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1102 FAST Ultrasound Examinations

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A B C
EXCRETORY UROGRAM Excretory urograms, ventrodorsal views. A, Ectopic ureter (left side), normal ureter (right
side). Ectopic ureter is diffusely enlarged (hydroureter), especially distally where it inserts in an ectopic location (arrow).
B, Pyelonephritis (right side). Right-sided hydronephrosis and severe hydroureter are apparent. C, Additional example
of hydronephrosis and hydroureter, affecting the right side. L, Left.

• Remove the IV catheter > 20 minutes after • Cystoscopy (p. 1085)/urethroscopy: excellent and to examine renal perfusion by obtain-
the procedure. visualization of ectopic ureter(s); opportunity ing rapid serial images during first-pass
for therapeutic intervention (laser) circulation
Alternatives and Their • Computed tomography (CT) provides excel-
Relative Merits lent detail of size, shape, and margination of Pearls
• Plain abdominal radiographs: inexpensive the kidneys. IV contrast media can be used The likelihood of the animal vomiting can be
means to survey the abdomen. Radiopaque for enhancing findings in the kidneys and/or decreased by injection of contrast as a slow
renal or ureteral calculi can be visualized. ureters. CT is excellent for assessing ectopic bolus over 20-30 seconds.
Evaluate renal size and shape if abdominal ureters. CT is more costly to perform than
detail is adequate and fecal material is not other studies listed and may require general SUGGESTED READING
obscuring their visualization. anesthesia.
• Abdominal ultrasound: excellent potential for • Nuclear scintigraphy (diethylenetriamine Muhlbauer MC, et al: Radiography of the dog and
cat: guide to making and interpreting radiographs,
visualization of kidneys, especially in animals pentaacetate [DTPA]): to determine global ed 1, Hoboken, NJ, 2013, Wiley-Blackwell.
with poor radiographic abdominal detail. and individual glomerular filtration rates,
Renal size, shape, position, and echogenicity to evaluate the animal’s response to treat- AUTHOR: LeeAnn Pack, DVM, DACVR
relative to the liver and spleen can be assessed. ment, to evaluate function of contralateral EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
The size of the renal pelvis and internal kidney before surgery and possible removal Thompson, DVM, DABVP
architecture of the kidneys can be assessed. of diseased kidney, to identify and determine
Ultrasound can determine if masses are solid the severity of subclinical renal disease in
or cystic. Resistive index can be calculated. an animal receiving nephrotoxic agents,

Video
FAST Ultrasound Examinations Available

Overview and Goals
Difficulty level: ♦♦ • TFAST has a high sensitivity and
• FAST scans aim to quickly identify pathology in specificity for the diagnosis of pneumo-
Synonyms emergency and critical care patients, determine thorax, pericardial, and pleural effusion.
Focused assessment with sonography for trauma, its significance, and evaluate its progression. Can help distinguish between cardiac
triage, and tracking (FAST), abdominal FAST • AFAST has a high sensitivity and specificity and noncardiac causes of respiratory
(AFAST®), thoracic FAST (TFAST®) for detecting abdominal effusion. distress.

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