Page 4 - Clinical Connections - Autumn 2023

RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Advanced imaging
HELPING REFERRED PATIENTS WITH A NEW
FLUOROSCOPY UNIT

Francisco Llabres-Diaz, Senior Lecturer in Veterinary Diagnostic Imaging and Head of the of the Small
Animal Diagnostic Imaging Service, Lindsey Berriman, Veterinary Clinical Radiographer and Head
Small Animal Radiographer, and Oliver Taylor, Surgical Resident

VC Small Animal Referrals has Research and clinical innovation
upgraded its fluoroscopy unit, which The unit also supports new clinical
R offers benefits for referred patients research projects and clinical innovations.
and their owners, research and veterinary Fluoroscopy studies are stored in an image
education. archive and are available for instant review,
Fluoroscopy is a specialist diagnostic through an associated image viewer. This
imaging modality, enabling capture of real- allows the studies to be utilised for student
time moving pictures of inside of the body. teaching or research both during the
It takes a continuous series of low dose process and afterwards.
radiographs, which creates a live movie of The new system is an upgrade from
the patient’s internal structures. the previous equipment. Technology has
The fluoroscopy unit enables more changed dramatically in the last few years
accurate or quicker diagnoses than would and the new system is easier to work with,
otherwise be possible. In other cases, it with increased computer capabilities that
increases the level of certainty of either allow the storage of longer movies. This
a diagnosis or the lack of it. The resource system also works with an increased frame
supports the RVC’s mission of providing rate. Images can be acquired at 30 frames
cutting-edge clinical facilities that advance a second compared to the old, slower rate
patient care, clinical education and research. of six frames a second. This increased rate
The upgraded system was partly funded means imaging the heart is far superior
by a grant from the Animal Care Trust, the on the new machine so interventional The new fluoroscopy unit supports research
and teaching, as well as treatment
registered charity of the RVC. cardiology (placing of stents) can be
Fluoroscopy has become a critical aspect undertaken.
of diagnostic investigations, particularly for Fluoroscopy is also used in such cases
many challenging conditions presenting Arthur’s case to determine whether the calculus can be
to the Internal Medicine, Cardiology, Seven-year-old British bulldog Arthur was pushed back into the bladder to alleviate the
Emergency and surgical teams at the Queen referred in August, as a result of a calculus difficulty in urinating.
Mother Hospital for Animals (QMHA). It also in the distal urethra. He presented to the Arthur underwent a fluoroscopy-aided
enhances the teaching of undergraduate QMHA with a history of abnormal urination. retrograde urethrocystogram with positive
students and veterinary specialists-in- The case required close collaboration contrast. This revealed a uniform contrast
training by exposing them to a variety of between the Internal Medicine Service, the column in the urethra and the presence of
unusual and complex cases. Diagnostic Imaging Service and the Soft a consistent round well-defined contrast
They then obtain a better understanding Tissue Surgery team. filling defect in the urethra. Towards the end
of those disease processes and how they He initially had two lateral radiographs of of the study, this filling defect moved slightly
may be seen on more conventional imaging the caudal abdomen. Although ultrasound towards the proximal end of the penis.
modalities, such as plain radiography. This could evaluate the bladder and very Although a retrograde urethrocystogram can
enhanced knowledge, in turn, may allow proximal and distal urethra, fluoroscopy be performed with conventional radiography,
them to either treat similar cases in the was required to fully assess the portions of those radiographs are only snapshots in
future, even if fluoroscopy is not available the urethra that could not be evaluated with time. Seeing the calculus move in real time
to them, or recommend earlier referral to ultrasound due to the pelvic bones. in these cases through fluoroscopy adds
owners. certainty and speed to the diagnosis and
highlights how useful fluoroscopy can be.
Arthur underwent a scrotal urethrostomy,
castration and scrotal ablation. He
recovered well from surgery with only minor
haemorrhage from his urethrostomy site. He
was discharged two days after surgery.

For small animal referrals, please call:
01707 666399
The image on the left shows the contrast going in (white). The image on the right shows the bladder Email:
filled with contrast, to highlight any stones present qmhreception@rvc.ac.uk

4 Autumn 2023