Medical Machines: Ultrasound Machines

Medical Machines“Medical Machines” is a new series of blog posts highlighting the equipment AMC veterinarians use to provide state-of-the-art care to thousands of pets annually. These machines save countless lives, but pet families rarely ever have the opportunity to see them up close and personal. This series will give readers a glimpse into the equipment AMC veterinarians rely on every day. The previous blog post in this series highlighted infusion pumps.

The machine for today is an ultrasound machine. I was shocked when I finished counting our ultrasound machines — AMC has ten different ones located on four different floors of the hospital.

An internal view without x-rays

Fifty years ago, if veterinarians wanted to see the inside of the body, we took an x-ray. To take an x-ray, we use a machine that emits radiation, creating an image on film. An x-ray reduces a three-dimensional dog or cat to a two-dimensional image. While x-rays are still used for the heart, lungs and bones, ultrasound is more commonly used to view the inside of the abdomen. The probe of the ultrasound machine bounces sound waves off the internal organs as the probe is moved about. The sound waves then create a gray scale image on the ultrasound screen. The veterinarian performing the ultrasound twists the probe which changes the orientation of the image and allows the various organs to be evaluated from side to side, top to bottom and front to back. By analyzing an organ in multiple directions, a clear picture of any structural abnormalities emerges.

Diagnostic images = radiology

Back when veterinarians only had x-rays, the department in charge of x-rays was called radiology. Now that we have x-rays, CT scans and MRIs, the department has expanded and these imaging modalities reside in AMC’s Diagnostic Imaging Department. Since ultrasound is another method of imaging the body, this group of AMC doctors has two of our best ultrasound machines in the hospital. Our radiologists have special training to perform and interpret ultrasounds. One of their most important skills is using the ultrasound to collect samples for laboratory testing.

Peering into a heart

An x-ray of the chest will identify an enlarged heart or fluid in the lungs as the result of heart failure. To hone in on problems with heart values or a thickened heart muscle, a specialized ultrasound called an echocardiogram is required. AMC’s cardiologists have two such machines: one about the size of a small refrigerator and a portable one for cage side use.

A quick look

The other six ultrasound machines are distributed on four different floors of the hospital, necessitated by AMC’s vertical space. All six of these machines have similar functions. They are quite small, about the size of a toaster and are strapped to a wheeled stand. ICU and ER doctors will wheel their machine to a critical patient to quickly determine if there is internal bleeding or an object stuck in the intestine. Oncology and Interventional Radiology use their mobile ultrasound machines to monitor the effect of treatment, as does Internal Medicine. We all use our ultrasound machines to facilitate collection of urine samples.

With all these essential functions, no wonder AMC needs a denary of ultrasound machines!

Day at the Museum: The Animal Medical Center Sequel

The Animal Medical Center has a computer system to manage our diagnostic imaging, including x-rays, ultrasound, CT scans and MRIs. The Picture Archiving and Communications System (PACS) lists all the images for any given day. If you looked at the list for June 17, you would see my patient Dakota, who got a chest x-ray, Chippie, the dog who had a full series of dental x-rays, and BooBoo who had a brain MRI — a typical list for a Friday.

But reading down the list you get to Croc 1, Bird 2, Snake 3 and Ibis 4. These images come from the oldest patients ever seen at The AMC. No, not a 25 year old dog or a 30 year old cat. These 32 patients are 2,500 year old animal mummies.

Like many AMC patients, these animals came to The AMC across the Brooklyn Bridge into Manhattan. Unlike any other AMC patients, these patients belong to the Brooklyn Museum’s Egyptian collection.

Like all patients who come to The AMC, they came for our diagnostic expertise, utilizing our state of the art equipment. In this case, the animal mummies came to The AMC for CT scanning in our 64-slice CT scanner.

The AMC’s 64-slice CT scanner rapidly produces high quality images. So fast, all 32 were scanned in one day as outpatients! Rapid is better for our usual patients, since the faster the scan, the shorter the anesthesia time. For the animal mummies, the high quality images are critical in helping AMC’s board certified radiologist, Dr. Anthony Fischetti, collaborate with the curators from the Brooklyn Museum to decipher the mummy’s contents. The 64-slice CT scanner can recreate three dimensional and multiplanar images of the patient. In our usual patients, we use these features to better diagnose and treat illnesses. Our colleagues at the Brooklyn Museum plan to use the reconstructed CT images to study the mummies’ contents without disrupting the intricate linen wrapping.

If our CT scanner is so fast and can scan thirty two mummies in one day, you might wonder why your AMC veterinarian wanted your pet here all day when it had a CT scan. A CT scan in one of our usual patients requires administration of a short-acting anesthetic. Obviously, an animal mummy does not require anesthesia, the associated monitoring of the heart, respiration and blood pressure and does not have to recover from anesthesia. All these differences shorten the procedure time.

Most of our usual patients have two CT scans back to back. The first scan is before and the second is after administration of a contrast agent. The contrast agent highlights abnormalities the veterinarians are hunting for, such as inflammation and tumors. Administration of contrast was not possible or necessary in the animal mummies.

This animal mummy project between The Animal Medical Center and the Brooklyn Museum will culminate in an exhibition in 2013, so mark your calendars now!

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.