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The 8 most common indications for an abdominal ultrasound in dogs and cats

Updated: 11 minutes ago

By Dr. Veronica Damian

Your patients can present with a variety of clinical signs. Based on our experience here are the 8 most common clinical signs where you should request an abdominal ultrasound.


1. Abdominal distension

2. Weight loss

3. Elevated liver enzymes

4. Jaundice

5. Polyuria/Polydipsia

6. Vomiting (+/- diarrhea)

7. Haematuria/Stranguria/Dysuria

8. Palpable mass or organomegaly


Ultrasound findings are often the doorway to the diagnosis for these clinical signs.

Read on to see why


1. Abdominal distension


Ultrasound can provide the distinction between organomegaly and abdominal effusion, two of the most common causes of abdominal distention.

Organomegaly can be caused by: (see 8. Organomegaly)

Ultrasound can visualize abdominal effusion, and ultrasound-guided abdominocentesis can help to obtain fluid for analysis to

determine the source especially where small sampling windows are present.

• Ascites (cirrhosis or cardiogenic),

• Haemoabdomen (secondary to neoplasia like haemangiosarcoma, carcinomatosis, metastasis),

• Peritonitis (secondary to pancreatitis, intestinal rupture, gallbladder rupture),

• Uroabdomen (secondary to ureteral or bladder rupture).


2. Weight loss


• Neoplasia (origin and invasion into other structures) (fine needle biopsy is required for

a definitive

• Inflammatory bowel disease (IBD)

• Chronic renal disease

• Carcinomatosis

• FIP


3. Elevated liver enzymes

Ultrasound can visualize changes to the liver, very important for distinguishing between the most common causes of elevated liver enzymes


• Endocrine diseases (hyperadrenocorticism, diabetes mellitus, and hypothyroidism which can develop vacuolar hepatopathy)

• Hepatic disease (cholangiohepatitis, chronic hepatitis, hepatic lipidosis (feline))

• Biliary tract (mucocele, cholecystitis, intraluminal biliary tract obstruction)

• Pancreatitis (extrahepatic compression of bile duct)

• Cholangitis and cholangiohepatitis (feline)

• Pancreatitis, pancreatic pseudocyst or abscess, pancreatic neoplasia

• Biliary neoplasia including neoplasia in the duodenal papillae

• Cholelithiasis

• Porto Systemic Shunts (PSS)

• Microhepatia (PSS, fibrosis, cirrhosis)

• Metastatic disease in the liver


4. Jaundice

Ultrasound can help to differentiate if the jaundice and hyperbilirubinemia are extrahepatic or hepatic based on evaluation of the liver, gallbladder, common bile duct, duodenal papillae, and the adjacent structures (hepatic lymph nodes, pancreas).

  • Cholangitis / cholangiohepatitis 

  • Lymphoma

  • Hepatitis 

  • Triaditis

  • Mucocele 

  • Cirrhosis

  • Diffuse hepatic neoplasia

  • Hepatic lipidosis

  • FIP

  • Intraluminal obstruction of the common bile duct less commonly by choleliths, masses 

  • Extrabilliary obstruction secondary to pancreatitis or pancreatic mass

  • Gallbladder rupture (by evaluation of the gallbladder wall, peritoneal fat surrounding it and performing guided abdominocentesis to determine if bile is present)


5. Polyuria/Polydipsia 

Ultrasound can help determine the cause of polyuria/polydipsia

  • Hyperadrenocorticism (pituitary dependent or adrenal tumor)

  • Pyometra

  • Renal disease

  • Pyelonephritis

  • Diabetes mellitus

  • Lower urinary tract (uroliths, neoplasia, infection).


6. Vomiting (+/- diarrhea)


Together with bloods and physical examination, ultrasound can help identify if vomiting is due to 

  • Primary gastrointestinal (GI) disease:  Intussusception, foreign body, IBD, intestinal mass (obstructing), gastric ulcer, pyloric obstruction (congenital stenosis, hypertrophic gastropathy, neoplasia, foreign bodies), functional ileus (parvovirus), gastritis (garbage induced, drug induced, infection)

  • Secondary GI disease: pancreatitis, liver disease, renal disease, mastocytoma, hypoadrenocorticism.


7. Haematuria/Stranguria/Dysuria


Ultrasound can help to identify or rule out the source of hematuria. 

  • Kidneys: Renal disease (e.g. Neoplasia like haemangiosarcoma, carcinoma),nephrolithiasis, renal infarct, 

  • Ureter: Ureterolithiasis, 

  • Urinary bladder: Urolithiasis, Transitional cell carcinoma (TCC), Cystitis, FLUTD, urinary bladder rupture.

  • Urethra: Urethral calculi, neoplasia.

  • Prostate: Prostatic hyperplasia, prostatitis, prostatic abscessation, prostatic neoplasia, paraprostatic cyst.

  • External pressure on the bladder/urethra by a mass.


8. Palpable mass or organomegaly


Ultrasound can identify the origin of the mass and is essential to performing ultrasound-guided fine needle aspirate or biopsy of this tissue. 

  • Hepatomegaly: cardiogenic hepatic congestion, Infiltrative disease like lymphoma, hepatopathy, metastasis.

  • Splenomegaly: Congestion, neoplasia/hematoma, splenic torsion, splenitis

  • Adrenomegaly:  even if not palpable adrenal glands can be enlarged secondary to pituitary dependant hyperadrenocorticism or adrenal tumors. 

  • Renomegaly (differentiating between hydronephrosis, perirenal pseudocyst (cats), renal tumor,

  • Others; Intestinal/gastric mass, lymphadenomegaly (lymphoma, inflammatory, granulomatous), FIP


Conclusion

Ultrasound is an excellent diagnostic tool and Soundiagnosis routinely helps to identify or orient the diagnosis towards the diseases listed above. We help many clinicians across Melbourne with their case work-ups and we can help you.

 

Call us on 0430 343 802 or email info@soundiagnosis.com.au for further information or to make an appointment.



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