Do You Need Lead Drywall Protection for a Digital X-ray Room in Your Veterinary Hospital?

Ensuring Compliance: Factors to Consider When Setting Up an X-ray Room in Your Clinic

If you are embarking on a new practice or renovating your clinic, there is an important question you must consider. Public health requirements regarding X-ray radiation shielding vary across states, making it necessary to assess the specific guidelines applicable in your location. These guidelines are designed to safeguard the well-being of your employees, patients, and customers. It is important to note that permits and inspections often incur fees.

Depending on the nature of your establishment, such as a veterinary hospital, specialized lead-lined sheetrock may be required.

For more detailed information about this specific type of sheetrock, you can visit - click here

Considerations should also be made regarding the physical location of the X-ray room within your veterinarian clinic, as certain states impose restrictions. For instance, regulations may limit the proximity of your radiography room to the waiting room, neighboring offices, or other businesses.

Another important aspect to obtain your permit is the type of X-ray equipment you plan to use.

It is crucial to provide specific details about your X-ray table/generator to ensure compliance. It is worth noting that different states have varying regulatory bodies overseeing radiography, including health departments and radiation environmental agencies.

To initiate your research, we have compiled a state-by-state list as a starting point. However, it is essential to thoroughly explore your state's official website to acquire accurate and up-to-date information.

When contacting the relevant agency, make sure to clearly communicate your business nature and the equipment you intend to utilize.

Since the person you speak with may not possess extensive knowledge about your specific industry, provide as much detail as possible.

Navigating government regulations can sometimes be frustrating, but it is crucial to prioritize accuracy.

Always inquire, "What else do I need to do?" to ensure you fulfill all necessary requirements for approval. Remember, your safety, as well as the safety of your staff and customers, is of utmost importance.

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

How to Talk to Pet Owners about Radiographs

“Does he really need an x-ray? Can’t you just give him some medicine and see how he does?

“Why is this so expensive? You just want to make money while my cat is sick!”

As a veterinarian, you’ve probably heard all of this and more.

Of course, most clients want the best for their pets, and many will understand why you want to perform certain tests like radiographs. However, even the most loving of pet parents may show some hesitation or “sticker shock” when you present the estimate…

Often, this isn’t personal. Many pet owners just aren’t prepared for a sudden expense, even if they want to do the best for their furkids. Here are some tips that may help take the conversation in a more positive direction…

Stay calm during the initial reaction

If an owner’s initial response is similar to the examples listed above, try to ignore the knee-jerk reaction to defend yourself. Get comfortable with allowing a moment of uncomfortable silence.

Often, clients will try to fill the silence themselves and offer more of their thoughts and questions. But even if they don’t do this, a quiet moment may give everyone the chance to take a breath and start over, calmly.

Don’t pile onto an owner’s guilt

Of course, you’ll need to explain why the radiographs are important for your treatment decisions, and what dangers exist for the pet if radiographs are delayed. 

However, if a pet owner understands this and is just having trouble affording the x-rays, they’re probably already feeling guilty. This causes them to lash out.

In this case, having empathy during the conversation can really help. Think about your tone of voice, body language, and anything else that may help elicit a productive conversation.

If you make an owner feel understood and accepted, they’re likely to come back to you as soon as they CAN afford the tests, rather than seeking care elsewhere.

Bundle your radiographs when possible

Often, estimates are presented as “a la carte,” with different options presented by cost, line by line. 

While this may work well in some situations, the client may try to pick and choose, asking which items can be eliminated in order to decrease the cost of treatment.

Instead, try estimates that list a total cost, with radiographs included. Some situations where this may work well include:

• Dental procedures with dental rads.

• Senior wellness testing, with bloodwork and screening rads.

• A blocked cat, with x-ray views included as part of the treatment plan.

• For three-view thoracic radiographs, bundle them together rather than listing the individual “per view” charges separately.

Of course, you can still list each item of the treatment plan, so the client knows the value they are receiving. But, list it as a total cost, rather than an itemized estimate.

Explain the benefits and limitations of radiographs

Many pet owners nowadays, especially Millennials, want to be fully involved in their pet’s care—that’s part of the reason why so many owners seek answers from Dr. Google prior to coming for a vet visit.

Those clients will want to receive answers about their pet’s condition right away—so, let the client know that radiographs will help to provide the answers they’re looking for. And since radiographs are available the same day, they can get answers to their concerns very quickly.

On the flip side, also prepare an owner that a radiograph might show normal results. If the pet is feeling well, then the client gets peace of mind. If the pet is ill, further testing may be required—by preparing the owner for this possibility ahead of time, you can avoid upset reactions as much as possible.

Ask about their biggest concern

Even though you probably already know the biggest concerns and questions clients have about x-rays, it never hurts to ask an owner why they’re hesitant. They may appreciate you listening to them, and it saves you time so you can address their biggest concern.

Some examples you may encounter include:

• Finances. In this case, you can suggest third-party financing options, such as Care Credit.

• Fear for their pet’s comfort, or having to leave their pet at the hospital. Here, discuss the procedure. If sedation is used, explain how this can minimize pain. Or, if digital radiographs are used, explain how this allows the views to be done fast so the pet can go home sooner.

Show clients the value you offer, even after the x-rays are finished

Be sure to go over the results of the radiographs with your client. Try using a quiet exam room rather than the treatment area, so they won’t be distracted.

Give the client a brief “x-ray orientation,” so they know which end is toward the pet’s head and what is abdomen versus chest, etc. Then, explain your findings. 

Whenever possible, bring a normal x-ray for comparison, so clients can really see the difference with an abnormal finding.

If you have digital images, share a copy with the client that they can look at after the visit. Offer to let them record you talking about the findings. That way, when the client goes home and shares the findings with their partner or family, everyone is more likely to understand and be on board with your recommendations.

With a little planning of the whole x-ray experience from the client’s perspective, you can make things easier on them—while at the same time, increasing compliance and getting better care for the pets you see.

Written by: Dr. Tammy Powell, DVM

What to Look for In the Radiographs of a Hit By Car Case

It’s been a slow day, and you just got back from lunch. Your first-afternoon appointment is waiting, and you look through their chart, preparing to go into the room… 

All of a sudden, the clinic doors burst open. You hear a big commotion upfront…

You walk up to see what happened and discover a distraught pair of pet owners holding carrying their Border Collie, who’s just been hit by a car.

How to avoid further surprises…

Of course, as a veterinarian, you’re probably used to something like this happening from time to time—panicked pet parents arriving at your clinic with a dog or cat in need. And you’re probably well-prepared to triage and decide what to do next…

However, you’ll want to avoid unpleasant surprises down the line—liked missed diagnoses—by ensuring that you find and plan for unexpected injuries.

For example, maybe that Border Collie has an obviously broken leg and some nasty road rash.

You’ll address those injuries, but first, you’ll explain to the owners that there are other conditions you need to check if their fur kid has just been hit by a car—conditions that could be life-threatening.

What to look for on the x-rays

Your physical exam will help direct you on what to look for. For example, if you feel a painful joint with crepitus, or hear crackles or decreased lung sounds when you auscult the chest, those will be areas you want to explore with radiographs. 

But, even if the lungs sound fine and you don’t find any other obvious abnormalities, it’s always good to evaluate the thorax and abdomen radiographically.

Sometimes, x-rays will need to wait…

For example, if the pet is in critical condition, they need stabilization first. And, you’ll use your judgment on whether sedation is needed and safe, for clearer and more diagnostic x-ray images, as well as for relief from pain and stress.

Then, when you read the radiographs, it’s important to evaluate EVERYTHING on your set of x-ray images. 

The impact of being hit by a car can cause trauma to many different parts of the body all at once, including serious internal injuries.

Here are a few things to check for on your radiographs…

• Pulmonary contusions. A strong trauma to the thorax can cause dangerous bleeding in the lungs, often visible on radiographs as alveolar or interstitial opacities.

• A ruptured bladder and uroabdomen. Look for signs of fluid in the abdomen, especially if you notice bloody urine. Try to visualize the bladder.

• Internal bleeding or damaged organs. If an organ such as the spleen has been injured, you may notice a hemoabdomen (although radiographically, this would be difficult to distinguish from a uroabdomen). In the case of ruptured intestines, you may notice spots of free air in the abdominal cavity.

• Broken bones, including the ribs and vertebrae. Visually trace along the bones one-by-one to be sure no lesions are missed. 

• Dislocations, such as a dislocated hip. Also, check for tail-pull injuries, especially in cats who may get their tail caught under a car’s wheels.

• Diaphragmatic hernia. Look for evidence of intestines or other abdominal organs in the thorax.

• Air or fluid in the pleural space. Seen as gas opacity, or fluid opacity.

• Skull and jaw radiographs if needed—in case of suspected head trauma.

Of course, other abnormalities are possible, too. As you know, pets don’t always “read the book” and clinical practice can be full of surprises! If you’re unsure of something on the films or digital images, it may be good to recheck it down the line to be sure no problems are brewing internally.

The number of views you take will vary depending on the size of the pet.

For emergency situations such as this, it may be worth having digital radiographs, for faster results without waiting for films to develop.

Also, it’s important to take orthogonal views. That way, you get the full pictures and lesions are less likely to be missed.

Re-evaluate and repeat radiographs as needed

This will depend on what you see on the first set of images, in addition to how the pet is doing in real life. Use your best clinical judgment to determine if and when repeat radiographs are needed, and keep the pet under close observation.

If there’s any doubt, consider using contrast studies to obtain more information, too.

By developing a plan for radiographs—and remembering to check everything on the images—you’ll increase the chances of finding unexpected injuries and addressing them earlier. Or, in case the radiographs are normal, you may be able to give more peace of mind to the worried pet owners.

---

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

What is the Warranty and Service Coverage if I Buy a Veterinary Digital X-Ray System?

Today, every veterinarian recognizes the importance of incorporating digital X-rays into their animal hospitals.

A considerable number of them plan to transition from traditional film and chemical X-rays to digital systems this year.

While the initial concern typically revolves around the cost of acquiring a digital X-ray system, it is equally crucial to inquire about the warranty and its coverage.

Here are some pertinent questions to ask the prospective vendor when considering the purchase of a veterinary digital X-ray system:

1. What is the duration of the hardware warranty for my veterinary digital X-ray plate?

2. How long does the software warranty for my veterinary digital X-ray software last?

3. For how long will I receive software upgrades for the X-ray system used in my animal hospital?

4. How long will my veterinarian technicians have access to tech support, enabling them to seek answers to any queries that may arise during the daily implementation of digital X-rays in my animal practice?

5. What are the costs associated with continued phone support, software upgrades, and technical assistance after the warranty period ends?

6. Which entity is responsible for providing software and technical support? Who developed and owns the software?

7. Does the warranty cover labor and shipping expenses, as needed?

8. In the event that my X-ray plate requires repair, will a temporary replacement plate be provided?

It is common for vendors operating in the animal health sector to offer a minimum of a 1-year warranty.

Not all vendors possess ownership of the software that operates their veterinary digital X-ray plate, which holds significant importance. While a digital X-ray plate can remain functional for many years, the software it relies on may become outdated within a short span of time.

An example of this can be observed with Windows XP platforms. Unless companies continually update their software, it becomes incompatible with new computing platforms.

When veterinarians transition from computed radiography (CR) to direct radiography (DR), the predominant issue they encounter is not the failure of the CR system itself but rather the poor performance or lack of support for the software.

This issue is not limited to small companies alone. Renowned brands like Idexx and Sound have discontinued support for their older product lines by ceasing software upgrades.

Our aim is to offer you transparent service and support. Our animal health software has been developed in-house by JPI which has been manufacturing x-ray equipment, writing software, and providing telephone support for these products since 1994.

Here are the responses to the eight frequently asked questions:

1. What is the duration of the hardware warranty for my veterinary digital x-ray plate?

- The hardware warranty lasts for 5 years.

2. How long is the software warranty for my veterinary digital x-ray software?

- The software warranty is also valid for 5 years.

3. For how long will I receive software upgrades for my x-ray system to be used in my animal hospital?

- You will receive software upgrades for 5 years.

4. How long can my veterinarian technicians receive phone support for any questions they may have regarding the daily implementation of digital X-rays in my animal practice?

- Our tech support helpline will be available for your veterinarian technicians for 5 years.

5. What is the cost of continued phone support and software upgrades after the warranty period?

- The cost for continued phone support and software upgrades after the warranty period is $750.00 per year.

6. Who provides the software and tech support? Who developed and owns the software?

- Our Examvue Veterinary software is developed, supported, and owned by JPI. They have been offering industry support since 1994. For technical support, please call 516-513-1330, and select option 2. Our support team is based in New York.

7. Are labor and shipping costs covered under the warranty if needed?

- Yes, labor and shipping costs are included in the warranty as required.

8. Will a loaner plate be provided in case my X-ray plate needs repair?

- Yes, we will provide a loaner plate in the event that your X-ray plate requires repair.

Will a new Digital X-ray System Work with my Old Innovet Summit X-ray Generator?

Many veterinarians invested in X-ray systems in the ’90s. Most purchased an Innovet Summit table and generator.

They used the table and generator along with cassettes enclosing film to capture X-rays and provide life-saving next steps for their pet patients.

Processing the film in the chemical rinse and developing the images in the darkroom enabled the practicing veterinarian to review the X-ray.

If the X-ray proved complicating or just interesting then the veterinarian would mail the X-ray to a specialist for a review or save the X-ray case for the next ‘radiology rounds’ in upcoming weeks and months.

During these radiology rounds, X-ray cases would be reviewed amongst veterinarian piers and sometimes even veterinary radiologist.

Even if the patient was deceased by the time of the review huge advances in pet medicine were and still are to this day applied.

If you're reading this you use to film with your old X-ray generator and table. You want to impact the neighborhood and village who depend on precise and timely diagnosis to treat their pets.

Digital X-rays can speed up the process not only of image acquisition but also provide clear diagnostic radiology rounds.

Most old tables and generators still can produce excellent X-rays.

Often times these old systems have new light bulb collimators and replaced fuses that enable the old workhorse to continue to provide the power for an X-ray.

Yes, you can use your old table and generator with two types of digital X-rays.

The first is computed radiography or CR which will work today with any generator as the image is captured on an erasable film cassette then scanned into the software where the digital image can now be interrupted, adjusted or emailed to pet owners.

The next is an AED cesium plate. Automatic exposure detection.

This allows the plate to prepare itself for the exposure to capture the image and send in second the inmate to the display monitor.

This is the newest way to capture X-rays.

Not having to wire the old X-ray system to the new digital X-ray system is a confinement advantage.

It removes an element of future failure in hardware by eliminating the interference box!

We can help answer more questions surrounding your old X-ray table and generator.

Reach out today and we would be happy to help.

Will my old Universal Easymatic x-ray table and generator work with a new digital x-ray system?

Some of the Universal Easymatic systems look like this

Some veterinarians purchased their x-ray table and generator 25+ years ago and they still work perfectly!

Through care and good maintenance, they have been able to produce diagnostic images over the years using film.

For some veterinarians, 2017 is the year they would like to stop using chemicals and standard film.

However, they do not want to spend the 17k-25k on a new table and generator when their old system is producing excellent mas/kvp options for each case.

The good news is your existing system can work well with proper installation with your new digital x-ray equipment. For computed radiography or CR it is a simple calibration that will enable the old table and generator be ready for use the day of the installation.

This installation should be carried out by the installer on the day of installation and prior to the training session with the veterinary staff.

For direct radiography or DR, the plate may be wired into the foot switch as a prep switch. The old universal Easymatic x ray table and generator send out a 120-volt prep and expose signal.

A conversion box is brought by our onsite installers so that the cesium technology can convert the voltage down to a high of 5 volts and a low of 0 volts.

Another item that we include with our system is a new foot pedal switch. Often times the old switch can be worn out and the wiring loose.

A new foot pedal switch ensures a smooth transition from prep to exposure. In some instances, we also include a hand switch which can be mounted on the wall.

This secondary option is nice especially if the foot switch was to go out you always have another backup to take a high-quality digital x-ray.

You do not always need to buy a new table and generators to enjoy the speed, safety, and quality of digital x-rays.

Contact us today.

We can help you upgrade your system to digital.

Here is a video showing the conversion from film to digital using the old table and generator.