UsTogether

UsTogether As a mobile vet ultrasonography we travel to your pet to run diagnostic scans at your vet and pregnancy diagnosis at your own home

How do you tell whether something on the bladder wall is a mass or a blood clot? Doppler! Here's a bladder mass protrudi...
10/04/2023

How do you tell whether something on the bladder wall is a mass or a blood clot? Doppler! Here's a bladder mass protruding into the lumen, and with Doppler interrogation you can see there is blood flow into the mass making a simple blood clot much less likely.
In this case the dog had presented with occasional haematuria and toileting mishaps. There was no evidence of metastasis and surgery was recommended.

See what you're missing with ultrasound.
Complete diagnosis and care with Us Together.

05/04/2023

Halo sign on a gall bladder- often this is seen in the emergency room when dogs are having an anaphylactic shock, but in this case the gall bladder wall was oedematous for a different reason- can you spot the enhanced liver vasculature? It's because the liver is hypoechoic. Aspirates of the liver confirmed intermediate to large cell lymphoma in this dog that had simply been off food and vomiting.
See what you're missing with ultrasound!
Complete diagnosis and care with Us Together.

This cat presented with a suspected early blocked bladder, and was scanned for a quick assessment but I thought these im...
24/02/2023

This cat presented with a suspected early blocked bladder, and was scanned for a quick assessment but I thought these images were fun and worth sharing! The urethra was enlarged for the first 2-3cm, which you can see on the first picture as a black tube coming down from the bladder on the left. If you look closely on the right side the tube ends with a white line. The second photo is applying Doppler on the white line and seeing a strong twinkle artifact, which is often seen with crystals, and confirms the suspicion that this poor cat was totally blocked up with crystals in his urethra!

Complete diagnosis and care with Us Together.

Us Together are closing over the Christmas holidays, our last day will be the 20th December. If you have any patients th...
13/12/2022

Us Together are closing over the Christmas holidays, our last day will be the 20th December. If you have any patients that need a scan prior to this please book quickly as places are filling fast!
For all your ultrasound needs including fine needle aspiration and cardiac mensuration we'll be back after Australia Day, and as always you can book directly through our portal on the website www.ustogether.com.au.
Have a very jolly Christmas from Us Together.

07/11/2022

In this video you can see the large adrenal mass has a soft tissue segment that descends down the phrenicoabdominal vein into the caudal vena cava. Sadly this has a very direct impact on prognosis due to high perioperative mortality, and palliation is often chosen.

At Us Together we routinely scan the whole abdomen to look for abnormalities, not just the organ of interest. In this case we'd been asked to image the liver but found this mass as part of a thorough examination.
Complete diagnosis and care with Us Together.

We recently scanned a patient showing urinary problems and diagnosed severe pyelonephritis (see photo). A study by Perry...
16/09/2022

We recently scanned a patient showing urinary problems and diagnosed severe pyelonephritis (see photo). A study by Perry et al(1) found that 50% of patients with urosepsis had a pyelonephritis as their focus of infection (which was almost double the rate of pyometra as a cause of sepsis!!). Which means that if you're not scanning those kidneys in your patients with suspected urosepsis, you're potentially missing half of them. Ultrasound is simply the best way to diagnose these patients, and remember- we come to you to help make the diagnosis.

1. Perry et al, Clinical features, outcome and illness severity scoring in 32 dogs with urosepsis 2017-2018 Journal of Veterinary Emergency and Critical Care, 32:2, March/April 2022, 236-242.

What to do when you find this?! Here's a kidney showing medullary rim sign, a common finding when scanning kidneys. Ther...
12/08/2022

What to do when you find this?! Here's a kidney showing medullary rim sign, a common finding when scanning kidneys. There is a hyperechoic ring which is below the corticomedullary junction as seen by the hypoechoic halo around it. But what does it mean?
Medullary rim sign can be associated with tubular inflammation eg FIP, acute tubular necrosis, chronic interstitial nephritis. But it is also commonly seen in normal pets too! 72% of dogs with only medullary rim sign did not have any renal dysfunction.
Takeaway message:- if there is other signs of renal disease present eg small kidneys or pyelectasia, then renal disease is suspected. If it is the only abnormality detected it is more likely to be incidental- urinalysis is still an easy worthwhile test to rule out dysfunction.
In this case the cat had an ascending pyelonephritis, which was managed after culture and sensitivity testing.
Complete diagnosis and care with Us Together.

Ref:- Mantis P, Lamb CR. Most dogs with medullary rim sign on ultrasonography have no demonstrable renal dysfunction. Vet Radiol Ultrasound 2000;41:164-166.

With huge thanks to all the clinics that we support we are proud to announce that July was a record-breaking month for s...
29/07/2022

With huge thanks to all the clinics that we support we are proud to announce that July was a record-breaking month for scans around Melbourne!
All sorts of foreign bodies, many neoplasms sadly, ureteroliths, pyelonephritis, cholecystitis, and many more all diagnosed in the comfort of your clinic.
Find out what you're missing with Us Together- scanning but simpler.

Two foreign body cases with a second problem!Co-morbidities are frequently encountered when performing a proper abdomina...
28/07/2022

Two foreign body cases with a second problem!
Co-morbidities are frequently encountered when performing a proper abdominal ultrasound.
In these cases both patients had eaten something daft leading to the ultrasound (which is more sensitive than xrays for blockages), but the first dog also had a splenic mass and the cat also had markedly enlarged muscularis throughout its gut not associated with the foreign body.
Both ended up in surgery to address both their issues with the surgeon fully briefed, no surprises!
Complete diagnosis and care with Us Together.

Yesterday we showed a video of a descending duodenum which was moderately dilated with fluid but showed peristaltic wave...
03/06/2022

Yesterday we showed a video of a descending duodenum which was moderately dilated with fluid but showed peristaltic waves. Aborally from this distended duodenum was an irregular-shaped object causing distal acoustic shadowing. The hypoechoic mucosa was visualised going over the surface of the object which made it likely intraluminal. Distal to this object there was a great example of reverberation artifact caused by gas, which can sometimes be confused for a foreign body (see previous post as it's a great side-by-side example)
The object was of course a foreign body which was promptly removed- see how well the object fits with the outline on the ultrasound!!
This kitten had inconclusive xrays prior to ultrasound- showing the superior power of ultrasound to detect foreign bodies.
Remove the unknown from your daily work and consider an ultrasound with Us Together for those vomiting cases.

02/06/2022

To cut or not to cut?
Here's a great video of a descending duodenum from a vomiting kitten. The serosal-serosal diameter at the start of the video is 7.5mm. The stomach was moderately dilated given the 2 day duration of anorexia.
How would you proceed in this case? Please write in the comment section below!
The answer will be posted tomorrow.

Ultrasound can also be used to look for different things than just organs. It is especially useful in those recurring ne...
25/05/2022

Ultrasound can also be used to look for different things than just organs. It is especially useful in those recurring neck abscesses which can both identify a migrating grass seed but can also direct the forceps to remove the foreign object in real-time through a key-hole incision.
In this case, an umbilical hernia was confirmed on ultrasound- you can see the hyperechoic muscle terminate either side of the hernia, with a small amount of anechoic fluid and adipose tissue connecting the abdomen with the subcutaneous space. The hernia was firm and irregular to touch so ruling out a mass lesion was important prior to surgical correction.
Complete diagnosis and care with Us Together.

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