hello everyone welcome back I'm Serge and I'm CERN all right and now going back to the most important organs in the body the kidneys we're going to be looking at the left paralympocyte and the left kidney we're going to get the most important organs later that's going to be the heart and lungs but we'll go ahead and look at the kitties keepsters happy here we're going to look at that left paralumber site big questions we're going to ask and answer that left paralumber site after surge explains the details on how to find that site we're going to ask the question do we have free fluid do we have free air and then we're going to look at the kidneys in long and short axis for symmetry we're going to look for cysts and we're most importantly going to look at renal pelvis and say do we have renal pelvic dilation or no you can see surge doesn't know how to count he was working along that was very nice yep French okay so how do we find that left kidney this one is going to be easier than the right kidney it tends to be right beside that 13th rib or sometimes just a little bit ahead or even more behind but the key thing is find that 13th rib which is that floating rib which you can find right there once you find that usually again remember to try to go more dorsal than you think part the fur don't be a doctor boys enough alcohol and squirt the entire animal of alcohol take your probe we start in Long axis and again think about depth because you don't want to be too deep so there we go I think I saw it sweep and slide sweep and slide boom there's the kidney right there nice long axis View and you can see again we're scanning Daisy here in sternal because that's the position she's most comfortable you can see how Serge has his probe a little off perfectly uh perpendicular just because the kidneys can be a bit slanted when they're sitting in the abdomen but you see a nice view of the left kidney here and you can see a bit of the spleen coming in here as well on this left paralumber site so we can also there we go we can see the spleen there is more Mobile on cat so we can pick it up nicely here at the left parallel site as opposed to the umbilical side as we showed you earlier so we're in Long axis here we're going to Fan through all planes until that kidney disappears we'll fan back the other way until that kidney completely disappears make sure you don't see any free fluid free air again check symmetry look for cysts and then once we've done that in Long axis we're going to rotate into short axis and then surgery again you get a fan all the way off the cranial pole he's going to come back it's going to Fan all the way off the cotton pole making sure we assess all planes of that left kidney once we've done that symmetry looks good no fluid no free air we don't have any assists now he's going to actually come in and answer that question again do we have renal pelvic dilation yes or no so he's going to try and get the perfect stroke axis and then he's going to Fan through that kidney in the transverse the short axis plane until he sees that renal pelvis we'll find that by seeing the crest and the renal sinus so we're just going to look for that renal sinus and that renal Crest in our short axis so we start to see a bit of the sinus coming in here let me see that now and we're just going to Fan back and forth nice and slow and again the other big thing to make sure you get this nice view so we're sort of getting it there but you want to make sure you do have the probe on short axis so you do want to make sure that you have a nice transverse so sometimes we're a little bit obliqued so sometimes we just need to go back to Long axis and we'll find the long axis plane and then we'll rotate the probe a little left and right to get that the longest we can and then once we get that and we're going to go drove 90 degrees and surges back to a transverse again and there we go we can see the sinus coming in there we go there's our crust there that's our renal sinus so again no obvious dilation so if you're spanning through and you're seeing the sinus nicely you've seen the crest of searches here we may not see the renal pelvis in our healthy cats because it's often negligible non-visible maybe one millimeter so this is uh normal and once you get the hang of looking for that renal sinus and Crest when they have renal pelvic dilation it becomes very obvious so there we go again short and long axis view of the left paralumber site that's right until next time all right
