Outpatient Imaging
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Outpatient Imaging: Instructions for Referring Veterinarians
About the Advanced Outpatient Diagnostic Imaging Service
The purpose of the Advanced Outpatient Diagnostic Imaging Service is to provide a mechanism whereby a
veterinarian in private practice can order advanced imaging procedures without giving up the primary care
responsibility for the patient. As such, the management of the case up to and following the imaging procedure
will be the responsibility of the referring veterinarian. This service is only available as a referral from a
practicing veterinarian.
How to Order a Procedure
Ordering of the imaging procedure will be accomplished through our website.
- There are three ordering forms, one for ultrasound, CT and MR.
- Ultrasound exams will be provided on Tuesdays and Fridays.
CT and MR exams will be provided on Wednesdays. - Outpatient appointments will be generated on a first come, first served basis.
- After submitting the imaging request form (via email or fax), you will be contacted to arrange the next available appointment.
Animal eligibility requirements for outpatient imaging services
- The animal will be required to be up to date on rabies vaccinations. The date of the last rabies vaccination will be requested on the imaging ordering form.
- Recent blood work will be required for outpatient imaging to ensure the animal’s state of health and to provide useful information to the anesthesiologist and radiologist. The specifics as to what blood work is required depends on the procedure being performed (ultrasound exam) or anesthetic category (CT/MR). The required blood work can be found on the imaging request form or at the following links:
- Animals will be prescreened prior to their appointment to ensure that all information is in order.
- If previous imaging studies are available, we request they be provided to the radiologist to facilitate a complete imaging diagnosis.
Preparation for Outpatient Imaging
The animals should not eat for twelve hours prior to the procedure; therefore, please ask the owner to not feed their animal after 8 p.m. the night before the exam. They should continue to provide free access to fresh water. The presence of food in the stomach makes it more difficult for the ultrasound to penetrate to the organs to be studied. For CT/MR, the animal should be prepared as for any anesthetic event.
Ultrasound
- Scheduling and Appointment Duration - Ultrasound will have 4 appointments on both Tuesday and Friday. Clients drop off appointments will begin at 7:30 am and will be staggered at 15 minutes intervals. The animals will be held in a holding facility within the Veterinary Teaching Hospital until the time of their imaging procedures. Normally these procedures will be performed first thing in the morning but this could vary depending on the in-hospital imaging schedule. Owners will be contacted when the imaging procedure is complete but they should be prepared to leave the animal for the day. The veterinarian ordering the procedure needs to have recently examined the animal and must indicate on the ordering form that the animal is sufficiently stable to stay in a holding facility for up to 8 hours. The Veterinary Teaching Hospital will be glad to provide imaging support for less stable patients but not through the outpatient service.
- Clipping of Hair - To ensure the best ultrasound results possible, we will clip the animal over the area of interest. For most abdominal exams, the clipped area will extend from the last few ribs to the brim of the pelvis, and about one third of the way up the side towards the back. A larger area may be needed depending on the specific areas being examined and your pet's body shape.
- Sedation - Sedation may be necessary for a thorough US examination. The anesthesiology section will provide the imaging service with recommended protocols. The animal may be disoriented and off balance for about half an hour and they will be hospitalized in our wards. The animal will not be discharged until he/she is standing and able to move around safely.
- Procedures offered
- Abdominal Exam - This is the most common procedure ordered. This exam will include a complete systematic evaluation of the abdominal organs.
- Thoracic Exam - A thoracic ultrasound exam is useful to identify mediastinal or pleural disease, especially if the animal has pleural effusion. Evaluation of lung disease is limited to patients with severe pulmonary infiltrate.
- Pregnancy Exam - This is an abbreviated lower cost exam which is limited to the female genital track. It is useful to diagnosis early pregnancy and to assess fetal viability. It is not an accurate method to determine the number of fetii in late pregnancy.
- Echocardiography - This service is not offered through the outpatient imaging services. Echocardiograms are available through referral through our cardiology service which offers full service cardiac evaluations.
Computed Tomography and Magnetic Resonance Imaging
- Scheduling and Appointment Duration - CT and MR will have 4 appointments on Wednesdays. Clients drop off appointments will begin at 7:30 am and will be staggered at 15 minutes intervals. The animals will be held in a holding facility within the Veterinary Teaching Hospital until the time of their imaging procedures. These procedures typically require general anesthesia, therefore the owner should be instructed to hold the animal off food after 9:00 pm on Tuesday. An anesthesiologist will be assigned to work with the outpatient imaging service and will supervise the anesthesia of the patient. CT procedures are usually short duration (15-30 minutes) and therefore we are providing up to 4 appointment slots on Wednesdays. MR takes longer (1-2 hours) and as such we will provide one appointment slot on Wednesdays. The veterinarian ordering the procedure needs to have recently examined the animal and must categorize the patient using the below anesthetic classification scheme.
- Anesthetic Classification Scheme:
| Category | Description | Examples |
| Category 1 | Healthy patient | No organic disease |
| Category 2 | Mild or moderate systemic disease without functional impairment | Compensated cardiac disease (no medications), geriatric animals, obesity, orthopedic disease, pediatric animals |
| Category 3 | Organic disease with definite functional impairment | Mild anemia, mild anorexia, compensated cardiac disease (with medications), dehydration, mild fever, mild neurologic symptoms (seizures, vestibular syndrome, ataxia, paresis) |
| Category 4 | Severe Disease that is life-threatening | Severe anemia, severe cardiac disease, decompensated pulmonary disease, renal failure, sepsis, shock |
| Category 5 | Moribund patient, not expected to survive | Major trauma, multi-organ failure, profound shock, severe head injury |
- Only animals in category 1-3 will be suitable for outpatient imaging. The Veterinary Teaching Hospital will be glad to providing imaging support for less stable patients but these animals will need to be seen through one of our other services such as internal medicine or neurology.
- Normally these procedures will be performed first thing in the morning but this could vary depending on the in-hospital imaging schedule. Owners will be contacted when the imaging procedure is complete but they should be prepared to leave the animal for the day.
Discharge
The owner will be provided with a CD containing images and discharge information but will be told their imaging report will be sent directly to their referring veterinarian. A report will be faxed or emailed within 24-48 hours of the study. A CD with images will be mailed to the referring veterinarian. An oral report the day of the study can be ordered as an option.
Invasive Procedures
Invasive procedures such as biopsies will not be performed as an outpatient procedure. Because of the higher risk of these procedures, this service will only be provided through a referral through one of the established service.
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