Choosing and Interpreting In-House Parvovirus Tests

Table of Contents

Parvovirus is a potentially deadly disease that, unfortunately, is also fairly common

Most veterinarians have diagnosed and treated their fair share of parvovirus. While most common by far in young puppies, the disease can also occur in adult dogs on occasion, especially those who are unvaccinated. 

Due to parvovirus’ ability to cause severe illness and death (even with treatment), many veterinarians use point of care tests for the virus in their practice. This can help provide an answer and aid in forming a treatment plan right away, along with a plan to isolate the affected dog to limit spread of the highly contagious virus. Also, having a tangible result to show clients may help with challenging conversations about the seriousness of the condition and the expense of treatment.

At the same time, it’s important to understand the limitations of the test and to choose the brand that best fits the needs of an individual practice. Here are some things to consider…

Which Tests are Available for Parvo Testing in Dogs?

Tests are available for in-house. Laboratory testing is also available, including PCR testing that may be helpful especially for follow-up on a suspected false-negative result.

For point of care tests, here are two popular options for veterinary practices…

• IDEXX SNAP Parvo Test

IDEXX claims to have high accuracy, with reference laboratory quality technology and 100% sensitivity and specificity as stated in the company’s supplemental materials on the test. They also claim to not cross-react (have a false positive test) following administration of modified live parvovirus vaccines. Results are ready in 8 minutes, and the test can be stored at room temperature. A SNAP Pro Analyzer is available to automatically activate and read tests, and add results to the medical record.

• Zoetis WITNESS Parvo Rapid Test

Zoetis states the WITNESS test is easy to use, without the need to snap the test. Some vets report it is more affordable, too. It has a reported sensitivity of 86.3% and specificity of 96.1%. The test offers results in 10 minutes, room temperature storage, and an extended (12-month) shelf life. 

Zoetis also offers the VETSCAN Parvo Rapid Test, which they report has a sensitivity of 96.0% and specificity of 98.7%. VETSCAN results take 10-15 minutes.

Considerations for In-House Parvo Testing

These tests look for parvovirus antigen (viral shedding) in canine feces. With this in mind, it’s important to consider everything that could affect a test’s accuracy.

For example, false negatives are possible—so a negative result doesn’t completely rule out a parvo infection in a symptomatic dog. This is because fecal shedding of parvovirus only occurs in a specific time window following exposure, and thus a puppy may have been outside this window when tested. Follow-up laboratory testing may be of value here, and treatment may need to be initiated in a clinically ill dog.

Anecdotal reports of false positives also occur following vaccination with a modified live parvovirus vaccine. It’s worth noting that IDEXX’s study on post-vaccinal false positives only included 64 dogs, so perhaps the occasional false positive would be seen with a much larger study population. In general, a false positive is more likely to be a “weak” positive rather than a strong one, and this most commonly occurs 4-14 days after vaccination. 

For both suspected false positives and suspected false negatives, it’s important to look at the entire clinical picture. Does the puppy have any vomiting, diarrhea, lethargy, fever, that characteristic “parvo smell,” or any other clinical signs? Is their CBC or blood smear normal, or is neutropenia or any other abnormality present? How old are they, and what’s their vaccination history? It’s often also worth running a fecal test or treating empirically for worms in puppies with GI symptoms.

Testing for Feline Panleukopenia Virus in Cats Using a Parvo Test

Veterinarians have reported using point of care parvovirus tests to test for panleukopenia virus in cats, with a good degree of accuracy. It’s worth noting that this is considered off-label and not necessarily endorsed by the manufacturers. A veterinarian must use their clinical judgment to decide if this is something that might be beneficial to feline patients with possible panleukopenia virus. Similar to testing for parvovirus, false negatives can occur, and false positives can follow a recent vaccination.

Purchasing Considerations

Be sure to consider brand preference (if special deals are available when purchasing other equipment or tests from the same company), contracts, quantity sold, expiration dates, availability of technical support, and any other factors that could be relevant to using the tests in clinical practice.

Details and specifics of these tests may evolve over time. It’s important to check directly with the company for the most up-to-date information before making a purchase.

Written by: Dr. Tammy Powell, DVM

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

In-House Heartworm and Tick-Borne Disease Tests

In-House Combination (Four-way) Heartworm and Tick-Borne Disease Tests: A Comparison

For dogs in some parts of the country, tick exposure (and risk of tick-borne diseases such as Lyme, Erhlichia, and Anaplasma) is a concern. Some infections can cause serious illness or even chronic disease.

Last week, we discussed some of the most commonly used in-house heartworm tests. But it’s important to remember that there are also combination heartworm tests available, which also test for common tick-borne diseases.

Depending on the risks in your area, it may make sense to screen canine patients for tick-borne diseases whenever routine or yearly heartworm testing is performed. These tests might also be good for screening patients who are symptomatic.

Here are two of the most common combination (sometimes referred to as “four-way”) heartworm and tick-borne disease tests used in-house by veterinarians…

IDEXX SNAP 4Dx Plus Test

IDEXX claims their test provides accurate results with reference laboratory quality technology. The test requires 3 drops of sample, and results are ready in 8 minutes. 

The six diseases that the SNAP 4Dx tests for are: 

• Heartworms.

• Lyme (Borrelia burgdorferi) infection.

• Ehrlichia canis and Ehrlichia ewingii.

• Anaplasma phagocytophilum and Anaplasma platys.

There is also a SNAP Pro Analyzer available, a device that saves time by automatically activating a SNAP test, reading and interpreting the test at the correct time, and adding results automatically to the medical record. 

Abaxis/Zoetis VetScan FLEX4 Rapid Test

The advertised benefits of the Abaxis (now a part of Zoetis) test are room temperature storage, a 1-year shelf life, and is very simple to use. The product information also states that the test can distinguish true Lyme disease exposure from Lyme vaccination.

The test requires 2 drops of sample and can be read in 8 minutes.

The FLEX4 tests for seven diseases, which are:

• Heartworms.

• Lyme (Borrelia burgdorferi) infection.

• Ehrlichia canis, Ehrlichia chaffeensis, and Ehrlichia ewingii.

• Anaplasma phagocytophilum and Anaplasma platys.

Similar to IDEXX, this company also offers an automatic reader—the VETSCAN VUE—to save time for veterinary technicians. Zoetis also advertises 24/7 technical support and confirmation testing (always available for heartworm, and on a case-by-case basis for tick-borne diseases).

A Few More Considerations

There is a lot of debate as to whether or not four-way tests should be used to screen healthy patients annually, versus just using a heartworm test by itself. The reason has a lot to do with the possibility of false positives.

Additionally, it’s important to know that the heartworm component tests for antigen, while the other infectious disease components test for antibodies.

This means a positive test for a tick-borne disease could potentially indicate a past exposure rather than current clinical disease. 

Some practitioners find that this can waste time—for the veterinary team and pet owner alike—and potentially make a client worry needlessly when their pet is actually healthy.

On the other hand, some practitioners feel that a positive result (one that indicates previous exposure in a currently healthy dog) opens the door to a conversation about the importance of tick control.

The best answer to these considerations will vary from practice to practice; it may be best decision based on the risk of tick-borne diseases in your area.

For example, the test may be more useful for screening in Lyme-endemic parts of the country. To determine the risk in your area, consider checking resources such as the CAPC’s Parasite Prevalence Maps.

Also, check with other practitioners in your area and see if your state board or state veterinary organization has resources or information available.

Follow-up testing can be a very useful option, especially for any positive or negative results that don’t fit the clinical picture, and to determine the best next steps for an individual patient.

Details and specifics of these tests may evolve over time. So, it’s important to check directly with the company for the most up-to-date information before making a purchase. Also, check for any special deals (or stipulations such as minimum purchase requirements) prior to finalizing a purchase decision.

Written by: Dr. Tammy Powell, DVM

Resources:

CAPC Parasite Prevalence Maps: https://capcvet.org/maps/#/2021/all-year/heartworm-canine/dog/united-states

In-House Heartworm Tests: A Comparison Veterinary Guide

The American Heartworm Society (AHS) recommends annual testing for heartworm disease in canine patients. While heartworm testing in cats can be trickier than in dogs, the AHS also recommends testing cats before starting them on heartworm prevention, to establish a baseline for each patient.

Heartworm disease can be a risk in just about any state in the US. Even in states that see less mosquito activity or have not been well-known for heartworm risk, there is still some possibility of exposure as more and more dogs from heartworm-prevalent areas travel with their owners, potentially exposing the local mosquito populations. 

Should Heartworm Testing Be Done In-House?

As with many diagnostic tests, a veterinarian has the option of performing the test in their practice or sending a blood sample to an outside lab for analysis—or a combination of both.

For example, sending blood to an outside lab might make sense for healthy patients who are having a wellness bloodwork panel performed at their routine checkup.

Many standard bloodwork panels include a heartworm test, so it may make sense—financially for the client, and to save time for the veterinary team—to do the heartworm test at the lab since the blood sample is already being sent out.

However, prices and bloodwork panel options vary depending on the company and contracts/deals obtained, so be sure to compare the prices at your own clinic.

On the other hand, sometimes it makes sense to do a heartworm test in-house. For example, maybe a patient is symptomatic, and the veterinarian and pet owner both want an answer right away.

Or, maybe the client can only do basic care—vaccines and a heartworm test before starting heartworm prevention. For that client, it may make sense to do an in-house test so they can receive the results right away and know they can safely begin their dog’s prevention.

Here are some of the in-house heartworm tests available to veterinarians…

IDEXX SNAP Heartworm RT Test

IDEXX claims their test provides reference laboratory quality technology, for accurate results even with a low heartworm burden.

Their improved test sensitivity comes from a technology called “bidirectional flow,” which gives the sample two chances to bind to antibodies during the test, and from amplification. And specificity comes from a wash step that helps remove debris from the result window.

Abaxis VetScan and Zoetis Witness Heartworm Rapid Tests

Abaxis (now a part of Zoetis) offers a very simple-to-use test. It requires just one drop of blood and two drops of buffer, with no need to physically snap the test.

The company advertises that their product has a 12-month shelf life and does NOT need to be refrigerated. It also has a spot to write the patient’s name, to ensure there’s no mix-up of results if performing many tests in a short time frame.

Because of the non-refrigerated storage and the ease of writing a patient’s name on the test, this rapid test might be a good option for mobile or high-volume practices.

The Zoetis Witness test is very similar to the VetScan, and Zoetis sells each one in different quantities. For practices that mostly send their samples out to a lab, it may make sense to order the Witness test, which is available to be ordered in smaller quantities, so the tests don’t expire before a veterinary practice uses all of them.

Heska Solo Step Heartworm Test

The Heska test is also supposed to be simple to use, requiring 3 drops of blood and no need to snap the test. One advantage that Heska advertises is free confirmatory testing at their lab for positive results on the in-house test. This test can also conveniently be stored at room temperature.

There are separate versions of the test available for canines and felines, with the feline test evaluating for heartworm antibody rather than antigen.

A Few More Considerations

In-house tests are great options for screening for canine patients. However, any positive in-house test should be followed up with additional testing. This would usually involve confirming the positive test at an outside lab, and doing microfilaria testing. It’s important to have this additional confirmation and information prior to beginning any treatment.

Testing for cats is more complicated, too

Since heartworm-positive cats are more likely than dogs to be negative on an antigen test, an antibody test is the test of choice for them. However, antibody testing must be taken into account with the clinical picture and additional testing, since it documents exposure and is therefore not necessarily indicative of a current infestation.

Details and specifics of these tests may evolve over time. It’s important to check directly with the company for the most up-to-date information before making a purchase.

And finally, consider additional factors such as whether a special deal is available on these rapid in-house tests if you are already purchasing other equipment (like a hematology or chem analyzer, for example) from the same company. It may make financial sense to stick with the same brand. Be sure to check for any stipulations (like a minimum number of tests per month) in the contract, though. Also consider if it would make sense for your practice to do a combination test—which often features testing for Lyme, Anaplasma, and Ehrlichia in addition to heartworm—based on the risk in your local area.

With all these factors in mind, the best test for each individual practice varies, depending on their unique needs. Doing research, and asking for opinions from colleagues who have used the tests, can help with making this important decision.

Written by: Dr. Tammy Powell, DVM

Choosing an In-House Veterinary Chemistry Analyzer

Serum chemistry analysis is something most veterinarians use at least daily, and often many times throughout their workday.

These tests can be used for well-patient health checks, for pre-surgical bloodwork, and to assess an ill patient.

Having accurate results and a system for obtaining them is important. So, when choosing the best method or machine for your practice’s needs, it makes sense to put research and time into that decision. Here are some things to consider…

Should You Use an In-House Chemistry Analyzer, or Send Samples to an Outside Lab?

Each veterinarian has their own preference. And many veterinary practices use a combination of both—in-house analyzers for when results are needed immediately (such as for guiding the treatment plan for an ill or injured patient), and an outside laboratory for more routine testing.

Depending on the pricing structure, an in-house machine might also allow the practice to keep a higher percentage of the profits with each test performed—although this will probably depend on volume and other factors such as contracts and maintenance. Either way, there is some freedom to create your own system for your practice flow.

What Should a Veterinarian Consider When Choosing an In-House Chemistry Analyzer?

Here are a few important considerations before making a purchase…

• Brand preference. Sometimes, a veterinarian or their team members prefer a particular brand due to previous experience or their relationship with the company or sales representative. Certain companies may offer discounts on other services or tests (such as snap tests, hematology analyzers, or consults with specialists) as a perk of using their equipment, which may make financial sense for a practice.

• Contracts. Sometimes, particularly when equipment is heavily discounted, there may be “strings” attached, such as a requirement to perform a certain number of tests per month (and a penalty for not doing so). It’s always important to check the contract closely when making a purchase or signing an equipment lease.

• Costs. Obviously, the cost of the chem analyzer itself should be considered. But remember to also factor in the costs of supplies (rotors, etc.) and the cost of each test relative to the cost to the client. 

• Machine specifics. Which specific tests are available (chem panels vary in size and comprehensiveness), and for which species? Are single tests available, for when you only need to retest one specific value (and how much do supplies for these tests cost versus the larger panels)? How fast are the results? How much blood is needed to run each test—and does the blood need to be spun down first? 

• Ease of operation. Is the machine simple and intuitive to use? Is training provided by the company that sells the machine? And, how are results added to a patient’s medical record? 

• Warranty and maintenance. Ask if there is a warranty included, what it covers, how long it’s good for, and if there’s an option to renew it once it runs out. Also, ask about routine maintenance costs, if there’s a helpline available if you have questions, and how fast an issue with the machine can be repaired/resolved.

• “Real-world” performance. Ask around and see if any colleagues in your area use the equipment, and see what their experience has been. Or, see if the company will let you use the equipment on a short trial period before buying.

IDEXX, Abaxis, and Heska

These three companies are popular choices for veterinary practices. Here are the stated advantages of highlighted chem analyzers from each company…

IDEXX Catalyst One Chemistry Analyzer

IDEXX’s machine offers up to 34 parameters for chemistry, electrolytes, and immunoassay profiles in a single run. They note the practitioner has flexibility in terms of test comprehensiveness, including individual tests and preloaded CLIPs (pre-programmed chem profiles, or the option to create custom testing profiles). Results are available in minutes, and they advertise high accuracy from proprietary technologies. The machine is supposed to be simple to use (“load-and-go” with whole blood, serum, or plasma), for easy workflow. The IDEXX Catalyst One also features 24/7 auto-monitoring and maintenance.

Abaxis VETSCAN VS2 Chemistry Analyzer

The Abaxis analyzer is a small, portable option. It allows a practitioner many options for analyzing chemistry, electrolyte, acid-base, and immunoassay tests, with 12 testing profiles available. The machine is advertised to be easy to use (only a few steps to use, and minimal maintenance), with the capability of connecting to practice management software. The VETSCAN VS2 operates on as little as 2 drops of whole blood, serum, or plasma, with results in 12 minutes. It features its own intelligent Quality Control (iQC) system, which contributes to accuracy.

Heska Element DC5X Chemistry Analyzer

Heska advertises that their analyzer offers ease of use, high performance/volume capabilities, and “gold standard” technology. Ease of use means a fully automated process (“load and go”), an intuitive touchscreen, and easy integration with practice management software (with bi-directional communication). High performance means up to five samples per operation, and up to 190 tests per hour, with the option to preload up to 50 pipettes at once to save time. Veterinarians can choose from a broad, pre-programmed panel or customize to run only the tests needed. Only 10mL of sample is needed per test. Heska also advertises a free warranty.

Keep in mind that there are different analyzer models available from each company that have varying specifications and that details may change over time. So always confirm the specifics before making a purchase.

There are many options available, so it’s important to do some research and see what’s the best fit for an individual practice and if any special deals can be obtained when purchasing or leasing. It’s worth the time since the machine will probably be used frequently to serve the needs of your patients and clients.

Written by: Dr. Tammy Powell, DVM

Choosing an In-House Hematology Analyzer

Complete blood cell counts and qualitative analysis of blood cells are some of the most common diagnostic tests used by veterinarians.

Just a few of the many uses for hematology include diagnosing and monitoring anemia and looking for signs of inflammation, infection, cancers such as leukemia, and many other ailments.

Since blood tests are so crucial to the diagnostic plan for many ill patients and are often included in baseline testing for well patients, choosing the right machine for your practice’s needs is an important decision.

Why Choose an In-House Hematology Analyzer?

When it comes to blood cell analysis, veterinarians have the option of doing tests in-house or sending samples out to a lab. Each method offers its own advantages, and some vets even use a combination of both. 

For example, when a sample is sent to an outside lab, there is usually the advantage of a specialist doing the qualitative/differential analysis. With in-house analyzers, it’s a good idea to include blood smears for increased accuracy and to look at cell morphology.

A veterinarian or their nurses can gain this skill through practice. However, a specialist may be able to detect subtle changes to blood cells that a general practitioner might not notice since the specialist looks at blood cells all day long. And, they can often confidently differentiate between artifacts and pathology when looking at cells on a blood smear.

On the other hand, the in-house analysis offers a lot of conveniences.

Sometimes, a veterinarian needs an answer quickly in order to start treating an ill patient right away. And worried pet owners might want answers as soon as possible.

Plus, depending on the specific contract the veterinarian has entered into, an in-house machine might allow the practice to keep a higher percentage of the profits with each lab test performed.

What Should a Veterinarian Consider When Choosing an In-House Hematology Analyzer?

Here are a few important considerations before making a purchase…

• Brand preference. Maybe a veterinarian or their team has had a good experience with a particular brand. Or, if the company has any additional equipment or tests (such as snap tests) the practice is also interested in, maybe it would be possible to negotiate a better deal for everything together.

• Contracts. Sometimes, particularly when equipment is heavily discounted, there may be “strings” attached, such as a requirement to perform a certain number of tests per month (and a penalty for not doing so). It’s always important to check the contract closely when making a purchase. 

• Costs. Obviously, the cost of the analyzer itself should be considered. But remember to also factor in the costs of supplies (rotors, reagents, etc.) and the cost of each test relative to the cost to the client.

• Machine specifics. How fast are the results? How much blood is needed to run each test? Which species can be tested? And how are results added to a patient’s medical record?

• Ease of operation. Is the machine simple and intuitive to use? Is training provided by the company that sells the machine?

• Warranty and maintenance. Ask if there is a warranty included, what it covers, how long it’s good for, and if there’s an option to renew it once it runs out. Also, find out about routine maintenance costs, if there’s a helpline available if you have questions, and how fast an issue with the machine can be repaired/resolved.

• “Real world” performance. Ask around and see if any colleagues in your area use the equipment, and see what their experience has been. Or, see if the company will let you use the equipment on a short trial period before buying.

IDEXX, Abaxis, and Heska

These three companies are popular choices for veterinary practices. Here are the stated advantages of highlighted analyzers from each company…

IDEXX ProCyte Dx Hematology Analyzer

IDEXX claims to have the industry’s most comprehensive CBCs (27 whole blood parameters plus fluid analysis options, with 17 species capabilities), with reference lab-quality results. They advertise dot plots with each in-house CBC report and extra help such as differential diagnoses and access to board-certified consultants at no charge. Results take two minutes.

Noted special capabilities include detecting band neutrophils and nucleated red blood cells, and including a reticulocyte count.

Abaxis VetScan HM5 Hematology Analyzer

This Abaxis machine reports 22 parameters in less than four minutes, including histograms. The company advertises compatibility with select practice management systems, ease of use, and minimal, quick maintenance with automated cleaning reminders.

Another benefit may be the small sample size requirement of just two drops of whole blood. It has capabilities for 15 species, as well as fluid analysis options. One noted special capability is a direct eosinophil count.

Heska HemaTrue Hematology Analyzer

Heska notes this machine can deliver accurate, reproducible results in 55 seconds, using just 20uL (about one drop) of blood. Results include 17 parameters and histograms. The color touchscreen interface is noted to be simple to navigate, with several species options.

The HemaTrue has daily automatic cleaning and quality control. The company states veterinarians have options such as a free analyzer use, low test prices compared to competitors and a free warranty. One additional advantage is a built-in blood tube mixer.

Keep in mind that there are different analyzer models available from each company that have varying specifications and that details may change over time. So always confirm the specifics before making a purchase.

There’s no one right machine that’s a fit for every veterinary practice. Instead, look at your practice’s individual needs and budget to find the hematology analyzer that’s the best fit for your team and for meeting the needs of your patients and clients.

Written by: Dr. Tammy Powell, DVM

5 Tips to Improve Proficiency With Ultrasound

By becoming proficient at ultrasound studies, a veterinarian can elevate patient care at their practice while also boosting profits.

Whether you’re evaluating the abdomen, the heart, or something else, an ultrasound study can be a very valuable tool.

Here are five ways for a practitioner to improve their ultrasound skills and offer more of this valuable service to pet owners…

The Right Equipment Can Make a Vet’s Job Easier

Having good, well-functioning equipment can really make life easier for a veterinarian and their team. 

This could include a variety of factors, such as…

• Does all of the ultrasound equipment—probe, machine and monitor, and any programs for saving videos and information—work? Does any component (or the whole system) need to be repaired or replaced?

• Is the equipment of a good quality? Maybe it’s technically working, but do the images you produce have enough detail and clarity to see what you need to see? Is any part of the process cumbersome, which can make it less likely that the ultrasound will be used to its full capacity and potential?

• Would routine maintenance or an upgrade improve efficiency and make it easier to offer this service to clients and their pets?

This is all-important because even as you learn, practice, and improve your skills, inefficient or subpar equipment may make it challenging to fully implement your new training and may lead to frustration.

Standard Protocols and Techniques Can Improve Efficiency

If an ultrasound is only performed once in a while, it may feel like a hassle or lead to confusion or inefficiency when trying to schedule and perform an ultrasound study.

To improve efficiency and make it easier to offer ultrasound services at your practice, consider all stages of the process, including…

• Has the veterinary team been trained and empowered in all aspects of scheduling an ultrasound study? For example, is there a specific day of the week, especially if there is only one doctor at the practice who performs ultrasounds? Has enough time been scheduled, especially if sedation is needed? Having a standard set of instructions or protocols can help the team and make things run smoother for everyone.

• If the patient needs any special instructions to prepare for their ultrasound study (such as fasting from the previous evening), is there a clear process for communicating this to the client?

• Does the veterinary team know all the tools you would prefer to have available during an ultrasound study? This may include everything from a v-trough, towel, and clippers, to syringes and microscope slides in case an FNA is indicated. Having a kit or list prepared ahead of time will help save time so no one has to run to the other room and grab supplies mid-study.

• If a patient is sedated or under anesthesia, is there a standard format/form for monitoring?

• Is there a report prepared for the client? Can video clips or still images be saved as part of the medical record? Will the client be present during the ultrasound in some cases? Make sure the whole team knows what should be done.

Take Advantage of All the Resources You Find Helpful

This may include textbooks and other references for what is normal on each ultrasound study and what is not. 

Access to a second opinion can also be helpful. Consider discussing your findings with colleagues within the practice, subscribing to an online forum such as the Veterinary Information Network (VIN), or even using a specialist consultation service for an expert, second set of eyes on your ultrasound images or videos.

Practice Makes Perfect

Any new skill can be challenging at the beginning. But ultrasound proficiency will improve over time, with practice. So even if fitting more ultrasounds into a busy schedule feels time-consuming at first, it will probably get to be second nature over time. 

In addition to training and courses, it may help to ultrasound healthy patients for practice, to gain a thorough understanding of all the different ways normal anatomy can look in different sizes and breeds of veterinary patients. This could be done with the pets of veterinary team members, or possibly offered to clients at a discounted price in the early stages.

Communicate Effectively With Clients

If pet owners are unsure about proceeding with ultrasound for any reason or experiencing sticker shock, the conversation can take up a lot of time for veterinarians and their team members. By planning what to say and gaining comfort with these conversations, time can be saved while providing patients with the care they need. 

Efficient conversations about pet ultrasounds may include general principles for good communication (active listening, empathy, non-verbal communication, etc.), as well as explaining the excellent value that clients are receiving for the cost. For example, explain just how much information can be gathered from an abdominal ultrasound study. In addition to looking at suspected abnormalities, it’s a thorough look at many important organs. Occasionally, unexpected issues are caught early, or if the dog or cat is normal then the owner can have peace of mind.

Putting all these principles together, a veterinary team may find the whole ultrasound process becomes more efficient. This is good for team morale, as it helps to keep the day running as smoothly as possible. It can also increase a practice’s bottom line while providing excellent care for patients.

For all these reasons, it may be well worth it for a veterinary team to invest time and effort in adding ultrasound to their practice!

Written by: Dr. Tammy Powell, DVM

5 Tips to Improve Efficiency With Radiographs

Efficiency can increase a veterinary practice’s income by allowing more patients to be seen or more procedures such as radiographs to be performed.

Additionally, it may lead to an increased average charge per patient—which can improve a practice’s bottom line while delivering excellent patient care.

When it comes to radiographs, here are five ways to increase efficiency…

Start With the Best Equipment for Your Practice’s Needs

Having good, well-functioning equipment can really make life easier for a veterinarian and their team. After all, slower machines and image processors can increase the time per shot. And equipment that’s not operating at its best may lead to frustrating retakes—or even to rescheduling a procedure.

To maximize the usefulness of radiography equipment at a veterinary practice, start by taking an inventory of which equipment is there, including: generator, table, plate or cassette, film processor or digital image software, etc.

Next, evaluate each piece of equipment with the following questions:

• How is the equipment functioning right now?

• If not working well, can repairs or maintenance solve the issue—and what is the cost?

• Is there any routine maintenance due to be performed?

• Does anything need to be replaced—and is it the whole system, or just one specific component?

• Would an upgrade improve efficiency? For example, upgrading from film to digital x-rays can save a lot of time that would otherwise be spent processing films.
  

  Develop Standard Protocols and Techniques

If certain procedures are performed infrequently or don’t have a standard set of protocols to follow, this may lead to confusion, inconsistency, or errors—all of which can waste time and cause frustration.

To make things more efficient, it helps to have standard protocols for team members to follow, which have been properly explained to them. Protocols may include:

• Specific instructions for patient positioning for different radiographic views, such as thorax, hip, spine, etc.

• Guidelines for effective patient restraint while minimizing the staff’s exposure to radiation. For example, be sure the team knows how to properly use positioning aids such as sandbags and tape. 

• If patients are sedated, be sure to have a minimum standard for patient monitoring, with prepared monitoring sheets a team member can easily pick up and use for their monitoring notes.

• Have a standard technique chart, or make sure the team knows how to properly set up an x-ray study using a digital program that automatically sets technique. This includes explaining how to measure a patient in the position in which they will be radiographed.

  Have the Right Resources Available for Radiographic Interpretation

This may include textbooks and other references for what is normal on each radiographic view and what is not. 

Access to a second opinion can also be very valuable. Try to create a collaborative environment where veterinary colleagues within the practice can help each other discuss and interpret radiographs. Consider subscribing to an online forum such as the Veterinary Information Network (VIN), where a vet can post their radiographs for a second opinion. Or, consider using a teleradiology consultation service with veterinary radiologists.

Practice Makes Perfect

Efficiency in taking and interpreting radiographs will improve over time, with practice. So even if fitting more radiographs into a busy schedule feels time-consuming at the beginning, it will get to be second nature over time. 

The same is true with x-ray image interpretation—many vets become faster and more proficient with practice. Also, be sure to study the radiographs of normal patients, to gain a thorough understanding of all the different ways normal anatomy can look in different sizes and breeds of veterinary patients.

Plan for Conversations With Clients

If pet owners are unsure about proceeding with radiographs—especially when sedation is required—the conversation can take up a lot of time for veterinarians and their team members. By planning what to say and gaining comfort with these conversations, time can be saved while providing patients with the care they need. Also, clients may feel more comfortable if everything is explained in just the right way.

Efficient x-ray conversation techniques may include general principles for good communication (active listening, empathy, non-verbal communication, etc.), as well as proactively discussing the answers to commonly asked questions and concerns. For example, explain how sedation not only makes the radiographs more detailed and accurate—it also makes the procedure less scary and more comfortable for a dog or cat.

Putting all these principles together, a veterinary team may find the whole x-ray process becomes more efficient. This is good for team morale, as it helps to keep the day running as smoothly as possible. It can also increase a practice’s bottom line over time while providing excellent care for patients. For all these reasons, it’s usually well worth it for a veterinary practice to invest in radiographic efficiency!

Written by: Dr. Tammy Powell, DVM

The Ultimate Guide to Veterinary Dental Cleaning Stations

A comprehensive oral health assessment and treatment (COHAT), also known as a veterinary dental procedure, is an important consideration for any pet’s long-term health.

Keeping the mouth healthy helps protect a dog or cat’s teeth and contributes to a pet’s overall wellbeing. And, it can be a source of revenue for the veterinary practice.

Here are some of the common components of a dental cleaning station, and the roles they play during a COHAT.

The Equipment Needed for Scaling and Polishing

Even for pets who need significant extractions, the dental procedure typically also involves scaling and polishing the remaining teeth, to clean them, keep them in good health for as long as possible, and avoid further tooth loss. 

So, it’s safe to say that scaling and polishing are an important part of any dental procedure.

Dental scaling and polishing are often delegated to skilled veterinary technicians and nurses. So, when it comes time to invest in a new dental cleaning station, it’s a good idea for veterinarians and practice managers to review the equipment available and see what is required to meet their practice’s needs.

These common tools on a dental cleaning unit play a role in scaling and polishing:

• Ultrasonic scaler. Hand scalers are still used, too, especially for tight spots that need extra attention. And curettes are needed for subgingival cleaning. However, it’s hard to beat an ultrasonic scaler for speed and efficiency when removing large amounts of dental calculus above the gumline. Many include a built-in LED light for easy visualization of the area being cleaned.

• Polisher/Low-speed handpiece. This tool is crucial for smoothing over any small defects or microabrasions in the tooth enamel caused during scaling. In other words, polishing should ALWAYS follow scaling. Recent AAHA dental guidelines recommend using disposable prophy angles and individually packaged, fine-grit prophy paste with a polisher.

• Air/Water syringe. This tool is useful for flushing away bits of tartar and other debris as you’re working, for drying a tooth prior to applying a sealant, or for irrigation and inspection of any visible subgingival areas after cleaning.

• Suction tool. Weak suction can be a convenient way to remove excess water and saliva during a procedure.

Equipment for Drilling and Extractions

Many extractions require drilling into alveolar bone to expose the tooth root or divide the tooth into segments. This allows for safe and efficient extractions, with less risk of leaving root tips or fragments behind.

For this reason, a high-speed drill is an essential component of any veterinary dental cleaning station. The drill should have several burs to choose from, too, since veterinarians see patients of all different sizes and since different bur shapes (rounded or tapered, for example) serve different purposes.

In addition to the drill, hand tools—such as elevators, luxators, extraction forceps, and suture kits—will be used. 

Other Factors to Consider In a Dental Cleaning Station

In addition to the tools available on the dental station, here are some considerations that may affect a veterinarian or practice owner’s decision to make a purchase…

• The size of the unit. Practices with small spaces may prefer a compact cleaning station, while others might not have a size restriction.

• Easy storage and access to tools. No matter the size of the station, it should be easy to store and access the tools right when you need to. No veterinary team member wants to fumble while reaching for a tool or accidentally drop something because it’s difficult to put back.

• Water reservoirs. No one wants to run out of water (which is used for many of the tools, including drilling and ultrasonic scaling) during the middle of a procedure, then put things on hold as the reservoir is refilled. For that reason, it may be beneficial to look for a station with a larger distilled water reservoir capacity.

• Service, maintenance, and warranty. It’s important to protect any equipment investment and to make sure it’s easy to keep the machine running so a veterinary practice can avoid canceling procedures due to equipment issues.

Also, remember to invest in high-quality complementary equipment. In addition to the dental cleaning station and other dental tools, a complete dental procedure also involves dental x-rays, appropriate anesthetic protocols and equipment, personal protection equipment, and anything else needed to perform a COHAT safely and effectively.

Veterinary dentistry can be a rewarding way to provide excellent patient care and generate income for a veterinary practice—a win-win scenario. To make sure these procedures run as smoothly as possible, it’s important to choose the equipment that’s the best fit for your practice’s needs.

Additional resources:

2019 AAHA Dental Care Guidelines for Dogs and Cats: https://www.aaha.org/globalassets/02-guidelines/dental/aaha_dental_guidelines.pdf 

Editor’s Note:

Currently, we offer a complete veterinary dental cleaning station at an affordable price including shipping, delivery, and a 3-year warranty. 

The space-saving machine is designed for high-volume use. 

It features key tools that are crucial to any veterinary dental procedure—plus, a few exciting special features like advanced cooling for the high-speed drill, a scaler with an endodontics feature, an LED light on the polisher, and more!

Learn more, and contact us with any questions, here: https://newvetequipment.com/cleaning-station 

Written by: Dr. Tammy Powell, DVM

Mastering Small Mammal X-Rays: Techniques and Tips

Small mammals can be rewarding to work with, although they can also present some unique challenges.

When radiographing these pets, it’s important to understand species differences and plan accordingly. 

Here are some tips and starting points for radiographing these unique pets…

Considerations for Small Mammal X-Ray Studies

While often lumped together as one group—commonly called “small mammals,” “exotic small mammals,” or even “pocket pets” for smaller species—this group of pets actually covers a range of diverse species. 

This can include everything from ferrets to guinea pigs and rabbits to small rodents like hamsters and mice—and even marsupials like sugar gliders.

It’s important to understand what’s normal and what’s not for each species. For example, hindgut fermenters (rabbits, guinea pigs, and chinchillas) often have notable gas in their GI tract, whereas that amount of gas would be abnormal for a ferret.

To gain an understanding as to what’s normal for each species, it helps to not only study texts and references but also to practice looking at radiographs of healthy pets for comparison.

In addition to understanding species differences in anatomy, it’s also important to consider each patient’s needs when preparing for an x-ray study. For example, certain small mammals may face health consequences with fasting prior to x-rays. For others, a short period of fasting (especially if anesthesia is used) might be appropriate.

Due to the small size of most patients, highly detailed images are needed. Many experts recommend using mammography films for this reason, with tabletop technique. For very small patients, or for extremity views, dental x-ray machines and films may provide good results.

Positioning and Restraint of Small Mammals

Since many small mammals are prey species, they may be prone to excess stress with strong manual restraint, especially if they are already ill. For critical, dyspneic, and otherwise in poor condition patients, it’s usually best to stabilize them prior to pursuing diagnostics.

For patients who are stable, it may make sense to use manual restraint for short studies. Chemical restraint is often favored over manual restraint, though, for reducing patient stress and patient movement. Chemical restraint may include injectable sedative drugs, or inhalant anesthetic delivered via intubation. If intubation isn’t possible, inhalant delivery via mask may also be an option for some patients. Check for appropriate drug doses for each species.

The use of positioning aids and props depends on the size of the patient. Due to their small size, heavy sandbags are not typically used for these patients. Taping a patient’s limbs to the cassette may be a better strategy. And a small trough may be helpful for obtaining a VD view.

Key Radiographic Views

As with any other species, it’s important to obtain a minimum of two orthogonal views (a lateral and VD/DV) with proper patient positioning. Then, additional views such as obliques can be added if relevant. 

Because most of these patients are small in size, whole-body radiographs are common. Then, additional close-up views of areas of interest (like limbs or the skull, for example) can be included, too. For patients who are large enough, it may be ideal to do separate thoracic and abdominal studies.

If needed, standard contrast agents such as barium and iodinated contrasts may be used. Keep in mind that GI transit time is variable depending on the species. In general, carnivores (like ferrets) have the fastest transit times, while hindgut fermenters have the slowest.

Skull radiographs are common in small mammals for evaluating dental issues. A complete set of skull radiographs usually includes DV/VD, lateral, right and left oblique, and “skyline” (rostrocaudal) views.

Conclusion

With the right knowledge, practice, and a few adaptations, radiographs can be used to help diagnose and treat small mammals. Owners of these unique pets often appreciate finding a veterinarian who is able to perform such procedures and deliver a high quality of care to these small patients. 

Written by: Dr. Tammy Powell, DVM

Radiographing Reptiles: Helpful Key Tips and Techniques

If you work with lizards, snakes, tortoises, or other reptiles, x-rays are an important diagnostic tool for these patients.

So, how does the process of radiographing reptiles differ from dogs and cats? Here are some helpful tips for reptile x-rays…

Considerations for Reptile Radiographs

Many reptiles are small in size compared to the average dog or cat. Thus, good quality radiographs with sufficient detail are required for images to be diagnostic. High detail films such as those used for mammography can be beneficial here.

At the same time, many reptiles have highly keratinized scales, or, in the case of chelonians (turtles and tortoises), a shell. These coverings can mean a higher power beam is required, which can also mean loss of detail for internal body structures. Fortunately, motion blur is not a common issue, though.

As with other species of pets, good general rules of radiography apply. This means taking a minimum of two orthogonal views to get a complete picture of the part(s) of the body being radiographed.

Indications for Reptile Radiography 

With reptiles, clinical symptoms are often subtle, and exam findings are often non-specific. So, diagnostic tools such as radiographs are important for figuring out what’s going on and providing the best treatment.

With this in mind, full-body radiographs are beneficial for any reptile who is showing symptoms of illness.

Additional common indications may include evaluating…

• Bone lesions, such as osteomyelitis, traumatic injuries, or metabolic bone disease such as nutritional secondary hyperparathyroidism.

• The digestive tract, including looking for ingested foreign bodies or other digestive ailments.

• Reproductive issues, such as dystocia, egg binding, or yolk coelomitis.

• Abscesses and other soft tissue swellings.

• Lung disease.

• Urinary issues such as bladder stones.

• Problems with other organs such as the heart or liver, although these organs may be difficult to evaluate in detail for many types of reptiles.

• Assessing if intraosseous catheters are placed correctly.

Restraint for Reptile X-Rays

Fortunately, many reptiles hold still without restraint, or with limited restraint, for certain x-ray views. But it’s still important to have a plan in place to ensure quality, diagnostic images are obtained.

A few examples of restraint for different reptile species may include…

• For snakes, allowing them to crawl inside a plastic tube. This also prevents coiling (which may interfere with radiographic interpretation) and ensures the snake is evenly extended for their radiographs.

• Cardboard boxes or other radiolucent containers for smaller species, especially small lizards. Note that this may result in a minor reduction in details/image quality.

• Vagal response in large lizards, which means placing pressure over the eyeballs when the lizard’s eyes are closed. This stimulates the vagus nerve, resulting in a lower heart rate and a calmer lizard. A vagal response could be accomplished with gentle digital pressure, or by placing cotton balls over the eyes and holding them in place with VetWrap wrapped around the head. Dimming the lights and avoiding any noise stimulation will also help.

• Chemical restraint if indicated. This could mean sedation or general anesthesia, depending on how challenging the patient is to work with, what information needs to be obtained from radiographs, and the health status of the patient. Be sure to check the best sedative drugs and doses for the particular reptile species you are working with.

Common Radiographic Views for Reptiles

As mentioned above, it’s important to obtain orthogonal x-ray views. Often, due to the smaller size of many reptiles, this means orthogonal views (a lateral and a DV) of the entire body. 

It’s important to remember that reptiles don’t have a diaphragm. They have a coelomic cavity, rather than separate abdominal and thoracic cavities like mammals have. Because of this difference, placing a reptile (except for snakes) in lateral recumbency may result in coelomic contents shifting, which can confound radiographic interpretation.

To prevent this issue and view organs in their natural position, many veterinarians obtain lateral radiographs of reptiles using a horizontal beam while the animal is standing. 

For chelonians, it helps to place them on some type of stand by balancing the plastron on a block, overturned bucket, etc. This facilitates the horizontal beam view and encourages the patient to hold still and extend their limbs and head from their shell.

Additionally, the horizontal beam can be used to obtain a craniocaudal view in chelonians. This allows comparison of the right and left lung fields.

Contrast agents, such as barium or iodine-based contrast, may be used, especially when evaluating the GI tract. However, it’s important to keep in mind that digestive transit times are highly variable (within a day at the shortest, and weeks at the longest) depending on the species, their nutritional status, and environmental conditions such as temperature and season.

If more detailed radiographs of the skull or extremities must be obtained, it’s important to collimate. For some species, veterinary dental films may provide better detail. Anesthesia may be needed for chelonians to fully view the skull or extremities outside of the shell.

Conclusion

Radiographs are a key tool when assessing reptiles for disease or injuries. But it’s important to understand the wide range of species variations in anatomy and become familiar with what’s normal and what’s not for each type of patient. This could mean having a good reference text, obtaining additional CE, or radiographing a healthy patient of the same species for comparison.

Once the best strategies and techniques are incorporated, diagnostic images can help a practitioner evaluate these unique pets and form an appropriate treatment plan. 

Written by: Dr. Tammy Powell, DVM

Radiographing Exotic Pets: avian patients

When it comes to avian patients, many general principles of radiology still apply, just as they would for a dog or a cat.

For example, proper technique and a systemic method for looking at the entire image are important.

However, birds also present unique challenges. For example, their small size means that fine details must be visible on radiographic images. And a bird’s rapid breathing rate can create motion artifact and blurriness, which can compromise radiographic details.

Here are a few strategies and tips for radiographing an avian patient…

Restraint of Birds for Radiographs

Appropriate positioning and stillness of the patient are both crucial for obtaining x-ray images with enough detail to be diagnostic. Because of this, sedation or anesthesia are usually necessary, with appropriate patient monitoring.

Of course, the decision to administer anesthesia depends on the stability of the patient and whether they can handle anesthesia. But even with ill birds, light sedation may still be beneficial to reduce stress, discomfort, or injuries that could be caused by physical restraint. 

When administering sedation or anesthesia, be sure to check the best medications and doses for birds, as these may vary from those used for dogs and cats.

Radiographic Technique for Avian Patients

It’s ideal to use the shortest possible exposure time. This helps minimize motion blur due to a bird’s fast respiration rate.

For small patients, tabletop technique is used. A grid is not needed, thanks to a bird’s air sacs which don’t cause significant x-ray beam attenuation or scatter radiation. However, a grid may be considered when radiographing an area wider than 10 cm.

Also, appropriate collimation should be used.

Positioning Avian Patients for Radiographs

Whether a patient is canine, feline, or avian, orthogonal x-ray images are more useful and accurate than single-view x-ray studies. So, whenever possible, try to obtain both a lateral and VD view.

A common view for studies is a “whole bird” radiograph for small or medium-sized birds, which means a head-to-tail view including the coelom, pectoral limbs, and pelvic limbs. However, it’s beneficial to focus on areas of interest, too—whether that’s examining organs in the coelom, evaluating a fractured limb, etc.

To visualize the coelom, it’s best to pull the wings and legs away from the body. That way, there’s nothing overlying the coelomic cavity that could complicate interpretation or cover up important details.

When positioning, it’s best to be gentle, especially with small birds that can be fragile. Pulling the wings too much can cause pain or injury, or lead to over-rotation and improper patient alignment. Tape may be used, but it should have minimal adhesive in order to avoid pulling feathers. Other positioning aids made from clear plastic can also be very useful.

For patients in poor condition, it may make sense to first do a “screening” x-ray via a horizontal beam. For this shot, the bird could be standing on a perch on the x-ray table. Sometimes, this gives enough information to rule out certain conditions (such as egg binding or heavy metal ingestion) and develop a preliminary treatment plan. Then, if needed, more detailed imaging could be pursued once the patient is more stable.

A Few Tips for Bird X-Rays

Here are a few more things to keep in mind when it comes to bird radiographs…

• If possible, it’s helpful to fast a patient prior to radiographs of the GI tract. This allows better visualization, and it reduces the risk of regurgitation and aspiration pneumonia. However, keep in mind a bird’s fast metabolism. For very small patients, fasting beyond two hours may be detrimental.

• Have a good reference guide available to use as a point of comparison for your patient’s images. This will help not only with distinguishing what’s normal and what’s not for an individual bird, but also for anatomic variations between species.

• Consider a referral or consult as needed. There’s nothing wrong with referring a patient to an avian and exotics specialist. Or, if you take the radiographs yourself, consider sending the images for a teleradiology consult.

X-rays can be a very important part of the diagnostic plan for birds. With knowledge and some practice, bird radiographs may become faster and easier for the team, leading to prompt diagnosis and treatment of ailments and excellent avian care. 

Written by: Dr. Tammy Powell, DVM

Dental Disease and Heart Disease: What’s the Correlation?

Dental disease is one of the most common health conditions affecting dogs and cats, even though much of it is preventable.

Estimates of dental disease prevalence vary, but many experts say that most (more than half of) dogs and cats over three years of age have some form of periodontal disease.

How Dental Disease Progresses to Periodontal Disease

The process begins with plaque, a thin, bacteria-containing film that forms on the teeth. Plaque can be removed by brushing. But if plaque is not removed, minerals in the saliva harden the plaque, which creates tartar (calculus). Tartar is much more difficult to remove, and it can build up to look like “concrete” deposits on the side of a dog or cat’s tooth.

Pet owners may or may not notice tartar on the crown of their pet’s teeth. But the biggest problem comes from the part they can’t see—the tartar that grows below the gumline.

This leads to periodontal disease, a condition that affects the structures that hold teeth in place. 

Consequences of Periodontal Disease

The early stage of periodontal disease is gingivitis, inflammation or infection of the gums that is often noticeable as red, swollen, or bleeding gingiva. Gingivitis is reversible if treated in a timely fashion. 

After that, further damages from periodontal disease are NOT reversible. This may include damage to the periodontal ligament, cementum, and alveolar bone. These three structures, together with the gingiva, are collectively called the ‘periodontium’.

As periodontal disease progresses, a pet may suffer from gingival recession, tooth loss, alveolar bone loss, and even jaw fractures in severe cases. And one ‘bad’ tooth may affect neighboring teeth, thanks to infection and damage to bone and other surrounding structures.

Bacteremia From Periodontal Disease

Tartar harbors a lot of bacteria, and a mouth affected by periodontal disease carries infections.

These bacteria may enter the bloodstream via areas of the mouth affected by periodontal disease, which may lead to negative health consequences for an affected pet. 

Studies demonstrate conflicting conclusions, so the association between bacteremia from periodontal disease and pathology of certain organs (especially the heart, liver, and kidneys) is not as clear-cut as it was once thought to be. 

For example, the common condition of MMVD (myxomatous mitral valve degeneration) in small dogs is no longer thought to be caused by periodontal disease. Instead, both are conditions that occur commonly in older, small breed dogs. 

The link between periodontal disease and heart disease is more firmly established in human beings. And in pets, there have been associations noted between periodontal disease and pathologic changes to the heart, liver, and kidneys on necropsy. 

Because of these associations with organ disease in other parts of the body, and since bacteremia can and does happen in dogs with periodontal disease, it makes sense to take extra precautions for pets with a condition that would make them more at risk from bacteremia. 

For example, immunocompromised patients, or patients with certain types of heart conditions may benefit from an injectable dose of prophylactic antibiotics during a dental procedure, whereas it might not be necessary for an otherwise healthy pet.

There’s some speculation that chronic inflammation is responsible for pathology to other organs just as much as (or more than) bacteremia. Maintaining good oral health is the best way to decrease the risks of both infections and inflammation from periodontal disease.

Preventing Dental Issues Is Good for a Pet’s Overall Health

So, what’s the conclusion to draw from all of this information, some of which is conflicting?

Of course, that’s up to each practitioner. But in general, maintaining a healthy mouth will always be a good thing. 

Having a chronic disease (such as periodontal disease) anywhere in the body can be a strain on a pet’s health. So appropriate dental care can only serve to improve the overall health of the pet and reduce any risks associated with bacteremia and chronic inflammation.

Additionally, good dental care can also improve quality of life by decreasing oral pain, preventing tooth loss, and decreasing halitosis that could interfere with the human-animal bond. So, preventive dental care is an important part of any pet’s health plan.

Written by: Dr. Tammy Powell, DVM

Ultrasound of the Duodenum and Jejunum in Dogs and Cats

There are many reasons why a veterinarian may perform an ultrasound of the duodenum and jejunum sections of the small intestines in a dog or a cat.

For example, the vet may suspect a GI foreign body, inflammatory disease, or neoplasia. 

Here are a few key checkpoints to remember when scanning the duodenum and jejunum.

Setting Up the Gastrointestinal Ultrasound Study

If a patient can be fasted, that’s ideal.

An empty gastrointestinal tract may be easier to visualize, whereas food or digestive content may cause artifacts such as beam attenuation. However, this won’t be possible for all patients, especially in an emergency situation.

Patients are often placed in dorsal recumbency, although lateral recumbency may also be used. The patient can also be repositioned mid-study if needed for better visualization. 

Performing a Thorough Evaluation

Often, a GI ultrasound study is part of an entire abdominal study. In some cases, the GI tract may be visualized on its own. Either way, to ensure nothing is missed, it’s important to perform the study the same way each time. Many experts recommend keeping it simple by following the GI tract in its normal order of digestion, i.e. starting with the stomach, then moving on to the small intestines (duodenum, jejunum, ileum), cecum, and colon. Examine each segment in both longitudinal and transverse views.

Evaluation should include wall thickness (and whether that thickness remains uniform within each GI section), wall layers, luminal contents, signs of obstruction, the presence of a GI mass or multiple masses, infiltrative disease, and whether there’s normal motility/peristalsis.

The Duodenum

The duodenum is located along the right lateral abdominal wall in dogs. It can be found near (ventral to or ventrolateral to) the right kidney. The cranial portion may be challenging to see and may require viewing via an intercostal approach.

In cats, the duodenum may be closer to midline, or just right of midline.

The wall of the duodenum is up to 5mm thick in dogs, and 2-2.5mm thick in cats.

Jejunum

It’s often difficult to trace the long jejunum loop by loop. So, most veterinarians evaluate the jejunum by sweeping the transducer from side to side across the abdomen, in a cranial to caudal direction. Slightly overlapping each sweep will ensure that nothing is missed.

The wall of the jejunum is 2-5mm in dogs, and 2-2.5mm in cats. 

Evaluating the Layers of the Intestinal Walls

The walls of the intestinal tract have 5 specific layers, in this order: the luminal-mucosal interface (most interior layer), mucosa, submucosa, muscularis, and serosa (outermost layer). 

In longitudinal view, these layers are easily distinguished from one another (in a normal patient), thanks to their alternating pattern of hyper- and hypoechogenicity. The inner and outermost layers, and the submucosa, are hyperechoic. The mucosa and muscularis are hypoechoic. 

If these 5 layers are not distinctly visible throughout the intestines, it could indicate a problem. For example, focal wall thickening with obliteration of the layers could indicate focal neoplasia.

Make notes of any wall thickenings, whether they’re focal or diffuse, and whether the 5 layers are still distinguishable or not.

One normal finding that could be mistaken for abnormal is Peyer’s patches (pseudoulcers) in dogs, which appear as focal, hyperechoic indentations within the hypoechoic mucosal layer.

Signs of Obstruction

Sometimes, the obstructing foreign body may be visualized directly. However, this is often not possible. So, a foreign body obstruction may be detected due to differences in intestinal dilation proximal and distal to the point of obstruction. The intestinal tract proximal to the obstruction would tend to be dilated with fluid and gas, while the distal intestinal tract is normal or even empty.

With a linear foreign body, plication of the intestines may be seen via ultrasound. The foreign body itself may or may not be well visualized.

In case of an intussusception, the affected section of intestines will have a characteristic “bullseye” appearance in transverse view. If this is noted in an older pet, be sure to search for signs of neoplasia that could explain why the intussusception occurred.

Intestines may be hypermotile with a recent obstruction, but possibly hypomotile with a more chronic condition.

GI Neoplasia and Inflammatory Conditions

Neoplasia in the digestive tract may occur as a solitary mass, multiple masses, or diffusely as an infiltrative disease.

As mentioned above, discreet masses are often identified because of their focal thickness relative to the rest of the intestines and disruption of the wall layers.

Infiltrative disease, however, can be more difficult to pinpoint. There may be wall thickening with or without disruption of the wall layers. In particular, it can be challenging or impossible to differentiate between small cell lymphoma and inflammatory bowel disease in cats without further testing.

Regional lymph nodes should be evaluated, too.

Conclusion

The duodenum and jejunum are an important part of any GI evaluation. It’s helpful to get an idea of what’s normal and what’s not for these sections of the small intestines, as they’re commonly evaluated for a variety of conditions, including those listed above. 

Written by: Dr. Tammy Powell, DVM

Evaluating the Urinary Bladder on Ultrasound

An ultrasound of the urinary bladder can be recommended for a number of reasons, including suspected uroliths, cystitis, and neoplasia—to name a few.

Often, the evaluation includes the entire abdomen and any other parts of the urinary tract that can be visualized.

Given all the conditions that can affect the bladder, as well as important information from an ultrasound study to help guide the treatment plan, it’s beneficial to gain proficiency in evaluating the bladder via ultrasound.

Use a Systemic Approach to Evaluating the Bladder

A systemic approach to the whole abdomen is good, and a bladder evaluation is usually just one part of an abdominal ultrasound study. So while it may be tempting to jump to the bladder right away if the patient is having urinary symptoms, it’s best to complete your abdominal ultrasound study in the same order that you usually do it.

Once you reach the urinary bladder, a systemic approach is again useful, to ensure nothing is missed. Here is one method for a stepwise evaluation…

• Is the overall bladder shape normal and as expected? Through practice, a veterinarian can get a good feel for what shape is normal for canine and feline patients, and how it may change if the bladder is full versus empty or nearly empty.

• How does the lumen of the bladder look? If urine is present, is the urine is anechoic? Is there sludge, sediment, crystalline material, a polyp, or anything else that is abnormal?

• If there are uroliths present, they generally appear as hyperechoic structures inside the lumen of the bladder. There may be acoustic shadowing, and the calculi may move freely depending on how large they are. 

• Is the bladder wall smooth, a normal thickness, and well-defined? Be sure to evaluate the entire bladder. If cystitis is present the wall may be focally or generally thickened or have irregularities in the mucosa, depending on the severity and duration of the cystitis. Keep an eye out for polyps or masses/tumors, too. Also, look for deviations in the wall that could indicate a urinary bladder diverticulum.

• If a mass is present, make note of the size, appearance, and location. Transitional cell carcinoma, the most common neoplasia of the bladder, tends to occur in the bladder wall near the neck and trigone. Commonly, these masses are hyperechoic or mixed echoic and have been compared to cauliflower in appearance. Evaluate nearby blood vessels and regional lymph nodes, too. Avoid cystocentesis or aspiration for samples, because of the risk of seeding the neoplasia into the abdominal cavity when the needle is withdrawn. Sometimes, it’s easy to confuse blood clots with masses, so keep this in mind and re-evaluate as needed.

• Be sure to evaluate other urogenital structures, including the kidneys and ureters (the latter are often not visible unless there’s an abnormality), as well as blood vessels and lymph nodes in the region. Remember to look for the uterus/ovaries in intact females and the prostate in males, although it might not be possible to visualize these structures in all patients, especially if they are normal.

Whenever abnormalities are noticed, describe them in detail and take measurements. Include all of this in the notes. Even if things look normal, it’s still a good idea to take some measurements (such as bladder wall thickness) and describe what you’re seeing, as a baseline for comparison in case anything changes in the future.

A Few Tips

A full bladder can help with visualizing certain lesions (such as hyperechoic uroliths) by providing “contrast” or a backdrop to help make abnormalities stand out. Also, a full bladder smooths out the bladder wall, whereas an empty bladder may lead to false readings of wall thickening or masses. Additionally, a large bladder allows for an easier ultrasound-guided cystocentesis. So whenever possible, try to ultrasound with a full, or at least partly full, bladder. In some cases, it may be appropriate to give the patient water or IV/SQ fluids and wait for the bladder to fill prior to the study.

Pressure from the transducer can alter the bladder’s shape.

So be sure to practice with various pressures and become familiar with how the appearance of the bladder might change.

Repositioning the patient can also be helpful.

This may give you a better viewing angle and position for certain structures. Having the patient stand up may put gravity in your favor by decreasing the distance between the bladder and the probe. Also, patient movement may cause sludge/sediment to move around or disperse so that it’s not mistaken for a urolith.

Have appropriately sized needles, syringes, and collection materials available.

In case an aspiration/cystocentesis is needed, it’s best to have supplies ready to go.

Ultrasound of the urinary bladder is a very valuable skill, and it works well in conjunction with information gained from x-ray studies. Training and practice in ultrasound of the urinary bladder are often well worth it for patient care and for additional income from ultrasound studies. 

Written by: Dr. Tammy Powell, DVM

Finding the Adrenal Glands in Large Dogs using Ultrasound

A thorough abdominal ultrasound includes evaluating the adrenal glands.

Common reasons to look at the adrenals include searching for signs of neoplasia, Cushing’s, or Addison’s disease. And even in animals where adrenal disease isn’t suspected, sometimes growths or other changes to the gland(s) are discovered incidentally.

Unfortunately, sometimes adrenals can play “hide and seek” and be tough to find. That’s true for any dog—but especially for large dogs with deep abdomens, since the abdomen may be too thick for the ultrasound waves to penetrate well. 

Having a repeatable system for where to look can help. Here are some steps for finding those tiny glands inside of a big dog…

Perform an Abdominal Ultrasound in the Same Order Every Time

Just like reading an x-ray or performing a physical exam, a systemic approach helps ensure that nothing is missed. 

Each veterinarian may have their own preference for how to go through a scan in a stepwise fashion. For example, some may scan cranially to caudally. Others may scan clockwise, or have some other system. Any system is fine, so long as it covers everything you need to see and is easy to repeat on each patient. So choose what works best for you.

In addition to revealing unexpected abnormalities of the adrenal gland(s) sometimes, systemically examining the entire abdomen will also help a veterinarian gain experience. Then, when it’s time to locate the glands on a patient with suspected adrenal disease, you’ll have plenty of practice to fall back on and may feel less pressure.

Where to Find the LEFT Adrenal Gland

• To narrow the search, first, find the left kidney by scanning the left dorsal mid-abdomen.

• Next, narrow the search even further by finding the vascular landmarks: the aorta (in long view) and the left renal artery. 

• Look for the spot where the left renal artery branches off from the aorta. The left adrenal gland should be just cranial to this junction.

Where to Find the RIGHT Adrenal Gland

• First, locate the right kidney by scanning the right cranial abdomen.

• Next, locate the vascular landmarks: the caudal vena cava (in long view) and the cranial mesenteric artery.

• Apply some pressure, which will cause compression of the caudal vena cava and allow better visualization of the adrenal gland. The gland is dorsolateral to the vena cava and just cranial to the cranial mesenteric artery.

A Few Tips

It may be tempting to use the kidneys as a primary landmark since the adrenal glands are located near each kidney. However, the kidneys may overshadow the small glands. So while the kidneys are a good starting point, it’s also important to use vascular landmarks.

Color Doppler can be a big help, too. It often makes it easier to find and view vascular landmarks.

Minimize the distance between the probe and the adrenal glands as much as possible. This can be done by moving the probe as needed, and by applying gentle pressure if the patient allows.

What to Include In the Medical Record

Be sure to describe any abnormalities. Additionally, rather than just noting ‘normal’ or ‘abnormal’, it’s good to provide specific details in case a comparison is needed in the future. Here are some things to note, even if the glands look normal…

• Measure and record the size of each gland. Measurements are typically taken from the cranial to caudal pole, as well as a measurement of the thickness of each pole.

• Note if the glands are hypoechoic to surrounding fat or if their appearance is different than expected.

• Classic adrenal gland shape has been compared to a ‘peanut’, or sometimes an ‘arrowhead’ for the right adrenal. Note if the shape is as expected or if it’s abnormal.

• If any abnormalities are noted, list the most likely rule-outs and a recommendation for follow-up/monitoring or further diagnostics if indicated.

With practice, locating the adrenal glands will become second nature. It may still be challenging on some patients, but having a repeatable system and gaining experience will help.

Written by: Dr. Tammy Powell, DVM

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

The EZ Dent Dental X-Ray System by MyVet USA

Dental radiographs are an integral part of dental procedures in small animal medicine

Without x-rays, it’s not possible to see the full extent of periodontal disease or other problems (FORLs, dentigerous cysts, tooth root abscesses, etc.) that happen below the gumline.

As dental radiography has become prevalent in modern veterinary medicine, there are many companies and manufacturers that offer dental x-ray equipment and software for veterinarians. Today, we’ll be examining some of the features and considerations of the EZ Dent dental x-ray system by MyVet USA—including the x-ray generator, intraoral sensor, and software.

MyVet Imaging

In 2018, the US-based MyVet Imaging became a subsidiary of South Korea-based Rayence, a provider of digital x-ray equipment for human medicine. 

Rayence and MyVet Inc. are headquartered in New Jersey for US operations, with veterinary offerings for small and large animal radiography, including digital dental radiography for small animal and equine patients. They advertise innovative dental imaging solutions, including the world’s first veterinary panoramic dental x-ray system and Carbon Nanotube (CNT) technology.

The EzRay VetTM Cart

Despite the intrigue of a panoramic system, many veterinarians prefer the details and consistency of traditional style DR or CR radiographs for small animal dental rads. The EzRay Vet Cart, a mobile intraoral x-ray cart system, is offered by MyVet for this purpose.

Some of the benefits of the EzRay Vet Cart advertised by MyVet include…

• Carbon nanotube (CNT) technology, which they claim reduces maximum exposure time by 75% while still maintaining image quality. The beam has a 0.4mm focal spot, and exposure setting controls are said to automatically adjust the exposure setting to maintain image density.

• Ergonomic design, featuring a non-drift arm and head that is compact, lightweight, and easy to position with one hand.

• Preset technique options.

• No warm-up time or waiting time between shots.

A wall-mounted unit is also available.

The EzRay Air VetTM

The EzRay Air Vet is a handheld generator option. This may suit the needs of veterinarians who require the unit to have ultimate mobility, or who have tight spaces in their clinic. MyVet advertises that the portable generator also features CNT technology, is up to 30% lighter than other handheld units, has no warm-up time (for faster workflow), and features a double scatter shield (with internal and external shielding) to protect from scatter radiation.

EzSensor Vet

The EzSensor Vet is an intraoral sensor for veterinary digital radiography, featuring CMOS technology. Available in sizes 1.0, 1.5, and 2.0, the sensor features rounded corners and a slim design to help with positioning. MyVet advertises superior image quality with low noise, as well as water and dust protection and a reinforced fiber optic cable, which helps with durability.

MyVet DentTM Acquisition Software

The DICOM-compliant MyVet Dent acquisition software is designed to be intuitive and work seamlessly with the EzSensor to quickly acquire, process, and manage images. Since it’s a digital system, there’s no need to process films or plates, so the results are fast. MyVet also advertises that the software features customizable options and tools, and easy integration into an existing clinical network.

Additional Considerations

The EzDent dental x-ray system from MyVet may be an affordable option for small animal veterinarians who perform dental procedures. As with any dental x-ray or other equipment purchase, it’s important to ensure you’re obtaining the best equipment for your needs and to calculate to see if the total costs are as expected and within a budget that makes sense for your practice.

To evaluate the equipment quality and user-friendliness, ask for a demonstration or for referrals to other veterinarians who are using the equipment and can give you honest feedback. 

To calculate total costs, ask about any additional upfront fees (shipping and installation, for example) and ongoing costs (service and maintenance, warranty renewal, software upgrades, etc.). 

By considering all these factors, you’ll know you’re receiving a good value, and you can confidently choose the best option for your dental needs. 

Written by: Dr. Tammy Powell, DVM

Portable Equine X-Ray Generators: What’s Better, Plug In Or Battery Powered?

Plug-In Or Battery Powered?

As an equine practitioner, many of your daily practice needs are different from those of your small animal colleagues. 

Maybe you meet your patients where they are, in a barn or on a farm call. Or, even if you have a facility that allows for equine visits and hospitalization, you may still need portable equipment to bring with you into a stall.

So, which type of portable generator is best for you: plug-in or battery-powered? Here are some things to consider…

Benefits of Battery Powered Portable Equine Generators

One obvious advantage is that a battery-powered generator may be easier to use out in the field, for the simple fact that you’re “wireless” and thus not dependent on a power outlet. This may be especially helpful in situations where power outlets are not immediately accessible, during power outages in inclement weather, or in some barns or other locations where the power supply may be less consistent.

The lack of a cord also allows for simpler mobility during use. There’s no need to untangle a cord and no possibility of tripping over the wire at any point during the procedure.

Benefits of Plug-In Portable Equine Generators

The most common reason for equine practitioners to choose a plug-in generator is probably this: They don’t want the battery to run out!

Nowadays, there are battery-powered generators available that have long battery life. However, depending on how many hours you’re out, a battery may or may not meet your needs. Or, a team member may forget to charge it between shifts. Also, some practitioners note that battery life may decrease over time—and that the batteries of an x-ray generator can be very expensive to replace.

Additional considerations mentioned by some veterinarians are that plug-in generators may weigh less than battery-powered units. Also, plug-in units may cost less on average. There are variations in weight and equipment cost from model to model, though.

Other Considerations

Different brands and models may offer different price points, battery/equipment expected lifespan and other important differences. Doing research before a purchase is crucial.

This includes talking to the company, as well as speaking to colleagues for recommendations (ask companies for referrals to other practitioners in your area who use the equipment or ask around in online forums or in-person events).

In addition to the equipment itself, you’ll also want to consider things like warranty, ongoing costs (repair and service costs, and image storage costs for digital), integration with any of your current equipment (for example, if you already have a plate), ease of use, durability in rugged conditions or temperature extremes, and whether 24/7 live technical support is available.

With all this in mind, different veterinarians may have different preferences—there’s no one size fits all in terms of plug-in versus battery-powered portable equine generators, or in terms of a particular brand and model that are best for everyone.

So be sure to do your research and gather feedback from colleagues, but also think about what will work best for your own preferences and individual practice needs.

Written by: Dr. Tammy Powell, DVM