in the period from June 2023 to August 2023 in two veterinary clinics. Due to the small size of the animal, different anatomical considerations, and different evaluation protocols, as well as to meet the optimal outcome of detailed thoracic ultrasound, a standard methodological protocol was developed, and the name RATTUS (Rat Thoracic Ultrasound) was proposed. Typical signs of normal RATTUS were described (bat sign, lung sliding, A-lines, abdominal curtain sign, ski jump sign, lung pulse, seashore sign in M-mode, and bamboo sign). The new evaluation of lung inflation symmetry by substernal access was also described. The methodical approach presented and the normal findings description are proposed to be used for a standard/routine thoracic ultrasound examination in pet rats.
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Affiliation(s)
- Anna Piskovská
- Jekl and Hauptman Veterinary Clinic, Brno, Czechia
- Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, VETUNI, Brno, Czechia
| | | | | | - Vladimír Jekl
- Jekl and Hauptman Veterinary Clinic, Brno, Czechia
- Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, VETUNI, Brno, Czechia
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Liu J. Lung Ultrasonography Does Not Distinguish between Interstitial and Alveolar Pulmonary Edema. Diagnostics (Basel) 2024; 14:324. [PMID: 38337840 PMCID: PMC10855817 DOI: 10.3390/diagnostics14030324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
For a long time, lung diseases have been considered the "forbidden zone" for ultrasound diagnosis because the lung is filled with gas, and the ultrasound waves are totally reflected when they encounter gas [...].
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Affiliation(s)
- Jing Liu
- Department of Neonatology and NICU, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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Rakowska A, Czopowicz M, Bereznowski A, Witkowski L. Investigation of the relationship between pulmonary lesions based on lung ultrasound and respiratory clinical signs in foals with suspected pulmonary rhodococcosis. Sci Rep 2023; 13:19401. [PMID: 37938262 PMCID: PMC10632467 DOI: 10.1038/s41598-023-46833-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 11/06/2023] [Indexed: 11/09/2023] Open
Abstract
Rhodococcus equi is a widely recognized bacterium responsible for pneumonia in preweaned foals. On endemic farms, foals with a subclinical course of the disease usually outnumber those presenting clinical signs. The disease is typically chronic and mainly manifests as fever and dyspnoea. Currently, field diagnosis is often based on lung ultrasound (LUS); however, both diagnostic and therapeutic approaches vary among practitioners and considerably change over time. This longitudinal, prospective study was designed to describe the appearance and progression of rhodococcal pulmonary lesions during the first months of life based on LUS and to evaluate the relationship between the presence and severity of rhodococcal pulmonary lesions and the occurrence of respiratory clinical signs in foals from farms with endemic R. equi infections. Nearly 26% of foals demonstrated respiratory signs highly suggestive of pulmonary rhodococcosis, and approximately 70% of the foals had abnormalities detected on LUS without concurrent clinical signs. The appearance and development of LUS abnormalities were age-related. An abscess diameter exceeding 15 mm in LUS and other pleural lesions were significantly linked with the occurrence of clinical signs suggestive of pulmonary rhodococcosis (P < 0.001) and may be considered predictive factors of rhodococcal pneumonia in foals.
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Affiliation(s)
- Alicja Rakowska
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159C, 02-776, Warsaw, Poland.
| | - Michał Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159C, 02-776, Warsaw, Poland
| | - Andrzej Bereznowski
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159C, 02-776, Warsaw, Poland
| | - Lucjan Witkowski
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159C, 02-776, Warsaw, Poland
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Rakowska A, Marciniak-Karcz A, Bereznowski A, Cywińska A, Żychska M, Witkowski L. Less Typical Courses of Rhodococcus equi Infections in Foals. Vet Sci 2022; 9:605. [PMID: 36356082 PMCID: PMC9698102 DOI: 10.3390/vetsci9110605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2023] Open
Abstract
This article aims to present several interesting and less typical courses of Rhodococcus equi infections in foals, collected during the 2019-2021 foaling seasons in some Polish studs. The study was conducted by the Division of Veterinary Epidemiology and Economics, Warsaw University of Life Sciences-SGGW, and concentrated on ultrasonographic contribution to diagnostics and treatment of the disease. Among many standard cases of rhodococcal pneumonia, some rare ones occurred. The aforementioned issues include the potential contribution of rhodococcal infection to a grave outcome in a prematurely born filly, lost as a yearling, so-called "extrapulmonary disorders" (EPD), a hypothesis of inherited immunodeficiency with grave outcome in a breeding dam line from one stud, and macrolide-induced anhidrosis. The main benefit of this report would be to supplement the general picture of clinical rhodococcosis.
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Affiliation(s)
- Alicja Rakowska
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | | | - Andrzej Bereznowski
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | - Anna Cywińska
- Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Monika Żychska
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | - Lucjan Witkowski
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
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Łobaczewski A, Czopowicz M, Moroz A, Mickiewicz M, Sapierzyński R, Tarka S, Frymus T, Mądry W, Buczyński M, Szaluś-Jordanow O. Integrated Basic Heart and Lung Ultrasound Examination for the Differentiation between Bacterial Pneumonia and Lung Neoplasm in Dogs—A New Diagnostic Algorithm. Animals (Basel) 2022; 12:ani12091154. [PMID: 35565580 PMCID: PMC9101849 DOI: 10.3390/ani12091154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Dyspnea is a highly alarming sign both for dog owners and veterinarians. Although its recognition is usually easy due to prominent suffering of an animal, finding its cause is challenging because many diseases of the heart, lungs, and airways may manifest themselves this way. Echocardiography and lung ultrasound allow for relatively quick and accurate identification of heart diseases. Dyspneic dogs without a heart and upper airway disease are usually suspected of either bacterial pneumonia or lung neoplasm. Although prognosis in these two conditions is diametrically different, differentiation between them is challenging. Chest radiography is performed in a lateral position, which is barely tolerated by a dyspneic dog, and intensive chest movements often make X-ray scans inconclusive. Computed tomography, although much more accurate, requires general anesthesia, which is difficult and potentially life-threating in a dyspneic dog. Therefore, lung ultrasound, which can be performed quickly in a conscious dog, standing or in sternal position, seems to be the method of choice. We develop and evaluate a diagnostic algorithm based on detection of three well-defined abnormalities in the lung ultrasound. The algorithm allows one to distinguish between bacterial pneumonia and lung neoplasm in a dyspneic dog with high probability of a conclusive result (91%) and high accuracy (>95%). Abstract The diagnostics of two of the most prevalent lung diseases in dogs, bacterial pneumonia (BP) and lung neoplasm (LN), are challenging as their clinical signs are identical and may also occur in extrapulmonary diseases. This study aims to identify ultrasonographic criteria and develop a lung ultrasound (LUS)-based diagnostic algorithm which could help distinguish between these two conditions. The study is carried out in 66 dyspneic dogs in which a heart disease was excluded using echocardiography. Based on imaging and laboratory diagnostic tests, as well as follow-up, the dogs are classified into LN (35 dogs) and BP (31 dogs) groups. LUS is performed at admission and the presence of seven lung abnormalities (pleural thickening, B-lines, subpleural consolidations, hepatization with or without aeration, nodule sign and mass classified together as a tumor, and free pleural fluid) and classification and regression trees are used to develop an LUS-based diagnostic algorithm. Distribution of all LUS abnormalities except for aerations differs significantly between groups; however, their individual differentiating potential is rather low. Therefore, we combine them in an algorithm which allows for definitive classification of 60 dogs (91%) (32 with LN and 28 with BP) with correct diagnosis of LN and BP in 31 dogs and 27 dogs, respectively.
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Affiliation(s)
- Andrzej Łobaczewski
- Veterinary Clinic Auxilium, Arkadiusz Olkowski, Królewska Str. 64, 05-822 Milanówek, Poland;
| | - Michał Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska Str. 159c, 02-776 Warsaw, Poland; (M.C.); (A.M.); (M.M.)
| | - Agata Moroz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska Str. 159c, 02-776 Warsaw, Poland; (M.C.); (A.M.); (M.M.)
| | - Marcin Mickiewicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska Str. 159c, 02-776 Warsaw, Poland; (M.C.); (A.M.); (M.M.)
| | - Rafał Sapierzyński
- Department of Pathology and Veterinary Diagnostic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska Str. 159, 02-776 Warsaw, Poland;
| | - Sylwia Tarka
- Department of Forensic Medicine, Medical University of Warsaw, Oczki 1 Str., 02-007 Warsaw, Poland;
| | - Tadeusz Frymus
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska Str. 159c, 02-776 Warsaw, Poland;
| | - Wojciech Mądry
- Department of Cardiac and General Pediatric Surgery, Medical University of Warsaw, Żwirki i Wigury 63A Street, 02-091 Warsaw, Poland; (W.M.); (M.B.)
| | - Michał Buczyński
- Department of Cardiac and General Pediatric Surgery, Medical University of Warsaw, Żwirki i Wigury 63A Street, 02-091 Warsaw, Poland; (W.M.); (M.B.)
| | - Olga Szaluś-Jordanow
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska Str. 159c, 02-776 Warsaw, Poland;
- Correspondence: ; Tel.: +48-22-5936-111
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