Northeast Veterinary Imaging

05/11/2025

This very regretful-looking young Labrador cross presented with a swelling on her left ribcage 5 days after pinching a kebab stick and its associated goodies from her owners BBQ. Ultrasound (images 4&5, bw=body wall, gw=gastric wall) showed a linear foreign object consistent with the missing kebab stick lodged within the stomach and extending from the luminal aspect of the right gastric wall, passing across the stomach and penetrating the left gastric wall, to then pass through the body wall on the left side and emerge between the ribs, causing the visible subcutaneous swelling. Remarkably asymptomatic other than the swelling, she was undeterred from her love of all things edible and had eaten a full breakfast the morning of presentation!
Surgical intervention allowed for removal of the kebab stick and gastric wall repair, from which she recovered uneventfully.

14/08/2025

This is a gallbladder tumour in a 9 year old male Dachshund. Gallbladder tumours are very rare in the dog; neuroendocrine neoplasia, smooth muscle tumours, lymphoma, and adenoma / adenocarcinoma have been reported. Differentiation of tumours from polyps is difficult sonographically. Features that alerted me to a possible tumour in this case were the absence of other inflammatory changes (in my experience gallbladder polyps tend to be small and multiple, with an irregular gallbladder mucosa, whereas in this case there is one large solitary lesion with no other changes); and the presence of vascularity, which I don't tend to detect in polypoid lesions and which were found in all gallbladder tumours in one study of 14 dogs. Cytology, while rarely performed, is highly diagnostic for most gallbladder tumours and if malignancy was confirmed, then cholecystectomy would be advised. I therefore felt justified in advising an ultrasound guided FNA in this patient, although I had some concerns about whether the procedure would be diagnostic given the limitations to my usual FNA technique which would be necessary in order to minimise the risk of bile leakage (only one aspirate; maintain a straight route in and out). However, via an intercostal approach (image 2), with a little direct backwards and forwards agitation and suction, my single cytology sample was representative and confirmed a neoplasm - an adenoma.
A preventative laparoscopic cholecystectomy has been advised by a soft tissue specialist in case of bile duct obstruction.

14/08/2025

This is ultrasound-assisted minimally invasive foreign body retrieval. It’s a variation on ultrasound guided wire placement for surgical location of foreign bodies, which I find a bit hitty missy with the wire often moving and also requiring a large incision for surgical access. With this catheter technique, the catheter leaves a pe*******on track large enough to allow passage of alligator forceps, and so permits retrieval through the catheter track, without the need for full surgical incision.

This spaniel presented with malaise and a focal swelling over the left rib cage. Ultrasound showed a large area of reactivity within which was a linear, shadowing echogenic structure 1.3cm long consisting of two parallel echogenic lines, consistent with grass seed / foliage foreign body, adjacent to the tenth rib (image 2). Under ultrasound guidance a 16 guage iv catheter was advanced to the foreign body and agitated to create a little space around it. The stylet was withdrawn and limited surgical intervention was then required which involved an incision over the catheter site, removal of the catheter, and retrieval of the offending foliage via alligator forceps passed along the catheter track, without direct visualisation. A post-procedure ultrasound confirmed no residual foreign material. A nice technique for these pesky, common, and sometimes immensely frustrating imaging - surgical combination cases!

23/07/2025

27/11/2024

Here is an endoscopic image to make a change!
This is an oesophageal squamus cell carcinoma in a 12 year old male DSH cat with persistent 'vomiting' and weight loss. He was very thin at presentation.
Oesophageal neoplasia is rare in cats but where present is usually malignant. SCC is the most common type and typically occurs in the middle third of the oesophagus, causing oesophageal obstruction, as was the case here. The prognosis is poor as these malignancies are usually advanced by the time of diagnosis, and metastasis to the liver and lungs are common. This neoplasm was diagnosed by endoscopic biopsy, and the patient was euthanised immediately following the diagnosis.

21/12/2023

These images are of a right ovarian teratoma in a 2 year old Rottweiler. This young dog presented with marked abdominal distension due to ascites. A very large right ovarian mass was evident on ultrasound, with very variable echogenicity and some mineralisation evident. A teratoma was suspected. A large right ovarian mass was confirmed at surgical ovariohysterectomy which had hair and cartilage evident within it on dissection. Teratomas are an uncommon neoplasm which are usually benign, but metastasis can occur infrequently.

21/12/2023

This is another interesting find - an aortic dissection, or aneurysm, in a cat. This 13 year old domestic short haired cat presented with pupd and weight loss with a mild azotaemia. Ultrasound confirmed renal pathology, however an aortic dissection was also noted. This is where blood leaks from the aortic lumen between the aortic wall layers to form an adjacent 'channel'. The location of blood leakage was detected in this patient and is labelled 'D' in the first image below. Screening for hypertension and cardiac disease is advised if this abnormality is detected on abdominal ultrasound. Blood pressure was normal in this patient and there was no evidence of cardiac disease. Incidental finding??!

21/12/2023

This is tuberculosis in a cat. A 6 year old male neutered Tonkinese cat presented in May 2023 with a history of weight loss, poor appetite, and an abdominal mass on palpation. Routine bloods showed a mild anaemia (HCT 27%) and low albumin (21g/l). Abdominal ultrasound (images 1-6) showed multiple eccentric small intestinal lesions causing wall thickening up to 5mm affecting predominantly the mucosal layer but causing some focal loss of layering. The remainder of the small intestinal walls measured up to 3.1mm with preserved layering. Additionally there was a large jejunal lymph node measuring 4.6x2.7cm in long axis. FNA of the node was inconclusive and a decision was made to perform exploratory surgery to biopsy both the intestinal lesions and the node, rather than an ultrasound guided trucut of the node alone. Surgical biopsy of the intestinal lesions and of the lymph node was performed and showed granulomatous enteritis and lymphadenitis with intracellular bacteria evident in macrophages in the node samples. Further staining confirmed the presence of acid fast bacterium and subsequent mycobacterial pcr was positive for the tuberculosis complex. He was treated with rifampicen, erythromycin and pradofloxacin, and a repeat ultrasound 6 months later (images 7-11) shows complete resolution of intestinal lesions and a reduction in the size of the node (now 2.5x2.7cm), with several small 'islands' of nodal tissue in the peripheral area - likely left behind during node shrinkage. Ultrasound guided trucut biopsy of the node confirms there are still many intracellular mycoplasmal bacterium present on histopathology. Therapy is ongoing.. a decision is to be made whether to excise the node or continue with medical therapy. Updates will follow in the comments!

21/09/2023

Nice example of the typical appearance of splenic lymphoma in cats - frequently described as a 'swiss cheese' type appearance! These are very amenable to ultrasound guided fine needle aspiration as cytology in these cases is highly diagnostic.

19/09/2023

When investigating dogs with urinary incontinence, such as this 5 year old female greyhound, it's nice to obtain this transverse view of the urinary bladder trigone if you can. It shows both ureteral jets firing almost simultaneously and is the best view for confirming correct ureteral location if ectopic ureter is a potential concern. Achieving this view is easier with a linear probe, but the colour is so much better with curvilinear. Angle your probe caudally and wait.. you can sometimes see the jets in B-mode too 🙂

12/07/2023

This is a nice example of the importance of ultrasound in cases of suspected pancreatitis. This 6 year old male Cocker Spaniel presented with acute onset vomiting and lethargy. He had a mild monocytosis and a mildly elevated globulin, and lipase was over 3 times the upper limit of the normal reference range. Radiographs showed no abnormality. Based on the breed, presentation and bloodwork, he was strongly suspected as having acute pancreatitis. Ultrasound of this patient however showed a normal pancreatic parenchyma, effectively excluding this diagnosis (images 1 & 2). There was however a thickened segment of jejunum where the wall thickness increased to 5.4mm (from 4mm) due to marked mucosal layer thickening and irregularity, and also with loss of definition of deeper wall layering in this area. There was a marked surrounding reactivity and mild localised effusion consistent with localised peritonitis (images 3-5). There was also a highly echogenic shadowing cap in the transverse colon 3cm long consistent with foreign content (image 6). The colon was otherwise distended with fluid. My theory was that this patient had an intestinal foreign body, currently in the colon, which had at one point lodged in the jejunum and caused damage to the jejunal wall, resulting in localised peritonitis. I advised close monitoring of the patients faeces, and indeed a corn on the cob was passed that evening (image 7). He subsequently recovered uneventfully - he's a lucky boy that the corn on the cob had moved on rather than perforate his jejunum! 🙂. This patient is one of so many I have seen with a variety of other (often surgical) conditions which are so easily suspected as having pancreatitis...always ultrasound!! Because lipase, and also specific pancreatic lipase in both cats and dogs, do NOT always indicate a primary pancreatitis.