ABC’s of Lung Ultrasound | Getting Started

by Susan Keane MVB MANZCVS DABVP, staff veterinarian for BCF Ultrasound. 

Lung ultrasound is a technique that most commonly used in equine practice but is often underutilized in other species. It is, in fact, useful for small animal and farm animal applications too.

Before we get on to the ABCs of lung ultrasound, here are our tips on how to get started with lung ultrasound…

Equipment

First things first – you need the right gear. When performing lung ultrasound, ideally, you should use a linear probe. For large animal vets, remember that a rectal probe IS a linear probe – so you can use this for chest scanning if a “tendon” probe is not available. Have a look at images below to see the probes you can use for lung ultrasound.

In horses, there are some circumstances where increased penetration will be required – mainly when it comes to scanning the cranial mediastinum (through the musculature of the triceps – see figure 2). Another situation is when you are scanning the adult horse with pleuropneumonia.  In order for you to be able to assess the maximal fluid depth and size of abscesses that may be developing in the chest, you should use a lower frequency probe. In these cases, your equine “abdominal” probe (i.e., large curvilinear, lower frequency probe) in the transducer of choice.

Patient Preparation

What else? If you have the luxury of being able to clip your patients, then please do so. After clipping, you should clean the area with soapy water, wipe off with alcohol/meths and then apply good quality* ultrasound gel. If you do not have the luxury of being able to clip, then meths, meths & more meths is the way to go to get the best contact. **

* not all ultrasound gels are created equal! Cheaper gels are usually runnier and don’t provide the quality of contact required to get the best images.
**My tip when applying meths or alcohol to foals or adult horses for chest scans try not to let it drip down their foreleg. They will start stamping, seriously affecting your ability to perform a good exam!

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