What are we doing today at Tally Oaks?
We're here at Tally Oaks today, and we are going to show how you ultrasound a spleen in a small dog. This is a King Charles Cavalier named Sky, and she is laying on her side and not sedated, so she's very comfortable. This procedure can be done in most animals without sedation.
How do you prepare the area for the ultrasound?
The ultrasound probe is placed on the abdomen after it's been clipped, and alcohol has been used along with coupling gel.
Where is the spleen located, and how do you begin the ultrasound?
For the spleen, it's on the left side of the body and starts right behind the stomach. The stomach can be seen on the left, which has these folds, and then the spleen is right behind it. You can start seeing that image behind it with the vessel right below it, which is the splenic vein.
How do you find the head of the spleen?
The first thing we're going to do is find the head of the spleen, which dives very deep into the abdomen, and you have to image up in between the ribs to find it. We're going to move our probe back, kind of image up into that space, and increase our depth so we can see the entire head of the spleen. Now we're starting to get an image of the head of the spleen.
Why is it important to see the head of the spleen?
It's important to see this when you're looking at the spleen because a lot of splenic tumors will hide down in the head there. That image there shows you the "shark's tooth" view, we call it, which is basically this point of view that kind of looks like a shark's tooth, and you can see the lining looks really regular. Those dark, dark things that are appearing in the middle of the spleen are vessels, and those are normal. So that's a good image of the head of the spleen.
How do you continue the examination of the spleen?
We kind of rotate and fan with our probe, try to go through the entire head of the spleen, change our angle a little bit, and go through the entire head of the spleen looking for any nodules or masses. It's very important for dogs to have this done. I would say large breed dogs starting at the age of two, maybe even younger, and smaller breed dogs probably very close to about that time also.
How do you follow the spleen through the abdomen?
That's the head of the spleen. Now we're going to follow the spleen as it courses through the abdomen, and it'll become much more superficial, so we have to change our depth to a little more shallow view. Now we'll follow the spleen as it goes across the abdomen. There's the kidney coming in on the right-hand side of the screen, and we're going to go even more shallow because the spleen is laying right up against the body wall.
What do you look for as you follow the spleen back?
There's a really good close-up of the spleen. Follow that spleen back. I'm moving my probe back the animal's abdomen. There's one of the major vessels of the spleen, the hilus, and we follow that all the way back to the very tail of the spleen, looking for any kind of abnormalities. What we see is just normal vessels, and that is where the spleen ends. Those little round circles next to that are just cross-sections of intestine, and if you look closely, they're moving, which is normal because there's peristalsis.
How do you ensure no lesions are missed?
Then we change the direction of our probe and go back up the spleen in a transverse orientation so that we don't miss any lesions. It's important not to press too hard because you can actually distort the spleen. Now we follow it all the way back up the abdomen to where we started, and that completes the full ultrasound examination of the spleen.
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