How Much Is a DR Digital X-Ray System for a Veterinary Hospital?

When choosing equipment such as an X-ray system for your veterinary practice, how do you know how much to spend?

Radiographs are used often—even daily—in many veterinary practices. Also, equipment is one of the largest investments a veterinary practice owner will make.

So, maybe a practice owner feels some pressure when trying to select the best equipment for their hospital but also stay within their budget.

Whether you’re opening a new practice or looking to update your current X-ray system, here are some things that may help with the decisions of what to purchase and how much to spend…

How Much Does a Veterinary X-Ray Machine Cost?

See our price here

The equipment itself can be a big investment, but it doesn’t paint the whole picture. When calculating the total investment, here are some things to consider…

• Which equipment do you actually need? For x-rays, do you require an entirely new system, or do you already have a table and generator that could be retrofitted for DR technology?

• How will images be acquired? While physical film is used less commonly in recent years if you do use film be sure to calculate the costs of purchasing and disposing of films and supplies for the processor. On the other hand, when calculating how much a digital X-ray machine costs, you’ll need to factor in the software and acquisition computer for viewing and storing images. 

• Are there shipping and installation costs?

• Is a warranty included, and for how long? If it’s possible to renew a warranty, how much does that cost? Or, is there a maintenance plan available after the warranty expires? What is and isn’t covered under these plans (i.e. drops and accidents, loaner equipment if repairs are needed, etc.)?

• What’s the expected lifespan of the equipment? Get input from colleagues if you can. Decide if it’s worth paying more upfront for something that will last longer, and which has an affordable warranty or maintenance plan.

How Much Can a Practice Afford to Spend?

Even experienced, savvy business owners can benefit from consulting a CPA or other financial professional when it comes to working out the budget and figuring out the best way to invest in a large equipment purchase.

When deciding how much your practice can spend on new equipment, it’s important to think about the return on investment, or ROI. Basically, this means using the equipment often enough (and charging enough for these services) to pay off the equipment AND earn a profit.

Calculations and questions to ask may include…

• Should you rent or buy the equipment? Many experts recommend buying if at all possible, although the recommendation may vary from practice to practice.

• If buying the equipment, will you pay everything up front, or use monthly payments over time? Monthly payments may be offered directly from the seller, or via bank financing. If using monthly payments, what is the interest rate?

• How often do you expect to use the equipment? Speak to your veterinarians, vet techs, and other team members to get input on the expected demand for the service—as well as what’s involved with communicating the value of this new service to pet owners.

• How much will you charge? Multiply your profit on each procedure (i.e. each x-ray study) by how often you expect to use your new equipment, to see if this fee covers the equipment cost and provides you with additional income.

• What sort of staff training is involved, to get everyone up to speed on how to use the new equipment? And is the software, equipment, etc. user friendly? This is important, because these factors may impact how easy it is to integrate the new equipment into your daily practice flow, and whether or not the equipment will actually be used the way you planned.

• Are there any tax benefits, such as a Section 179 deduction? These tax savings may help to offset some of your equipment costs.

All in all, a large equipment purchase is a big decision for any practice owner. But by analyzing each factor in the decision process one at a time, knowing your practice style and budget, and consulting with a financial professional, you can make the best decision for your hospital—and hopefully see a great return on investment, all while improving patient care!

Written by: Dr. Tammy Powell, DVM

Choosing an X-Ray System for Shelters and Non-Profits

X-ray equipment is an important purchasing decision for animal rescues, state and county-run shelters, and 501(c)(3) organizations. 

Animal shelters and non-profits have a mission to help as many pets as possible, including those pets who have nowhere else to turn.

As a veterinarian working for a non-profit or rescue organization, you know that every dollar counts. The more you can save on expenses, the more money can be used to care for pets. 

With that in mind, here are some considerations for purchasing x-ray equipment…

What Radiographic Equipment Does Your Shelter or Non-Profit Need?

Here are some questions to ask to help evaluate your organization’s radiographic needs…

• Which services will you offer that require radiographs? For example, limited-service operations like vaccine or spay/neuter clinics may not have a strong need for radiography. Some rescue organizations will use x-ray equipment moderately—say, for diagnosing bone fractures and creating a plan for stabilization, or for counting the number of puppies in a pregnant dog. And some well-funded non-profits may offer full-service diagnostics and treatment, including dental imaging. Your clinic’s needs will determine which type of equipment is a practical investment.

• Do you need an entirely new system—or do you already own some components such as a table, generator, software, etc. that are still in working order?

• Are you looking for film or digital x-rays—and if digital, CR, or DR technology? Digital offers many advantages such as the speed of obtaining images, while film may be more affordable. Although, by the time the cost of a processor (and maintenance), as well as physical film purchases and disposal, are taken into consideration, the savings might not be as much as expected. So it’s important to factor in all associated costs over the expected lifespan of your equipment.

Where to Obtain X-Ray Equipment for Shelters or Non-Profits

Here are a few options…

• Purchase new equipment. This may be the most expensive option upfront. Although if a warranty for service is offered, it’s possible this may be a cost-effective option for some organizations.

• Purchase used equipment. This option may provide a lower upfront investment for equipment that’s still in pretty good shape. Of course, it’s important to do your research. Ask the seller about the condition of the equipment and whether there is still a warranty in place (and if that warranty can be transferred to a new owner). Figure out what legal rights you have to recoup your money if the equipment doesn’t work as advertised. If it’s from a nearby practice, ask about coming to try out the equipment in person.

• Ask for donations. Sometimes, veterinary practices may be willing to donate their used equipment to a good cause when they want to upgrade. This can be an exciting opportunity that’s difficult to pass up, especially for new rescue and non-profit organizations that don’t have a lot of cash flow yet. Just check the condition of the equipment, and see if excessive maintenance and repairs are expected.

Conclusion

Shelters, rescues, and non-profit organizations can benefit from minimizing expenses whenever possible.

The x-ray equipment needs of each operation are unique.

Factoring in your organization’s services, budget, and available supplies will help with the decision of which equipment is the best fit for your clinic.

Written by: Dr. Tammy Powell, DVM

Editor’s Note:

Our Complete DirectVet X-Ray System is available for $29,995, which includes the table, generator, DR plate, software, and acquisition computer, as well as a 5-year warranty.

Convenient, affordable monthly payments are also available. Learn more and contact us with any questions, Click Here

Looking for used equipment? Be sure to also check out usedvetequipment.com.

Naomi CCD Versus CareRay Cesium Panels: When Is an Upgrade Needed?

Comparing X-Ray Panels: Naomi and CareRay

Digital radiography equipment continues to evolve, with several types of x-ray detectors or sensors available to veterinarians.

So, which is right for your practice? Do you need the latest technology to provide the best care, or is it best to get the most mileage you can out of previous generations of technology?

The Evolution of Digital X-Ray Detectors

Just like our cell phones and tablets, maybe it feels like there’s always a new type of x-ray technology available, whether you’re looking for small or large animal x-ray equipment, or for general, mobile, or dental radiography.

When trying to research the technology and all the lingo, maybe the choice feels a bit overwhelming.

To start with the basics, here’s a quick overview of the most common digital radiography plates on the market right now…

• CR (computed radiography). CR cassettes are also known as phosphor plates. In terms of practical application, the biggest difference between CR and DR is probably the fact that CR requires an extra step—rather than the image being transferred directly from the plates to a computer, the sensors must be read by the CR plate reader.

• DR (direct [capture] radiography). DR technology allows images to be read directly from the plate and then show up on a computer screen, which is usually a rapid process. Within DR, there are two main types of plate technologies: 

  • CCD panels. Charge-coupled device (CCD) detectors are generally built into or attached directly to the x-ray table. This technology has been compared to a digital camera in the way it detects and records light. 

  • Flat-panel detectors. Here, the x-rays are converted into an electrical signal (either directly, or indirectly by first converting x-rays into light and then into an electrical signal). The panel is separate from the x-ray table and can be removed in case a horizontal beam is needed. 

The advantages of flat panels include lower x-ray doses and better detail and clarity in the images (although opinions on image quality vary amongst practitioners). On the other hand, flat panels tend to cost more than CCD panels.

Note: The abbreviation DR is also used for “digital radiography” in general, in addition to direct capture panels.

Additional X-Ray Equipment Considerations

In addition to the detector that picks up the x-ray beam, successful radiographs also require…

• An x-ray generator, which produces the x-ray beam. This may be purchased as part of a new digital x-ray system. Or, older generators and tables may be retrofitted to be compatible with a new digital sensor.

• Software. This is what shows the x-ray image that was picked up by the sensor so that a veterinarian can see and read the image. It’s also where images are stored as part of the medical record, or shared electronically with clients, other veterinary clinics, or specialists as needed.

• Wired or wireless technology. So far as the sensor or plate goes, some have wire connections while others are wireless.

In addition to considering which sensor technology is a good fit for your practice, it’s important to think about whether or not any other equipment needs to be upgraded, and how compatible the whole system will be together.

When Is It Time to Upgrade?

This depends a bit on a veterinary practice’s needs. Typically, it’s not necessary to replace equipment for the latest model every time new technology is available, and it may be possible to keep older equipment in good working order for many years.

Using the Naomi CCD panels and CareRay Cesium (DR) panels as an example, here are some considerations…

• If a clinic is using older Naomi CCD panels that are still producing great, diagnostic images, then it’s typically not necessary to upgrade to a flat panel detector.

The veterinarian is not missing out by hanging onto older technology that still gets the job done.

• What if the plates work fine but there’s a software problem—say, the software is no longer supported? Or, what if there’s no longer any technical support or a warranty available for the plates, which sometimes happens with older technology? 

Here, the decision to upgrade may come down to personal preference, budget, risk tolerance, and how much time and effort it takes to get readable images from the software. 

• Of course, if the panels are no longer producing diagnostic images, then it’s probably time to upgrade. 

You can always check on your warranty if it’s still in place or ask about the cost of repairs, but sometimes veterinarians find that repairs are costly on older technology and their investment may be better spent on an upgrade. But this strategy will vary depending on each individual business and situation.

No matter which equipment you are currently using (or considering purchasing), remember to also think about things such as availability and cost of technical support, whether a loaner plate is available during repairs, and how the software integrates with your practice software.

Also, see if you can sell your used equipment (or make a trade-in, if your vendor allows) to offset the costs of new equipment.

All of these factors will aid in the decision of whether or not it’s time for an upgrade. 

Written by: Dr. Tammy Powell, DVM

Decoding Your Digital Radiography Purchase: Considerations for Sound and Idexx, and Gadox versus Cesium Panels

Comparing Sound and Idexx digital x-ray.

Equipment purchases are a large but important investment for patient care and for the financial success of a veterinary practice.

While diagnostic imaging purchases may seem daunting, it helps to take the process step by step to figure out what’s best for your clinical needs and budget.

As a starting point, here are a few things to consider…

Sound and Idexx Veterinary Equipment Companies

Sound and Idexx are two widely used sources of digital radiography systems in veterinary medicine.

This includes options such as an entire x-ray system (equipment, software, and support), or having flat panel detectors retrofitted into your current equipment.

Sound claims their advantages are:

• Being the #1 provider of veterinary digital radiography, and supporting vets since 1996.

• Their software, MUSICA, which is highly regarded for excellent quality image processing, optimization, and consistency (across different species, users, and techniques), and includes features such as a 3D position assistant for readily available positioning guides for less common views.

• Excellent quality images and equipment.

• A strong focus on education and training so you can easily use your equipment and get the most out of it. Courses are available through the Sound Academy of Veterinary Imaging via board-certified instructors.

• Long-term relationships with panel manufacturers—which is a good thing when it comes to long-term product support.

• 24/7 live phone support.

• Headquartered in the US (Carlsbad, CA) with in-house production and repairs.

According to Idexx, their advantages include…

• Sharp, high-resolution images obtained in less than 5 seconds.

• Availability of their patented Irradiated Side Sampling on Cesium panels, which raises the detection layer near the top of the scintillator crystals. This means the x-rays have less distance to travel, creating a sharp image at the lowest radiation dose on the market (see below for more information on scintillator layers).

• Idexx Web PACS advanced viewer, powered by AI for faster viewing and easy sharing, and with a reference image library to help clients see abnormal findings compared to a normal image.

• Integration with practice management software.

• 24/7 support.

• Idexx telemedicine consultants.

• An online learning center.

While Idexx and Sound and two major players, there are other companies out there, too.

And of course, each company offers a variety of products, so you can find the technology and a price point that’s a good fit for your needs.

When making a purchase decision, do your research and ask plenty of questions to figure out what’s best for your practice.

The technology and terminology can be a little confusing for new and experienced practitioners alike, especially if this is your first big radiology purchase.

We can’t cover everything in the scope of one article, but here’s some information about common types of DR flat panel detectors…

Cesium, Gadox—What Does It All Mean?

Cesium and Gadox refer to two possible substances that could be used in the scintillator layer of an indirect flat-panel detector.

Now, that’s a mouthful, so here’s what it all means…

A flat panel detector is a panel or plate you use to capture digital images with your x-ray machine.

There are two types of flat-panel detectors: direct and indirect. In a nutshell, direct panels convert x-ray photons into an electric charge, while indirect panels first convert x-rays into light and then into an electric charge. Either way, the final image is read out by a detector layer that contains millions of pixels.

Within an indirect flat panel detector, the scintillator layer is the one that absorbs x-rays and converts them into visible light.

This scintillator layer is most commonly made of either cesium iodide (Cesium) or gadolinium oxysulfide (Gadox).

Gadox is produced by formulating a liquid that hardens into thin sheets.

Cesium, on the other hand, is a bit more complicated to produce in a uniform way because it is “grown.” Cesium is composed of crystals that grow upward (acting as “tubes” for light to pass through) after being formulated and heated.

That means sometimes the composition and quality of Cesium can vary, although reliable manufacturers generally have good quality flat panels whether they use Cesium or Gadox.

What’s Better—Cesium or Gadox?

Each substance is useful and can produce good quality x-ray images.

A major advantage of Cesium is its high sensitivity to the x-ray signal. In addition to producing a clear, detailed image, this also means that images can be produced at a lower x-ray exposure.

Gadox can also produce clear, detailed images—but it requires a slightly higher exposure (within 10% difference) dose.

It’s worth noting that the higher sensitivity of Cesium can also lead to higher noise in the image, but Cesium is generally considered to deliver excellent quality images.

Also important is the fact that the price varies between Cesium and Gadox. Because the process of producing Cesium is more complicated and less consistent than with Gadox (as described above), good quality Cesium flat panels cost more than standard Gadox.

Finally, there is a consideration of how and where the panel will be used. Some veterinarians state that Cesium is less reliable in temperature extremes, and thus they prefer Gadox for their large/equine practices and other mobile practice needs. But this preference may vary between individual veterinarians.

Additional Questions to Ask

As many veterinarians will tell you, your equipment and the initial investment is only part of the story. 

It’s also important to calculate ongoing costs, such as renewing warranties, service costs, software updates, and support, and storage fees for digital images. And, is loaner equipment available if a repair is needed?

Another consideration is the expected lifespan of the equipment, and whether support may eventually be discontinued on older models or parts (asking about where the company obtains their equipment is one way to learn more, so you can research the manufacturer).

Before you buy, it’s also a good idea to look at a variety of images from the equipment you’d like to purchase—at the very least, compare a large dog abdomen and a small cat paw, to view details over a range of sizes.

You can ask for a demo from the equipment company or distributor, or ask for the names of colleagues in your area who have purchased the same equipment who could tell you about their experience.

Keeping all these things in mind will help you choose the best option for your veterinary practice, whether you’re considering Idexx or Sound, Gadox or Cesium panels, or even CR or anything in between. 

Written by: Dr. Tammy Powell, DVM

The Canon Cesium Flat Panel Detector and the Cuattro Flat Panel Detector by Heska: Choosing the Best Option for Your Veterinary Practice

Compare before you buy

If you’re thinking of upgrading your x-ray equipment from films or CR, a DR flat panel detector is a great option.

There are several manufacturers that make these products, with Canon Cesium and Cuattro by Heska being top contenders.

Read on for more information that may help you decide which system is best for you.

What Is a Flat Panel Detector?

A flat panel detector is used for capturing images with digital radiography. There are two types: direct and indirect.

Direct FPDs involve converting x-ray photons into an electric charge, while an indirect FPD converts electrons to light and then to an electric charge. In both systems, a thin film transistor (TFT—a reader that contains millions of pixels, similar to the sensor inside a digital camera) reads out the image.

For indirect FDPs, the scintillator layer (the one that converts x-rays into light) may be made of cesium iodide or gadolinium oxysulfide, with cesium generally considered the superior of the two options.

Why Use a Flat Panel Detector?

One of the primary advantages is the speed of DR systems, which allows you to take radiographs more quickly and efficiently. 

This means greater profits (many clinics report taking MORE radiographs after upgrading to digital) and improved patient comfort/safety.

DR also provides excellent image quality with less retakes and lower radiation doses.

Canon Cesium Flat Panel Detector

Canon is generally regarded by the veterinary community as a manufacturer that makes good quality products for diagnostic imaging.

The Canon CXDI flat panel detector features…

• A cesium iodide scintillator, along with an amorphous silicon detector.

• 6.1 million pixels for a 14”x11” plate, 9.5 million pixels for a 14”x17” plate, and 11.3 million pixels for a 17”x17” plate.

• A/D 16 Bit.

• Carbon fiber design with ergonomic handgrips.

Cuattro Flat Panel Detector by Heska

Heska is also widely regarded as a reliable system that produces high-quality images.

The Heska Cuattro flat panel detector features…

• A cesium iodide scintillator, along with an amorphous silicon detector.

• 15 million pixels for a 14”x17” plate, and 18 million pixels for a 17”x17” plate.

• A/D 16 Bit.

• Automatic exposure detection.

• Carbon fiber housing front and back.

Which Is Better: The Canon Cesium Flat Panel Detector, or the Cuattro Flat Panel Detector By Heska?

You really can’t go wrong with either system. Both have received overall positive reviews from veterinarians, and the final decision may come down to personal preference, along with complementary factors and services.

Here are a few things to consider when purchasing…

• Warranty. Ask about warranty type (what it covers, and what it does not cover) and length, as well as cost to renew a warranty once it expires.

• Loaner equipment availability. If you need to use your warranty or have equipment repaired, ask if loaner equipment is available and how quickly it can get to you. After all, you don’t want to be without radiographs for longer than necessary!

• Ongoing expected costs, such as service/maintenance, software upgrades, and cloud-based storage costs.

• Durability/expected lifespan of the equipment. Ask your sales rep and your veterinary colleagues for their experiences.

• Software. You will use the software with each image you take, so be sure you like the accompanying software’s quality and ease of use. Also, check for image formats (jpeg or DICOM, for example) that you may need.

• Compatibility. Will you use your current generator/table, and if so, does the DR system need to be fitted to your current equipment? Does the software integrate with your current practice management system?

• Support availability. 24/7 support is best.

Upgrading to DR is an important decision that may take some research to choose the best system for your needs. 

We recommend choosing a high quality, reputable brand (like Canon or Heska) and evaluating the software, deals, warranty/service, storage, and other factors that will impact your overall investment and satisfaction with your purchase.

Written by: Dr. Tammy Powell, DVM

The MinXray Portable Plug-in Equine Generator: A Perfect Match for Equine Veterinarians

Mobile Generator for Equine Veterinarians

As an equine or large animal veterinarian, you don’t always have the option of practicing under ideal conditions.

Instead, you’re often out in the field—in a variety of weather conditions, and while transporting your equipment with you over long distances.

To make your life easier, and to get the maximum usage out of your equipment investment, it’s important to have equipment that’s lightweight and durable, that delivers high quality while being easy to transport.

That’s why a MinXray portable, plug-in equine x-ray generator is an excellent option for your equine radiology needs.

Why choose a MinXray?

MinXray is considered a “go-to” brand by many equine practitioners. 

The US-based company has been around for more than 50 years (since 1967) and has become a trusted source for quality x-ray equipment that’s easy to carry and use in rugged conditions. In addition to generators for veterinarians and MDs, MinXray also produces x-ray equipment for military use.

That’s why a MinXray generator is great for equine and large animal vets—because of the tried-and-true durability and portability combined with high quality images.

Advantages of the MinXray Portable, Plug-in Equine Generator

• Lightweight and easy to carry and transport. The lightest models weigh less than 15 pounds, for simple transport and positioning. A hard-sided carrying case, tripod, and tripod bag are also provided.

• Durable, for use in rugged conditions. The machine is built for use in a variety of environmental conditions. It’s designed to last and to perform well, even after bumpy rides through pastures, dirt roads, and more, and while working out in the field.

• Excellent image quality. The MinXray generator is high frequency, meaning it can produce a powerful x-ray beam despite the machine’s small size and compact design, and that the beam is consistent for high quality, diagnostic images with fewer retakes and less motion artifact.

• Easy to use. Pre-program up to five exposure techniques, to save time. And use the large, touch-pad control for easy setting adjustments when needed. You also have the option of displaying mAs or exposure time.

• Simple to set up your shots. An adjustable light beam collimator with adjustable dual integrated laser pointers (bright lasers to indicate central x-ray position are easy to see even in sunny conditions) makes the process of focusing and setting up shots simple.

What Else Should I Know About the MinXray Portable Equine Generator?

The DR compatible MinXray generator comes with an 8-foot exposure cord and exposure switch, as well as a 20-foot power cord. A plug-in unit means you’ll never have to worry about batteries running low.

Also, a 5-year, limited warranty is available to protect your investment.

Conclusion

For an equine or large animal veterinary practice, you need durable equipment that can move with you and stand up to a variety of rugged conditions or travel to remote locations.

A high-quality, high-frequency generator like the MinXray is a great option, because it produces consistently superior quality images, while also being lightweight, tough, and easy to transport.

Compare other options

Other options for generators include the Cubex and the Poskum.

Written by: Dr. Tammy Powell, DVM

Perfect for Mobile Veterinarians: Poskom Battery Powered Portable X-ray Generator

Call: 877-545-1202

$135 per month* or $7,995.00

If you want to be able to take an x-ray anywhere, a battery-powered generator is a great option for you.

A Poskom battery-powered portable x-ray generator offers the ultimate portability, making it a popular choice among mobile practitioners.

Capture X-ray Images Anywhere

Since the Poskom VET-20BT is cordless with long battery life, you’re not limited to an external power source during the course of your daily practice or on-call shifts.

That means that as an equine practitioner, you can conveniently use the machine in a barn or out in the field, without a power outlet nearby.

And as a small animal veterinarian, you can easily port your x-ray equipment with you—which is perfect for mobile practitioners.

No Cord, No Fuss

The Poskom battery-powered portable x-ray generator is cordless, which means it takes less time for you to set up for a procedure and then pack everything up again.

No cord also means no chance of anyone tripping over the cord or of patients becoming entangled.

Wireless Technology

In addition to no cord for the power supply, the Poskom VET-20BT also incorporates wireless technology for communication between the generator and the plate.

Radio-frequency (RF) communication means images can be captured without the need for a wire between the generator and the DR interface.

Lightweight and Compact

The generator is only 36 x 20 x 17 cm (approximately 14 x 8 x 7 inches), and weighs merely 6.8 kg (15 pounds). This makes it the lightest, most compact battery-powered generator on the market.

If you’re short on storage space or have to plan for carrying your equipment all day, having a compact, lightweight unit can really make your life easier.

Long Battery Life

With one full charge of the high-capacity lithium-ion battery, you get up to 300 exposures—which means you shouldn’t have to deal with a battery running low right when you need it!

For easy battery monitoring, the Poskom x-ray generator also features an energy balance indicator (so you know the time for battery charging) and an LED indicator for when the battery is fully charged (which usually takes just 2-3 hours).

And should you need to replace the battery (its lifecycle is over 5 years, with no battery maintenance required), you’ll find the process to be simple and easy. 

High-Frequency Technology Means Good Quality

The compact Poskom VET-20BT features advanced, high-frequency technology, with 20mA and 90kV capabilities.

High frequency means a strong power output, with stable/repeatable settings for consistent, high-quality images.

So you receive excellent images, with less need for retakes.

Easy to Use

In addition to being lightweight, compact, and cordless, the Poskom battery-powered portable x-ray generator is simple to use, with the option of programming your favorite settings so you don’t have to adjust the settings every time.

Introducing The Veterinary Saddle Stool

The collimator features a dual laser alignment system and a push-button light with a 30-second timer.

If taking an x-ray anywhere, without the need for electricity or an external power source sounds good to you, click here to learn more.

The Poskom VET-20BT is available for affordable monthly payments (so it can pay for itself and earn a profit right away with use each month), as well as a 3-year warranty.

Written by: Dr. Tammy Powell, DVM

Ultrasound-Guided Cystocentesis: Pros & Cons for Veterinary

A cystocentesis offers advantages over other urine collection methods

If you work in a small animal veterinary practice, there’s a good chance you’ve performed, assisted with, ordered, or overseen a cystocentesis in many of your patients.

A cystocentesis offers advantages over other urine collection methods in that it provides a sterile sample, as opposed to free catch or even catheter methods that may contain contamination with pathogens or cells from the skin or urethra.

But how does an ultrasound-guided cystocentesis compare to a blind cystocentesis obtained via palpation or anatomical landmarks?

Your preference may depend on your practice style, experience, and patient needs. But here are a few things to consider…

Which Patients Are Good Candidates for Ultrasound-Guided Cystocentesis?

Here are a few factors that may determine if an ultrasound-guided cystocentesis is a good option for any particular patient…

• Large or overweight patients. A blind (or non-ultrasound assisted) cystocentesis may be straightforward on cats, and even small dogs, who are not overweight. In these patients, it is often possible to palpate the urinary bladder and to easily reach the bladder with a standard-length needle. 

However, difficulties arise in patients who are overweight, which makes it more challenging to feel and reach the bladder. Additionally, an ultrasound can help guide your needle with large dogs.

• Patients with “hard to stick” bladders. Maybe your patient’s bladder is thickened due to chronic cystitis or another condition. Or, maybe the patient’s bladder is small. 

Either way, an ultrasound provides additional direction (and visualization) of partially-full or otherwise difficult-to-obtain-a-sample-from bladders.

• Patients whose bladders could use a visual evaluation. If you’re obtaining a cystocentesis because the patient has urinary symptoms, a quick scan can provide more information about any obvious lesions. 

Use this for your own peace of mind (i.e., there’s no bladder tumor present at the time of the cysto), or create a charge for urinary ultrasound evaluation packaged together with other diagnostics.

Which Patients Are NOT Good Candidates for Ultrasound-Guided Cystocentesis?

• Thin cats with big bladders. Depending on your practice style and preference, you may find it’s easier to do a blind cystocentesis on a cat with an easily palpable bladder, especially for routine health checks. 

Although it may still be worth doing an ultrasound if the cat presented for urinary symptoms, so you can look at the bladder.

• Patients with bladder masses or tumors. If a patient has transitional cell carcinoma, placing a needle into the bladder may “seed” tumor cells into the abdomen as the needle is withdrawn. 

So any time a mass is present or suspected, it’s good to be cautious and skip the cysto (with or without ultrasound).

• Fractious or wiggly patients. These patients may not be good candidates for either ultrasound-guided or blind cystocentesis, since it wouldn’t be good for them to move around while the needle is inserted.

However, sedation may make the procedure possible for these dogs and cats.

PROS of Ultrasound-Guided Cystocentesis Versus Blind Cystocentesis 

Advantages include…

• Quick and easy. If you’re new to ultrasound-guided cystocentesis, it may take some practice. But soon it becomes a habit and may even be faster than a blind cysto.

• Visualization of the bladder. You know exactly where the needle is heading, and therefore you have an improved likelihood of getting a sample from a small or partially-full bladder. 

Plus, you may want to do a quick bladder evaluation to look for things like uroliths, sludge, or bladder masses, as this could change your recommended course of treatment.

• Safety. Supporters of ultrasound-guided cystocentesis point out that if you can see where the needle is going, there’s less risk of accidental puncture of other organs or blood vessels. 

CONS of Ultrasound-Guided Cystocentesis Versus Blind Cystocentesis 

• Training and practice are needed. It may take a little time for your team to become comfortable with this new method. Fortunately, it’s simple and straightforward to learn.

• Creating a charge for the service. This isn’t necessarily a bad thing—after all, you should be paid for your time and expertise when you provide a service.

However, there are differing opinions from practice to practice as to when and how to charge.

• For example, will you charge for all ultrasound-guided cystocentesis?

• Or only charge as part of a package with other diagnostics (urine analysis, urine culture and sensitivity, and quick ultrasound evaluation of the bladder, for example) in patients who are symptomatic?

• And how much will you charge?

• Small risk of side effects. The most common side effect is hematuria, which is mild and transient. Other risks do exist, such as bladder rupture or injury, organ or blood vessel puncture, urine leakage into the abdomen, the spread of bladder cancer, or vagal reactions (retching, panting, hypersalivation, collapse). 

While these effects are quite rare, it’s always worth considering the risks of any procedure before performing it, especially in patients who may be at higher risk due to underlying health conditions.

Investing in Ultrasound Training

In addition to teaching your team members to do an ultrasound-guided cystocentesis, it’s worth considering training in ultrasound examinations for you or one of your DVM associates.

There are plenty of other uses, including but not limited to abdominal evaluation for organs, masses, ascites, or even pregnancy, and cardiac or pericardial evaluations.

By maximizing your ultrasound usage, you can offer more diagnostics to your patients, while also getting the best ROI on your equipment investment—a win-win.

Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.

Written by: Dr. Tammy Powell, DVM

The InnoVet Summit X-Ray Table and Generator Is Ideal for Veterinary Use

InnoVet Summit X-Ray Table and Generator

Whether you’re starting a new practice or looking to upgrade your x-ray equipment, an InnoVet Summit (powered by Americomp) X-ray table and generator offer convenience, dependability, and excellent value for your investment.

Here are some of the things that make this x-ray table/generator a favorite among veterinarians…

Why Choose a High-Frequency Generator?

The InnoVet Summit is high frequency. Frequency refers to the speed of the waveform/x-ray beam production, and higher frequency means it’s faster with a higher penetration power. 

This results in consistency and efficiency—with excellent precision, tissue penetration, and image quality.

There is also a narrowing of the x-ray beam spectrum, which means a lower dose of radiation to your patients. 

Efficient Operation

Since high-frequency generators are more efficient, they only require a standard mains electrical supply (unlike older units that required a three-phase electrical supply).

Plus, efficient operation means a generator is more compact in size and not as heavy.

Preprogrammed Settings for Fewer Retakes

Instead of physical dials, the high-frequency generator offers preprogrammed settings.

This means rather than doing calculations, your staff can simply choose the type of study being performed (for example, thorax or hips) and use the patient’s measurements. The machine does the rest.

With less room for confusion, your x-ray studies are less likely to need a lot of retakes.

Minimal Motion Blur

Since a more powerful x-ray beam is produced in less time, motion blur artifacts will be minimized as much as possible.

This is especially important in veterinary medicine, where motion blur is a common challenge in pets who are nervous and moving around. Even sedated pets may take deep breaths as you try to obtain thoracic and abdominal views, so shorter exposure times are to your advantage.

Flexibility and Adaptability

The unit works with all film and any CR or DR digital system, including 8” x 10”, 10” x 12”, and 14” x 17” cassettes in either long or cross direction. 

This gives you the ultimate flexibility with your preferred method (and adaptability if you are looking to update from film to digital down the line).

And since the table and generator only require a 35” x 56” floor space, you have choices as to where to place your new x-ray system within your practice, especially if you have limited space.

Excellent Safety Standards

A powerful and efficient x-ray beam may allow you to lower the kV setting compared to lower frequency generators. This reduces scatter radiation—which is great for your images, and also for safety.

The collimator exceeds federal standards for radiation leakage protection. And a 20-foot cord for the footswitch allows staff to be out of the room during exposures.

An Ideal, Easy-to-Use Collimator

The collimator features high-intensity lighting for accuracy and ease of use, as well as “soft start” bulb power circuits that double bulb life. A selectable “on” time for the light allows you to set the collimator timing to your liking at 30, 60, 90, or 120 seconds.

A convenient swivel mechanism facilitates table-top procedures.

And the unit is designed for use with clunky lead gloves, along with a rubber edge to help prevent head injuries while resetting and repositioning.

What to Look For When Purchasing the Innovet Summit powered by Americomp X-ray table and generator…

• The brand name. InnoVet products were started by veterinarians, for veterinarians. And Americomp has offered high-quality standards since 1987. It’s best to go with a brand you know and trust.

• Shipping and installation. Find out if these costs are included.

• Monthly payments if you prefer a plan that will help you earn a return on your investment right away by simply using the equipment a couple of times per month.

• A good warranty to protect your investment.

• High-frequency technology, for all the reasons listed above.

• New or used units, depending on your needs. High quality used veterinary equipment is available at usedvetequipment.com (https://www.usedvetequipment.com/). If you don’t see what you need today, check back frequently for updated and added listings.

• Optional features such as tabletop extensions, tie-down brackets for restraint, and an out-of-room exposure switch.

A Special Deal on the InnoVet Veterinary X-ray table and generator…

We are offering the Innovet Summit, powered by Americomp, X-ray table, and generator at an amazing price (with convenient outright or monthly payment options), including free shipping and installation, as well as a 5-year warranty, free Simplex cassette tray, and several optional features, to suit your practice’s needs.

And contact us any time with questions 877-545-1202