Point-of-Care Ultrasonography (POCUS)

Chapter 89 Point-of-Care Ultrasound (POCUS) procedures

Søren Boysen DVM, Dipl. ACVECC

Veterinary Point-of-Care ultrasonography (POCUS) is a limited or focused ultrasound technique performed by non-specialists to rapidly assess patients and help direct diagnostic and therapeutic interventions. It is safe, non-invasive, repeatable, objective, and performed during triage or routine patient evaluation. Do not compromise patient safety: bring the ultrasound machine to the cat, and complete/continue any emergency stabilization and concurrent diagnostic efforts. Currently, POCUS involves focused organ assessment of the abdomen (fig. 89.1, video 89.1 section 1), the pleural space and lungs (fig. 89.2, video 89.1 section 2), and the cardiovascular system (fig. 89.3, video 89.1 section 3), which can be applied within four clinical settings:

1. Triage to rapidly identify the most immediate life-threatening conditions.

2. Serially to monitor progression or resolution of pathology.

3. Systemically to detect asymptomatic conditions or new developments. 

4. Therapeutically to reduce complications of interventions where applicable.

POCUS is indicated in any cat in which the answer to a relevant and specific clinical question derived from the signalment, history, and clinical evaluation can’t be answered via physical exam alone. Scan cats in the position they are most comfortable with minimal stress; scanning cats in oxygen incubators or their carry cages with lids removed often minimizes stress. Air rises and fluid falls; modify protocols considering the suspected pathology and patient positioning. All feline POCUS can be completed with a microconvex/curvilinear probe with frequencies between 7.5-10 MHz; a linear probe can also be used. Clipping of fur is unnecessary. 70% isopropyl alcohol is the preferred coupling agent; gel can also be used. Minimal restraint is required, and sedation is rarely necessary. Feline-specific POCUS findings compared to dogs are presented in box 89.1.


Point-of-Care Ultrasonography (POCUS)

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video 89.1 Complete feline Point-of-Care ultrasonography (POCUS) examination: abdomen, pleura and lung ultrasound (PLUS), and cardiac.

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