Page 2196 - Cote clinical veterinary advisor dogs and cats 4th

1094 Echocardiography

on otoscopy, but failure to visualize mites
does not rule out infestation.
VetBooks.ir with persistent infections. Ear cytology is
• Culture of the ear canal may be necessary
typically performed first to confirm bacterial
infection.
Pearls
• Ear cytologies can contain high numbers
of bacteria or yeast without a neutrophilic
response. The presence of neutrophils, espe-
cially if degenerative, indicates that rupture
A of the tympanic membrane and concurrent
otitis media is likely and that the ear should
be flushed with the patient under anesthesia.
• Pseudomonas otitis externa tends to be ulcer-
ative. Rod bacteria on cytology surrounded
by a blue- to purple-staining biofilm with the
presence of neutrophils from an ulcerated
ear canal is suspicious for Pseudomonas.
AUTHOR: Mark S. Thompson, DVM, DABVP
EDITOR: Leah A. Cohn, DVM, PhD, DACVIM

B
EAR CYTOLOGY Prepared cytology slides (40× magnification, Wright stain) showing mixed infection of a
few Malassezia yeast and cocci bacteria (A) and Malassezia yeast with rod bacteria (B).

Echocardiography Client Education Bonus Material
Online
Sheet

Contraindications
Difficulty level: ♦♦♦ coded), and electrocardiogram (ECG)
• Patient should be stable enough to handle capabilities.
Synonyms restraint. • Sedation/anesthesia is neither required nor
Cardiac ultrasound, echo • Animals with life-threatening problems (e.g., desired except in very uncooperative animals.
respiratory distress due to pleural effusion
Overview and Goal or pulmonary edema) need to be stabilized Anticipated Time
A complete echocardiographic study should first; limited echo study may be warranted Varies due to experience and case complexity
• Reveal the pertinent congenital or adult-onset to screen for effusions, extensive structural (5-40 minutes)
heart lesions heart disease.
• Evaluate valvular function Preparation: Important
• Quantify ventricular systolic and diastolic Equipment, Anesthesia Checkpoints
function • Scanning table with holes cut out because • Dogs and cats usually require little prepara-
• Estimate the hemodynamic burden through examination from beneath the animal tion for echocardiographic examination.
quantification of chamber size (dilation, improves image quality • Fasting is not needed.
hypertrophy) • Ultrasonic transmission gel • Hair might be clipped over the right third
• Isopropyl alcohol to sixth intercostal spaces (ICSs) and left
Indications • Hair clippers might be needed. fourth to seventh ICS (precordial transducer
• Congenital or adult-onset cardiac disease • Ultrasound equipment; sector-scanning locations); however, in most dogs and cats,
(e.g., valvular, myocardial, pericardial), transducers preferred satisfactory images can be obtained by
cardiac neoplasia, pulmonary hypertension, ○ For cats and small dogs: usually 7- or parting the haircoat and applying isopropyl
systemic hypertension, and pleural effusion 8-MHz transducer; medium-sized dogs: alcohol and transmission gel.
or respiratory distress of uncertain cause 5-MHz transducer; large dogs: 2.5-3.5-
• Limited echo studies can be useful in selected MHz transducer Possible Complications and
emergency situations (e.g., pericardial effu- ○ It may be necessary to use two different Common Errors to Avoid
sion, estimation of atrial size, or ventricular probes during one examination. • Although the technique has no known
ejection fraction during initial stabilization • The echocardiography machine should have physical hazard, there are risks associated
if other initial diagnostic modalities are M-mode, two-dimensional (2D), Doppler with the improper interpretation or use of
hazardous or nondiagnostic [p. 1102]). (pulsed wave, continuous wave, and color the results of the ultrasound.

www.ExpertConsult.com