Clip fur over the region of interest for diagnostic abdominal/echo studies. Air trapped in the coat completely blocks the beam. Emergency POCUS (AFAST/TFAST) is often done with alcohol and gel only, parting rather than clipping the fur, to save time.

Wet the skin with isopropyl alcohol to displace air, then apply generous coupling gel. Alcohol alone is inadequate for a full diagnostic study but is fine for a rapid focused look. Warm gel improves patient tolerance.

Fast 8–12 h before an elective abdominal study to reduce gastric/intestinal gas and to allow gallbladder filling. Withhold food but not water. Emergency and FAST scans are performed unfasted — do not delay a trauma workup to fast.

A moderately full urinary bladder aids the cysto-colic view and pelvic imaging; avoid letting the patient urinate immediately beforehand where practical.

Standard for a thorough diagnostic abdomen (often in a padded V-trough). Gives a consistent, reproducible window and gravity settles gas dorsally away from ventral organs. Least tolerated by dyspnoeic patients.

Preferred for AFAST/TFAST, echocardiography (right lateral for standard cardiac windows) and for dyspnoeic or fractious patients. Less stressful; the down-side lung/heart is imaged through a cut-out table or from underneath.

Useful for very dyspnoeic patients and for Vet BLUE lung scanning — minimises respiratory compromise. Image quality is variable but acceptable for focused questions.

Sometimes used for kidney/retroperitoneal or dorsal windows and for cats that resist being turned over.

Most focused scans are achievable with calm, competent manual restraint and gentle handling. Minimise stress — a frightened cat that struggles gives worse images and higher stress markers.

Consider light sedation for prolonged diagnostic studies, painful abdomens, fractious patients, or guided procedures (cystocentesis, FNA). Choose agents that maintain cardiovascular stability if echo is planned — sedation alters chamber size and heart rate.

Low-stress handling is critical. Towel wraps, quiet environment and pheromone support help. Cats decompensate quietly — watch respiratory effort constantly.

Use clean gel and probe covers for guided procedures. Clip and asepsis for any needle guidance to reduce iatrogenic infection.

A single normal AFAST does not exclude a slow bleed — fluid takes time to accumulate. Repeat at ~4 h (or sooner if the patient deteriorates) in trauma and suspected haemoabdomen.

An increasing AFS on serial scans indicates ongoing bleeding — escalate monitoring, resuscitation and consider intervention.

AFAST also screens non-trauma effusions: neoplasia, ruptured splenic mass, uroabdomen (bladder rupture at CC), septic peritonitis, right-heart failure.

The gravity-dependent HR/umbilical pocket is the target for ultrasound-guided abdominocentesis — analyse the fluid (PCV, cytology, biochem: creatinine/potassium for uroabdomen, lactate/glucose for sepsis).

Normal lung slides against the parietal pleura with respiration — a shimmering to-and-fro at the pleural line. Its presence effectively rules out pneumothorax at that spot.

No sliding suggests pneumothorax (air between pleural layers) — but also occurs with pleural adhesions, apnoea or main-stem intubation, so interpret in context.

The junction where sliding lung meets the non-sliding pneumothorax — the most specific sign of pneumothorax. Scan dorsal (air rises) to ventral to find it.

Identify the “Gator sign” (two rib heads with the pleural “lung line” between them) before calling glide present or absent.

Anechoic fluid surrounding retracted (collapsed) lung lobes — the “jellyfish”/waving lung sign as atelectatic lobes float in effusion. Best seen in the dependent (ventral) thorax.

Distinguish at the PCS/DH: pericardial fluid is confined to the sac around the heart and moves with it; pleural fluid surrounds lung and is bounded by the pericardium. Tamponade physiology → see the Echo section.

Homogeneous, mid-grey; less echogenic than spleen, similar to or slightly more echogenic than renal cortex. Portal vessels have echogenic walls; hepatic veins do not. Assess size, margins, echotexture and focal lesions.

Thin-walled anechoic sac with distal acoustic enhancement. A little gravity-dependent, mobile sludge is common and usually clinically silent.

Fine, homogeneous, the most echogenic of liver/spleen/renal cortex. Smooth capsule, uniform texture. The canine spleen is large and easily imaged along the left cranial abdomen.

Nodules/masses, “Swiss-cheese”/honeycomb (common with congestion, torsion, or neoplasia such as haemangiosarcoma), diffuse mottling. A ruptured splenic mass with free fluid links straight back to AFAST.

Distinct cortex (echogenic) – medulla (hypoechoic) demarcation, smooth capsule, central hyperechoic renal pelvis/sinus fat. Cortex is less echogenic than spleen.

Increased cortical echogenicity, loss of corticomedullary distinction, pyelectasia/hydronephrosis, calculi (echogenic + shadowing), infarcts, cysts, mineralisation.

Anechoic, thin smooth wall (wall thickness depends on distension — assess when moderately full). Look at the trigone and urethra where masses arise.

Calculi are hyperechoic with clean acoustic shadowing and gravitate to the dependent wall (move with repositioning). Suspended echogenic debris/crystals may swirl. Wall masses (e.g. transitional cell carcinoma at the trigone) are fixed and vascular.

Located craniomedial to each kidney beside the aorta (left) and caudal vena cava (right). Dogs classically peanut/bilobed and hypoechoic; measure the caudal pole thickness. Look for rounding/enlargement (hyperadrenocorticism), asymmetric mass, or invasion of the CVC by an adrenal tumour.

Often subtle; slightly hyperechoic to surrounding fat when normal. In pancreatitis: an enlarged hypoechoic pancreas surrounded by hyperechoic (inflamed) mesenteric fat, sometimes with local free fluid and a corrugated adjacent duodenum. The right limb (near duodenum) is easiest in dogs; the left limb is often more accessible in cats.

Four-chamber and left-ventricular-outflow views — overall chamber sizes, valve motion, myocardial function, pericardial space.

Serial “sweep” from apex to base: LV mushroom (fractional shortening), papillary muscles, mitral “fish-mouth”, and the LA:Ao / “whale-sign” heart-base view.

Four- and five-chamber views for Doppler alignment of inflow/outflow (specialist).

The AFAST/TFAST DH view already screens the pericardium and caudal vena cava — a quick pericardial-effusion check without a formal cardiac window.

Anechoic space between the heart and the pericardial sac, following the heart’s motion. Look in the dependent pericardium; a swinging heart suggests a large volume.

Diastolic collapse of the right atrium/ventricle (the thin-walled chambers buckle inward in diastole) indicates the effusion is haemodynamically significant — an emergency requiring pericardiocentesis. A distended, non-collapsing caudal vena cava (from the DH view) supports raised right-heart pressure.

Ultrasound detects pregnancy earliest (gestational sacs from ~day 20–25 post-LH/mating in the bitch; foetal heartbeat from ~day 23–25). It confirms pregnancy and viability but is unreliable for counting foetuses — radiographs late in gestation (after ~day 45, once skeletons mineralise) give a better count.

Foetal heart rate is the key viability sign. Normal foetal HR is high — roughly twice the dam’s rate, typically >200 bpm. A falling rate signals distress: <200 bpm = stress, and <~150–180 bpm = severe distress, prompting consideration of intervention (e.g. caesarean). Absent heartbeat = foetal death.

Distended, tortuous, fluid-filled uterine horns — convoluted tubular structures between bladder and colon, containing anechoic-to-echogenic (turbid) fluid. Wall may be thin (open) or thickened with cystic endometrial hyperplasia.

No gestational sacs, no foetal parts, no heartbeats — and the clinical picture (recent oestrus, systemic illness, purulent discharge if open). Fluid-filled small-bowel loops can mimic uterine horns — trace continuity and check for peristalsis (bowel moves; uterus does not).

Symmetric, homogeneous, bilobed gland caudal to the bladder neck; small in neutered dogs. Image midline just cranial to the pelvic brim.

Benign hyperplasia (symmetric enlargement, cysts) in the intact dog; prostatitis/abscess (heterogeneous, fluid pockets); asymmetric mineralised mass in a neutered dog raises concern for neoplasia. Guided aspiration/biopsy can be performed under ultrasound.

With a moderately full bladder, aseptically guide the needle real-time into the bladder lumen (aim toward the apex/ventral wall, away from the trigone). Ultrasound confirms needle tip position and avoids adjacent bowel and vessels.

Avoid in bleeding disorders or a suspected bladder tumour at the puncture site (seeding risk). Watch for a small amount of post-procedure fluid; a rising AFAST-style fluid pocket suggests leakage.