all right dr boison let's go ahead and talk about the urinary bladder site all right so this is very simple when we do our scanning we come from the subxiphoid to the umbilical and back to the urinary bladder we make a straight line and then we get the two lumbar sites at the end so we're going to now look at the urinary bladder this is very simple we just simply come back to the region of the pelvis where the urinary bladder is located so we're going to come back to this region here we have to lift the leg up a little bit darker loop just so that we can get into that site again separate the fur so you can see the skin and then once you've got that vision there we put again with the probe marker towards the head to start with we'll start with our longitudinal uh image of the urinary bladder so i'm just going to fan back and forth and see if we can pick up that urinary bladder at this um pelvic region the urinary bladder site now again when we're doing this think about patient position if our patient was standing i would come in straight on midline and pick up my urinary bladder if my patient's in lateral as we have with penny here then i want to think about where that pathology is going to accumulate and make sure i angle the probe down towards where that fluid accumulates just like we did at the umbilical side so i'm going to angle this down towards the body wall so i pick up that gravity dependent region in proximity and around that urinary bladder 100 dr poison so the binary questions we want to ask here again is there free abdominal fluid here yes or no and there are some very sensitive sites to find this one being the apex of the bladder yeah so right now penny's got a large bladder so i'm gonna fan all the way up one side at the apex and i'll fan all the way off the other side of the apex again making sure i do check that gravity-dependent region but i do want to fan all the way across the bladder i don't want to get stuck in only one plane and only angle down towards the tabletop because i might miss pathology that otherwise exists in the urinary bladder there might be stones there or something else i can pick up so i do like to make sure that i fan all the way across the urinary bladder the fluid accumulates at the apex then i will slide back and i'll check more in the trigone region like you're seeing here and again make sure i found all the way up one side fan all the way up the other side till the bladder disappears now i've done that in long axis is that a stone that i'm seeing there dr schlub coming right in the middle of the urinary bladder dr boison you stole my punch i love explaining this this is the colon and you have to be careful with the shadowing gas in the colon it gives off the impression that it is a bladder stone which is why it's important to fan that probe dr poison to show that it is actually a tubular structure under the bladder all right now once we've done that in long axis droop what do we want to do you want to go ahead and rotate the probe into short axis and you will do the same thing you're going to go ahead and fan and we're looking for free abdominal fluid yes or no all right so we'll go all the way back to the trigon we'll fan and sweep a little bit this is a large bladder so i can't just fan i have to do a little bit of fanning and sweeping off the apex there we go no free fluid no obvious abnormalities in the bladder itself again we see the colon there no obvious stones so that's short and long's access dr shalou what else can we look for at this site well there's a couple of other things dr bois and you can actually look for pyometra here so again we're not going to go in the details of this because she is a spayed female so we won't be able to even see the uterus but you can actually detect pyometra in dogs that are potentially affected by this condition absolutely and we'll look distal to the urinary bladder so it's going to be dorsal that we're looking for that fluid filled structure that is the uterus so again you'll have to watch some of the lectures or podcasts on how to identify that for pathology but that's where we would look for it as well exactly and the last thing we look for dr lube over time well you can actually measure bladder volume using the volume of a sphere dr boys and that equation if you go back to what is it like fifth year sixth high school sometime very long time for you dr boyson but yes you can actually use that formula dr poison and calculate the volume of the sphere in other words the urinary volume in millimeters absolutely so take the length in long axis and the depth in long axis like you see here so to do that we come in on midline and we basically sweep through the bladder until it gets smaller sweep till it gets bigger and then smaller and then sweep back to the largest point we'll get the length here and we'll get the depth here dr schluben long axis then we'll turn it into short axis and we'll do the same exact thing then in short axis we pick up that urinary bladder we sweep backwards until it actually starts to get smaller forward till it gets bigger and then smaller come back to the widest point and when we get the widest point there actually we'll do the width and the depth in short axis and then we take the length times the width times the average depth in the two different views times 0.52 the old formula used to be 0.625 but there's some recent research to show that 0.52 is the better constant to use when doing this calculation and that is essentially what we look for at that urine bladder site it sure is dr boyson you
