hello and welcome to this case from first opinion veterinary ultrasound I'm Dr Camilla Edwards this case was a five-year-old male neutered Cockapoo who had a history of five days of being unwell some vomiting but otherwise vague symptoms and came in very lethargic so let's have a look at some ultrasound images so here we can see the liver we were doing an abdominal fast scan or point of care ultrasound scan we can see the cranial part of the liver here we can see the gallbladder coming into view and we can see into the thoracic cavity as well it doesn't appear to be any free fluid we can see the cordovan Cava coming in at the bottom of the image as well here we can see the the cordovina Cava also which appeared a bit enlarged a bit fat but um the animal was receiving um quite quite a lot of fluids at the time was perhaps being high over perfused so here we've got the diaphragmatocarpatic view again but we've increased the depth and this allows us to look into the chest cavity a bit more and we can see the heart here and we can see that it's beating incredibly slowly foreign so we've got a bradycardia going on here [Music] our next view is that our spleno renal view so here we've got our kidney and we've got our spleen off in cranials view so we're looking in this region for any um any um free fluid in the abdomen or in the retroperitoneal space there's none seen here again just looking at that kidney and further cranial to the splenic region here we're looking at the sister colic view so we've got our bladder we want to ensure we've got enough depth so that we can see the colon and we're Fanning through and rocking um to get a good view for any free fluid in this region there's none seen here and then our spleno intestinal view I've got Loops of intestine occasionally the spleen pops into view as well and just looking for any sign of free fluid in this area then we were looking at our thoracic views point of care ultrasound views and here we can see the heart we can see a rib with a rib Shadow another rib with a rib Shadow and another one over here here we've got the heart beating incredibly slowly we've certainly got a bradycardia here again we've had we've got the heart beating incredibly slowly um just getting the probe onto the heart assessing for any free fluid around the heart in the pericardial Sac any free fluid in the thorax or any free gas in the thorax so here we're looking we've reduced our depth and we can see a bit more clearly the gliding sign across here we're looking for a lines which show us that there is air in the lungs and the gliding sign shows that us that that air is not free in the chest but instead it is in the lungs and again we're looking at some lung space so we've got a rib here and a rib here that's our Gator View and in between we have our um our plural line and we've got a lines down here these horizontal lines showing us that there is air and this gliding sign this sideways movement is showing us that the air is within the lung space so our abdominal Focus failed to find any free fluid there was a slightly large cordovina Cava possibly due to some overfusion there's no sign of peripheral lung disease free fluid in the pericardium or in the floral space no pneumothorax was present but we did note that heart contractility appeared good there was no sign of hypovolemia however there was a significant radicardia and that led us to doing an ECG which revealed a heart block foreign
