Ultrasound

Abdominal ultrasound is one of the most powerful and versatile diagnostic tools in small animal medicine. With a non-invasive and dynamic scan, we can assess every abdominal organ in detail from the largers, such as the liver or spleen, to smaller but equally vital structures like the adrenal glands, duodenal papilla or even the portal vein and its branches.

Unlike other imaging modalities, ultrasound allows us to observe not only organ structure, but also vascular flow, peristalsis, and real-time interactions between systems. It turns the abdomen into a live map of function and pathology.

What Can We See?

A properly performed abdominal ultrasound enables the systematic exploration of:

• Parenchymal organs (liver, spleen, kidneys, pancreas, adrenal glands)
• Hollow viscera (stomach, intestines, bladder, gallbladder, uterus)
• Lymphatic structures, including deep abdominal nodes often invisible on radiographs, like the jejunal, medial iliac, hypogastric, colic and gastric nodes
• Major vessels, such as the caudal vena cava, portal vein, renal arteries and veins, and even evidence of abnormal shunting
• Peritoneal space and mesentery, which may reveal effusions, adhesions, or infiltrative disease

This level of detail is essential in the diagnosis, staging and management of a wide spectrum of diseases like:

• Hepatic disease, including chronic hepatitis, vascular anomalies, or biliary obstruction due to choleliths
• Pancreatitis and pancreatic neoplasia
• Adrenal tumours, particularly pheochromocytomas or cortical carcinomas
• Gastrointestinal disease, from inflammatory bowel disease to intestinal lymphoma
• Portosystemic shunts, which can be identified with high accuracy through detailed vascular mapping
• Urogenital and reproductive disorders, including nephrolithiasis, prostatomegaly, pyometra, and more

This is not just about identifying a lesion—it’s about understanding its structure, context, and vascularisation, and what this means for the patient’s diagnosis and prognosis.

Cervical scanning is indispensable for sizing thyroid and parathyroid nodules, tracking salivary cysts, or exploring jugular anomalies. High-frequency linear probes resolve structures only a few millimetres wide, allowing early detection of hyperthyroidism in cats or functional adenomas in dogs before systemic signs escalate.

Tendons, ligaments and muscle bellies lend themselves perfectly to ultrasound’s real-time, high-detail view. Whether you are localising a partial Achilles tear in an agility dog or following the healing of a biceps-brachii strain, sonography guides treatment choices and return-to-sport timelines, often before radiographs show any change.

While full cardiology studies are best left to echocardiography specialists, thoracic sonography still offers enormous value. We can:

• Scan the pleural space for effusion or adhesions;
• Characterise peripheral lung nodules that sit against the chest wall;
• Size and sample the sternal, cranial mediastinal lymph nodes—structures invisible on plain radiographs until they enlarge

This bedside view is particularly helpful when repeated imaging is needed in patients who might not tolerate or can not have a repeated anaesthetic CT.

The ability to sample what we see under ultrasound guidance makes the modality not only diagnostic but also decisive.

Fine Needle Aspiration (FNA)

FNA uses a thin needle (typically 22–25 gauge) to collect cells from a targeted structure. It’s minimally invasive, quick, and often diagnostic for a lot of conditions like Round cell tumours (e.g. lymphoma, MCT), inflammatory or reactive lymph nodes or diffuse hepatic or splenic disease.

It’s especially useful when time is a factor or when a histological diagnosis is not essential. Sedation is often minimal but necessary.

Tru-Cut® Biopsy (Core Biopsy)

Sometimes, cytology isn’t enough. For diseases that require architectural assessment, such as chronic hepatitis, hepatocellular carcinoma, or intestinal lymphoma, a Tru-Cut® biopsy provides a cylindrical sample of tissue.
This allows the pathologist to analyse the organisation and integrity of tissues, distinguishing between hyperplasia, inflammation, or malignancy, and even grading the disease.

Biopsies are always performed under real-time ultrasound and colour Doppler to choose safe paths, avoiding major vessels and adjacent organs. Sedation or general anesthetic is often necessary.

Cholecystocentesis

Direct aspiration of the gallbladder is the gold standard to:

• Diagnose and culture biliary infections
• Guide targeted antibiotic therapy

Despite being more technically demanding, when performed correctly it carries a very low complication rate. Sedation is often minimal but necessary.

Patient Safety: What We Check

All procedures follow strict protocols for patient safety:

• Recent haematology is required for FNAs to confirm adequate platelet count (>100,000/μL), especially prior to liver biopsy or cholecystocentesis.
• Clotting times (PT, aPTT) are not routinely needed, unless there is clinical suspicion of Coagulopathic profile, anticoagulant exposure). For Tru-Cut biopsies clotting times are always recommended.
• Sedation or general anaesthetic is used only when necessary and tailored to the patient’s clinical status.

Every summer seems to bring a surge of grass-awns, splinters. Ultrasound excels at spotting tiny hyperechoic foci with acoustic shadowing, then guiding mosquito forceps or graspers through a keyhole incision to remove them. The technique is quick, minimally invasive and dramatically reduces exploratory surgery time and postoperative discomfort.