Page 4 - Clinical Connections - Autumn 2023

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Page 4 - Clinical Connections - Autumn 2023
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ºÚÁÏÉç RESEARCH    STUDY    VETERINARY SERVICES       ºÚÁÏÉç.AC.UK
         Advanced imaging
        HELPING REFERRED PATIENTS WITH A NEW
        FLUOROSCOPY UNIT


        Francisco Llabres-Diaz, Senior Lecturer in Veterinary Diagnostic Imaging and Head of the of the Small
        Animal Diagnostic Imaging Service, Lindsey Berriman, Veterinary Clinical Radiographer and Head
        Small Animal Radiographer, and Oliver Taylor, Surgical Resident

              VC Small  Animal Referrals has   Research and clinical innovation
              upgraded its fluoroscopy unit, which   The unit also supports new clinical
        R offers  benefits  for  referred  patients   research  projects  and  clinical  innovations.
        and their owners, research and veterinary   Fluoroscopy studies are stored in an image
        education.                          archive and are available for instant review,
          Fluoroscopy  is  a  specialist  diagnostic   through an associated image viewer. This
        imaging modality, enabling capture of real-  allows the studies to be utilised for student
        time moving pictures of inside of the body.   teaching or research both during the
        It  takes  a  continuous  series  of  low  dose   process and afterwards.
        radiographs, which creates a live movie of   The new system is an upgrade from
        the patient’s internal structures.  the previous equipment.  Technology has
          The  fluoroscopy  unit  enables  more   changed dramatically in the last few years
        accurate or quicker diagnoses than would   and the new system is easier to work with,
        otherwise be possible. In other cases, it   with  increased  computer  capabilities  that
        increases the level of certainty of either   allow the storage of longer movies.  This
        a diagnosis or the lack of it. The resource   system also works with an increased frame
        supports  the  ºÚÁÏÉç’s  mission  of  providing   rate. Images can be acquired at 30 frames
        cutting-edge  clinical  facilities  that  advance   a second compared to the old, slower rate
        patient care, clinical education and research.   of six frames a second. This increased rate
        The upgraded system was partly funded   means imaging the heart is far superior
        by a grant from the Animal Care Trust, the   on the new machine so interventional   The new fluoroscopy unit supports research
                                                                                and teaching, as well as treatment
        registered charity of the ºÚÁÏÉç.      cardiology  (placing  of  stents)  can  be
          Fluoroscopy has become a critical aspect   undertaken.
        of diagnostic investigations, particularly for                           Fluoroscopy is also used in such cases
        many  challenging  conditions  presenting   Arthur’s case               to determine whether the calculus can be
        to the Internal Medicine, Cardiology,   Seven-year-old British bulldog Arthur was   pushed back into the bladder to alleviate the
        Emergency and surgical teams at the Queen   referred in August, as a result of a calculus   difficulty in urinating.
        Mother Hospital for Animals (QMHA). It also   in the distal urethra. He presented to the   Arthur  underwent  a  fluoroscopy-aided
        enhances the teaching of undergraduate   QMHA with a history of abnormal urination.   retrograde urethrocystogram with positive
        students  and  veterinary  specialists-in-  The case required close collaboration   contrast. This  revealed  a  uniform  contrast
        training by exposing them to a variety of   between the Internal Medicine Service, the   column in the urethra and the presence of
        unusual and complex cases.          Diagnostic Imaging Service and the Soft   a  consistent  round  well-defined  contrast
          They then obtain a better understanding   Tissue Surgery team.        filling defect in the urethra. Towards the end
        of those disease processes and how they   He initially had two lateral radiographs of   of the study, this filling defect moved slightly
        may be seen on more conventional imaging   the caudal abdomen. Although ultrasound   towards the proximal end of the penis.
        modalities, such as plain radiography. This   could  evaluate  the  bladder  and  very   Although a retrograde urethrocystogram can
        enhanced  knowledge,  in  turn,  may  allow   proximal  and  distal  urethra,  fluoroscopy   be performed with conventional radiography,
        them  to  either  treat  similar  cases  in  the   was required to fully assess the portions of   those  radiographs  are  only  snapshots  in
        future, even if fluoroscopy is not available   the urethra that could not be evaluated with   time. Seeing the calculus move in real time
        to them, or recommend earlier referral to   ultrasound due to the pelvic bones.   in  these  cases  through  fluoroscopy  adds
        owners.                                                                 certainty and speed to the diagnosis and
                                                                                highlights how useful fluoroscopy can be.
                                                                                 Arthur underwent a scrotal urethrostomy,
                                                                                castration  and  scrotal  ablation.  He
                                                                                recovered well from surgery with only minor
                                                                                haemorrhage from his urethrostomy site. He
                                                                                was discharged two days after surgery.




                                                                                       For small animal referrals, please call:
                                                                                     01707 666399
         The image on the left shows the contrast going in (white). The image on the right shows the bladder     Email:
         filled with contrast, to highlight any stones present                       qmhreception@rvc.ac.uk


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