welcome to this case from first opinion veterinary ultrasound I'm Dr Camilla Edwards and this was a case of a domestic shorthaired cat five years old male neutered who had a history of ascites the vet had started them on photocore and fruzamide thinking that heart disease was most likely in this case okay so here we've got the diaphragmatical hepatic view so we've got the um diaphragm here and we've got the liver here in the background and we can see this free fluid surrounding with its pointy Corners uh it's anechoic um very typical of free fluid around the liver what would be good is to try and get we've got a bit of a mirror image artifact around this diaphragm would we get to get a deeper image to see if we can look more deeply into the chest and have a look at the heart look for pericardial effusion look for um lung parenchymal disease and um free fluid around the the lungs as well here this is more towards the spleno renal view we've got the left kidney which I've just measured here um no obvious free fluid in this part of the abdomen here we've got the spleen though and just a difference but moving the probe a little bit can make we see masses of of free fluid in this area here we've got the the right kidney um we can see deep in in the image and we can see masses of free fluid surrounding it and again kidney so this is an interesting um image we've got a mesentry um in enveloping the uh small intestines uh cut through that with all this free fluid between it so it can free fluid can really highlight organs as well so uh really really interesting image there so now looking at the heart we can see that we've got um this left ventricle here with this very thickened wall we've got the right ventricle around here I've got the tricuspid valves here and the right atrium here and we've got the left atrium here and we can see with the mitral valves here we can see this left atrium is absolutely enormous and these this left ventricle is very thickened foreign and in this image we've got a short axis view the right parasternal short access View and we've got the aorta here with its valves opening and closing and we can see the right ventricular outflow tract wrapping around this area here with the left atrium here and the left Oracle here and really what we're trying to assess on from this view is is how many aorters we can fit in to the left atrium across here and um really really it should be under 1.6 to be normal but this left atrium is is so enlarged that we can fit much more and then if we pause ideally when we can see this Mercedes-Benz sign when the aorta aortic valves are closed and then we can take a measurement across the aorta and see how many times we can divide that into a measurement across the left atrium and that should in a normal animal be less than 1.6 in this case it was much more than that so here we had a case with ascites which we could see in all four quadrants we can see at the diaphragmatica hepatic view the splenorenal view the sister colic View and there's spleno intestinal umbilical view we could also see that the cat had a thick left ventricle wall and a very large left atrium so we had a case of congestive heart failure following hypertrophic cardiomyopathy foreign
