Cardiac ultrasound protocols and in-person sonographer training were provided by local cardiologist Dr. Katie Nadolny DVM, DACVIM - Cardiology
STANDARD DOG PROTOCOL
-LA volumetric (in some circumstances)
Pulmonary hypertension / right-sided disease
STANDARD CAT PROTOCOL
-LV volumetric (RARELY)
-LA volumetric (in some circumstances)
Still images Video clips
Table 1: Recommended image documentation of the hepatobiliary system.
1 Representative longitudinal and transverse images of the liver parenchyma and vasculature
2 Liver and spleen comparison (if needed with split screen image). Liver and falciform fat comparison in cats
3 Parenchymal liver lesions with measurements in two planes (largest and most representative, if many)
4 Gallbladder wall and contents with wall thickness measurement if abnormal
5 Common bile duct with measurement of intraluminal diameter and wall thickness if visible
6 Hepatic lymph nodes with thickness measurement if visible
7 Portal vein and aorta diameter at portal vein entrance into the liver if a portosystemic shunt is suspected
Table 2: Recommended image documentation of the spleen.
1 Representative areas of the dorsal and ventral splenic extremities and body
2 Splenic hilus with measurements in a longitudinal plane
3 Splenic lesions with measurements
Table 3: Recommended image documentation of the gastrointestinal system
1 Gastric fundus, body, antral and pyloroduodenal locations in at least one or both planes, if possible, with wall thickness measurement
2 Duodenum (descending portion) in at least one or both planes if possible, including wall thickness measurement
3 Representative jejunal segment (multiple if not uniform in appearance) in at least one or both planes if possible, including wall thickness measurement
4 Ileocecocolic junction in cats, and if visible in dogs in at least one or both planes if possible
5 Representative large intestinal segment (multiple if not uniform in appearance) in at least one or both planes if possible, including wall thickness measurement
Table 4: Recommended image documentation of the pancreas.
1 Left and right lobes (if visible) and body of the pancreas in at least one or both planes if possible
2 Pancreatic duct with measurements if visible
Table 5: Recommended image documentation of the urinary system.
1 Left and right kidney in longitudinal and transverse
2 Left and right renal length measurement
3 Renal pelvis in transverse with measurement if distended
Tracing the ureters from origin to insertion or as far as possible if abnormal
4 Urinary bladder apex and/or body depending on indication, and trigone with measurement of wall thickness if abnormal
Table 6: Recommended image documentation of the adrenal glands.
1 Both adrenal glands in longitudinal with maximal thickness measurement
2 Adrenal nodules/masses in longitudinal, and if feasible transverse with measurement
Video: For adrenal masses Color or Power Doppler examination of adjacent vasculature
Table 7: Recommended image documentation of the genital system.
1 Left and right ovaries in intact female dogs and cats at maximal dimension.
2 Uterine horns (left and right), uterine body, cervix and pre-pubic aspects of the vagina
Tracing each mammary chain in transverse if abnormalities are present
3 Representative gestational sacs and fetuses in pregnant dogs and cats.
Fetuses documenting heartbeat if present
4 Fetal heart rate using M mode with calipers documenting heart rate calculation
5 Focal abnormalities of the mammary chain in at least one image plane
1 Longitudinal and transverse images of the prostate with measurements
2 Both testes in at least one image plane at the points of maximal dimension to include the median raphe or mediastinum testis.
Table 8: Recommended image documentation of the lymph nodes, mesentery and omentum, great vessels, peritoneal and retroperitoneal space.
1 Medial iliac and jejunal lymph nodes in longitudinal
1 If discrete medial iliac lymph nodes are not identified then a video clip in longitudinal and transverse of the region of the lymph nodes including both the left lateral aspect of the aorta and right lateral aspect of the caudal vena cava at the level of the aortic trifurcation between the deep circumflex and external iliac arteries should be acquired
2 Any abnormal lymph nodes in longitudinal with measurements
Region of the jejunal lymph nodes along the cranial mesenteric artery and vein.
3 Abnormalities of the peritoneal and retroperitoneal fat/space including free fluid and gas
Abnormal portions of the abdominal fat with anatomical landmarks
4 Abnormalities of the abdominal vasculature
Abnormalities of the peritoneal and retroperitoneal space with anatomical landmarks
5 Abnormalities of the abdominal vasculature
Any abdominal lesion is thoroughly documented with still and video loops.
Seiler, GS, Cohen, EB, d'Anjou, M-A, et al. ACVR and ECVDI consensus statement for the standardization of the abdominal ultrasound examination. Vet Radiol Ultrasound. 2022; 63: 661– 674. https://doi.org/10.1111/vru.13151