Dr. Broussard
The Waggin' Train Veterinary Clinic
How is diagnostic imaging used in diagnosing my dog?
Diagnostic imaging is used to give you a better, more clear diagnosis for a suspected problem. For example, the dog comes in limping. You think they may have a fracture. You need diagnostic imaging to know that for sure. Maybe you feel a lump in their belly. You might want to use either x-rays or ultrasound to determine whether that lump is a bad thing or a baby thing. But still, you could use either x-rays or ultrasound to get a better look at what's going on, and to ultimately help you get an answer or a diagnosis.
What does a veterinary radiologist do?
Well, they’re identical to human radiologists. Their job is to read and interpret images. A lot of times in veterinary medicine, we don't quite have the staffing that some of the larger facilities on the human side may have. So sometimes radiologists may take their own images, or have assistants taking their own images. Certainly with ultrasound, I know a lot of radiologists that actually do the ultrasounds themselves. But primarily their job is to interpret those images regardless of what study they have performed, and to help the clinician or the internist to make a definitive diagnosis.
What are the different types of diagnostic imaging?
There's a wide array. The most common ones that we use on a day-to-day basis in veterinary medicine would be radiology or x-rays and ultrasonography. I think those are the two big ones. There are facilities in the state and certainly in the nation that can use more advanced studies, such as MRI, CT, even things like nuclear scintigraphy, where you might give some sort of a radioactive contrast agent that will pick up the issue better. Those types of things are often used for thyroid and things like that.
I do not have those last three at my disposal, as very few facilities do. But they are some of the more advanced methods and, when you use one versus the other, it really depends on what you're trying to diagnose. Bone is great for x-rays, soft tissue is good for ultrasound. But MRI and CT technicians are really looking at soft tissue that maybe is encased in bone, like ligaments and joints or tumors that might be like brain tumors, things like that. So there's a different place and time for all of those different modalities.
What are some of the things that the veterinarian will look for with diagnostic imaging?
Again, it depends on what we're looking for. So, if I have a dog that comes in with a limp and I do an x-ray, what am I looking for? Of course, I'm looking for a broken bone or a dislocation or something like that. Very straightforward. Sometimes with ultrasound, maybe you have a dog that you think is pregnant or maybe has an abdominal tumor. So what are you looking for? You're basically looking for anything abnormal.
I had somebody a long time ago tell me when it came to medicine in general that you can't recognize abnormality until you know what normal looks like. And to me, I feel like that’s never been truer than when you're talking about diagnostic imaging, especially x-rays and ultrasound. You have to know what normal looks like so, that way, when you do get that abnormal image, you can say, "Oh, there's the liver, kidneys. Oh my goodness, what is this thing?" So that's what you're looking for. Is anything out of the norm compared to what you’re accustomed to seeing?
Does my dog need to be sedated for diagnostic imaging?
That's a good question. Sometimes, yes. It depends on what the issue is and on the temperament of the dog. Like today, I've done two or three x-rays on dogs already and one ultrasound and none of those animals had to be sedated. They were all very good patients. They sat perfectly still and we got really good, straight images and each dog was fine with it.
I think where it comes in is if you have a very fractious, potentially aggressive dog, or maybe a very painful dog—sedation is usually necessary for these types of scenarios. Also, for the more advanced things like CT, MRI—those are big machines and the dog has to be on a table and sit perfectly still for a good long period of time. That won't happen when you have a dog that's awake. It just won't happen. The best of dogs won't do that. So that's when the sedation comes in.
Is diagnostic imaging safe for my dog?
Yes. I would say very safe because most of the things we're mentioning, most if not all of them are very non-invasive. We're talking about taking an image or using ultrasound where you're seeing through the skin and or bone. But there's nothing invasive. There are no punctures, there's no cutting, or anything like that. So yes, I would say that they would be very safe.
FAQ - Dog Diagnostic Imaging
Dr. Broussard
The Waggin' Train Veterinary Clinic
Will my dog need a lab test prior to diagnostic imaging?
Not necessarily. So, perhaps if people haven't seen... The first thing, very quickly, I want to touch on diagnostic imaging means to me, ultrasonography, radiology, or x-rays, CT scan, MRI, those kind of things, those are imaging type studies.
Other lab work might be blood work, CBC chemistry, coagulation panels, that kind of thing. So with that background being said, does your dog need to have lab work before diagnostic imaging is done? And the answer is no.
It purely depends on what we are trying to diagnose by doing these studies. So, for example, if an animal comes in with a limp and we're doing x-rays because that's one of the more common things we do, to see if there's a fracture and obviously I don't need to run a blood work and look at the dog's liver and kidney function if I'm worried about if there's a fracture there or not.
So, I think that's a prime example of when lab work would not be required. There's multiple others, but I won't go into all of them because there's too many scenarios, but simply put, no, they do not require lab work necessarily before imaging can be done.
What can I expect from a dog diagnostic imaging session?
Again, because we're talking about four or five, potentially different modalities of imaging, it's hard to answer that question with one answer. I guess the biggest thing with some of those imaging studies would require an animal to be very still.
Not all animals are very still, especially when they're ill or painful or things like that. So sometimes mild or sometimes not so mild sedation might be necessary first.
Then the animal can be handled safely or stay in a position, usually a somewhat vulnerable position like being on your back, kind of stretched out for x-rays or ultrasounds, things like that for an extended period of time, that requires sedation. That's probably what comes to my mind at the forefront when I hear that question, yeah.
What will a veterinarian be looking for using dog diagnostic imaging?
All of these are so variable, but it's okay. So orthopedic injuries, obviously I'm looking at fractures, dislocations, any change in the structure of the bone, if there's a tumor there, those kinds of things is what I'm looking for, for that.
Where it gets a little hairier, you start getting into ultrasound, maybe MRI. A lot of times you're looking at soft tissue structures for that. So maybe you're looking for a tumor that's growing off as a soft tissue organ.
Maybe you're looking for something with the integrity or lack thereof inside of an organ, like in the lungs or the spleen or the liver or things like that. So again, if people saw the last segment I talked about, you have to know what normal looks like before you can recognize abnormal.
That's where it's difficult to answer this question with being very specific, because it just depends on what condition or disease process we're looking further into. I'm sorry, that's a real fake answer.
How can x-rays help my dog?
The x-rays themselves don't help your dog, but they can help your dog by potentially providing a diagnosis so that we know what the best treatment modality is to fix or heal your dog.
How effective is the use of diagnostic imaging on my dog?
Usually very effective. Nowadays with the advancements and all these equipment, x-ray machines, it's very rare to come across a non-digital x-ray machine. And the real reason I say digital, digital itself is not better, a clear image is a clear image, but digital allows you to darken or lighten an image or focused on a certain area to increase contrast.
And it allows you to do so much once the image is taken. Whereas with the old hand tank, x-rays you had one shot, like a negative one, it's not like negative, it is a negative one, like old photography film. You either get it or you don't get it. And if you don't get it, then you got to do it again and again and again.
So yeah, a lot of the imaging now has come so far. Ultrasound is very commonplace in practice where when I started practicing 20 years ago, very, very few people that I can think of at all had ultrasound. It was only something that was available in referral centers and things like that.
So, imaging has come a long way, that has definitely aided the diagnosis of some of the tougher conditions out there. And if you can diagnose things more accurately, then you can treat things more quickly and more effectively. And it has the potential [inaudible] much better for every patient healthier because of that.
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