Current Diagnostic Techniques in Veterinary Surgery

Veterinary World, Vol.1(3): 90-91 REVIEW Current Diagnostic Techniques in Veterinary Surgery Roon Mathai, R. H. Bhatt, Shivraj Jhala, N. H. Kelawala,D. B. Patil and P. V. Parikh Department of Surgery & Radiology, Veterinary College, AAU, Anand - 388001 Medical diagnostic technology has made rapid nonsurgical armamentarium of the veterinary clinician strides after the advent of computer. Many of the since the advent of fibreoptic endoscope. Although advances in human diagnostic medicines are other sophisticated imaging modalities like CT and translated into veterinary medicine in the developed nuclear imaging can provide additional information, countries. In brief, newer branches like Imaging, the accessibility and cost effectiveness of these Radiodiagnosis, Telemedicine, Telesonography and procedures do not make these as promising as Teleradiology have emerged. Broadly, the ultrasonography. instrumentation /devices devised with the modern 3) Computed tomography: CT has been an technology in the present digital age are listed below. extremely significant development which has a unique 1. I.I.T.V. cross sectional imaging ability useful for the diagnosis 2. Ultrasonography (USG) of tumors, malformations, inflammation, degenerative 3. Computed Tomography (CT) 4. Magnetic Resonance Imaging (MRI) and vascular diseases and trauma. CT is a diagnostic 5. Bone Scintigraphy modality that is fundamentally different from X-ray 6. Digital Substraction Angiography (DSA) method in which an organ is scanned in successive 7. Laparoscopy-Thoracoscope,Theloresectosc- layers by a narrow beam of X-rays in such a way that ope, Rhinoscope, Otoscope etc the transmission of X-ray photons across a particular 8. Endoscopy layer can be measured and by means of a computer, 9. Pulse Oximetry used to construct a picture of the internal structure. All these imaging modalities have brought sea 4) MRI: MRI is a highly sensitive and noninvasive change in the diagnosis of a clinical case. Precise technique providing accurate and detailed anatomic and an instant diagnosis of an intricate case can be made with their usage. The modalities which can be images with good contrast and spatial resolution. used under Indian conditions are: However, in veterinary medicine MRI is still in its infancy and its use is infrequent. To date, MRI has 1) Image Intensifier T.V. system: Generally used in orthopaedic surgery. This facilitates fracture been used in developed countries in clinical cases repair using a small incision thus achieving minimal as well as a research tool especially for CNS diseases invasive surgical manoeuvre. IITV helps in X-ray in small animals. MRI has a wide spectrum of imaging of the intraoperative site for the intraoperative application. It can be used for imaging all body regions orthopaedic manipulations, and the same can be in small animals, but only the extremities and the head stored for future reference purpose. This facilitates can be imagined in large animals. It is useful in introduction of Steinman pin giving a small incision. answering many questions related to the 2) Ultrasound: In small animal and equine musculoskeletal diseases in animals such as practice, ultrasound is routinely used as a diagnostic understanding the pathogenesis of navicular disease, aid. Applications of ultrasound in ruminants have not traumatic arthritis and osteochondrosis in equines been fully exploited, except in pregnancy. There could and wobbler syndrome in dogs. The newer be numerous organs which can be scanned using applications of MRI are Magnetic resonance an ultrasound scanner. Ultrasonography seems to angiography and MR spectroscopy. It is especially have a promising future in veterinary medicine, used to differentiate an inflammatory process from a particularly for the assessment of intra-periabdominal neoplastic mass, tumors from peritumoral oedema. disease. Ultrasonography is viewed as the single It is more specific and sensitive in detecting localizing most versatile addition to the noninvasive and and differentiating osteomyelitis, cellulites and Veterinary World, Vol.1, No.3, March 2008 090 Current Diagnostic Techniques in Veterinary Surgery abscess. However, its use is contraindicated in lung, mediastinum, great vessels, pericardium and pregnancy. oesophagus. Visceral inspection of the thoracic cavity 5) Nuclear scintigraphy: Nuclear scintigraphy is by thoracoscopy has been used to provide a more a highly sensitive advanced procedure in which accurate diagnosis and prognosis in horses affected radioisotopes are used to detect the functional with pleuropneumonia and other thoracic and abnormalities of the body system. The interpretation oesophageal disorders. Thoracoscopy allows is based on the appearance of the increased (hot visualization and biopsy of a large surface of the lung spots) or decreased (cold spots) radioactivity regions. and provides adequate specimen for For eg. an active process is indicated by a hot spot histopathological diagnosis. while a dull process like lack of perfusion is indicated 8) Endoscopy: It is a minimal invasive diagnostic by cold spot. Nuclear scintigraphy has been used to modality which aids in a best way to document detect functional disorders of the kidney, liver, lungs, mucosal inflammation- hyperemia, active bleeding, GI tract, thyroid gland and many other organs. It is irregular mucosal surface, and facilitates biopsy in very useful in the diagnosis of occult lameness, lung tubular organs like the GI tract, and repiratory and perfusion and ventilation and patency of the ureter the urogenital organ systems in both large and small animals. Also used for 9) Pulse Oximetry: Pulse oximetry represents the vertebral column imaging and monitoring the greatest advance in the patient monitoring. It has the progress of fracture healing and in tumor detection. unique advantage of continuously monitoring the 6) DSA: DSA is a radiographic modality which saturation of haemoglobin with oxygen, easily and allows dynamic imaging of the vascular system noninvasively, providing a measure of cardio- following intravascular injection of iodinated X-ray respiratory function. The fundamental physical contrast media through the use of image property that allows the pulse oximeter to measure intensification, enhancement of the iodine signal and the oxygen saturation of haemoglobin is that blood digital processing of the image data. Temporal changes colour as haemoglobin absorbs varying subtraction of the images obtained during the first amounts of light dependent on it’s saturation with arterial phase of injection of the contrast medium from oxygen. Hence, pulse oximetry remains the standard the images obtained before and after contrast of care during anaesthesia as well as in the recovery medium administration yield images which are devoid room and intensive care unit. of bone and soft tissue. This imaging modality plays A vital part of treating equine problems is an an important role in highlighting the vascular initial accurate diagnosis. High quality images are an pathologies like stenosis etc. important aspect of this. As well fixed and mobile X- 7) Laparoscopy: Laparoscopy has been a ray machines, the Hospital has an image intensifier valuable diagnostic and therapeutic tool in human for intra-operative monitoring with x-rays. The clinical medicine. Only in the last 15 years, its use Ausonics Impact ultrasound machine provides high has been extensive in various animal species for quality images of muscles, tendons and ‘ligaments; research and clinical diagnostic and therapeutic where as the Ving-med System V can image the purposes. Laparoscopic surgey offers significant equine thorax and abdomen, as well as giving advantages over open surgeries in fields of detailed analysis of blood flow in various organs and cholecystotomy, appendicectomy, vagotomy, hernia tissues. repair and adhesion release etc. For gynaecological To conclude, the advances in diagnostic problems like ovarian cyst or in the case of technology in veterinary surgery is in infancy stage in India. An all out effort is required to introduce the oophorectomies and hysterectomies, laparoscopic basic imaging modality - ultrasound in veterinary surgery (scarless surgery) is now considered a better practice at district polyclinics and city hospitals. The alternative in addition to laparoscopic sterilization. The use of radiology needs to be strengthened by its most advantageous characteristic of laparoscopy is optimum use in clinical cases. that it allows direct examination of abdominal cavity “The little neglect may breed mischief….for want with only minimal and superficial surgical intervention. of a nail the shoe was lost; for want of a shoe the Thoracoscopy has been employed in man for the horse was lost; and want of a horse the rider was diagnosis and treatment of diseases of the pleura, lost.” - Benjamin Franklin **** Veterinary World, Vol.1, No.3, March 2008 091.

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