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Outpatient Ultrasound Referrals at Mass Vet

July 27, 2021

Outpatient ultrasound services are currently offered at Massachusetts Veterinary Referral Hospital for stable patients referred by their primary veterinarian. Outpatient ultrasound appointments include a full abdominal ultrasound and conversation with the radiologist about the results of the ultrasound. These patients must meet certain criteria to qualify for an outpatient ultrasound through the radiology service.

Patients with the following symptoms do not qualify for outpatient ultrasounds if they are referred for any of the following and should be advised to come through the emergency room.

Patients Who Do Not Qualify for Outpatient Ultrasounds:

• Fluid in abdomen – ascites, hemoabdomen, decreased serosal detail on radiographs (especially with a concern of an abdominal mass)
• Anemia
• Elevated tbili (bilirubin)
• Icteric or jaundiced 
• Foreign material or obstruction
• GB mucocele or obstruction, bile duct obstruction, EHBDO 
• Anorexia
• Pancreatitis – confirm clinical signs and discuss with radiologist or senior technician
• Vomiting multiple times a day for multiple days – confirm clinical signs and discuss with radiologist or senior technician
• Fever of unknown origin
• Straining to urinate with little to no urine production

Patients Who Require Sedation

If it is noted on the referral or records that the patient is fractious or requires sedation, an additional estimate should be prepared for the owner. This estimate will include: abdominal ultrasound, anesthesia planning, sedation – minor, and medication for sedation ($100-$200).

The primary vet should also be contacted so they can provide oral medications as a pre-procedure sedative for the owner to give at home.

Abdominal ultrasounds vs. other types

Only abdominal ultrasounds qualify for outpatient ultrasound referrals.

If the patient is being referred for a neck ultrasound or thoracic ultrasound, they should be referred through the internal medicine or emergency service.

If the patient is being referred for an ultrasound of the heart or an echocardiogram, they should be referred through the cardiology service.

If the patient is being referred for a musculoskeletal (i.e. shoulder, tarsus, etc.), they should be referred through the surgery service.

Patients should be referred through the internal medicine service if there are concerns for a possible insulinoma or if there are concerns for a possible shunt. These patients will often times require more advanced imaging to evaluate the abdomen.

Requirements & Exceptions

A referral and any records and bloodwork from the past year should be received prior to scheduling an appointment. We do not accept verbal referrals from a client or referring veterinarian.

The patient must have been examined by their primary veterinarian within 10 days of us receiving the referral

Exceptions to this are chronic issues that are being managed by their primary vet and the owners have been following all recommendations and remained in contact with the primary veterinarian. Examples of this include:

• Ongoing hematuria or urinary tract infections: Have had follow up a follow up urinalysis and been on medication.
• Elevated liver enzymes: Have been on liver protectants or antibiotics, have had recheck bloodwork and have been in communication with rdvm.
• Follow up or recheck ultrasound that has been recommended by one of our radiologists. (Should try to book with the same radiologist for consistency)

Every case is unique and should be evaluated on a case-by-case basis. Any questions or concerns with booking an appointment should be directed to a radiologist or senior technician.

Any additional diagnostics, procedures, or treatments that the patient requires will be performed by their primary veterinarian. Alternatively, if the primary veterinarian requests, the patient can be scheduled with a different specialty service for additional diagnostics or procedures that need to be performed or they can be seen through the emergency department for more critical treatment.

Patient Transfer Reminder

We are experiencing an increase in patient transfers who have not been examined by a doctor prior to transfer. Given our current diversion status, we would ask that all patient transfers have an exam prior to arriving at Mass Vet. This will help us by being able to facilitate triage and treatment for cases based on the PSI model.

If you have any questions or concerns about any potential case transfers, please call us to discuss.