This is an addendum to a prior email and questions regarding how soon to utilize ultrasound in a clinical workup. This was spinning off a GI case that was interpreted:
EL: Thank you Nancy for the kind words,
If a GI case animal is sick enough to bring into the hospital.. anorexia 2 days and it isn’t from pain then they are usually at least 5% dehydrated so depends on the case. I am a big fan of rapid volume restitution initially first few hours then backing down for the reassessment. The GI motility usually kicks in if the GI shutdown and/or obstructive pattern is just metabolic within 5-6 hours or so. So if coming in at 10 am then by 3-4 pm you can reassess. If anorexia is owing to pain like a back or something then IV lidocaine drip or aggressive pain management can help do the same thing because the GI will shut down on pain as well in a similar manner. I know it may not be politically correct but my specialty is getting to the chase asap so what I would do is sick animal> hydrate, relieve pain if present >>US while the data base is being created >>> then you have your answers on direction tx (which you are ahead of the game on), cut, or send home or euthanize owing to non resolvable disease. US is the bridge to the direction in a sick patient.
I call this the “24 hour rule in diagnostic efficiency.” ( I feel like Austin Powers when I say this:)
Get to the answers within 24 hours at all costs in a sick patient which will usually get them to you sooner but 24 is the target. The owners are “jonezing” (Sorry the California coming out in me) for answers, the patient is maximally stable for sx or chemo or whatever… within 24 hours as opposed to compromised by perforations, sepsis, toxins and so forth. at 24 hours you have your Dx Tx peak so its best to act then. This is good for all involved including the practice and your reputations not to mention the patient and owner’s emotional and economic expense. I speak on this often.
Eric Lindquist DMV (Italy) DABVP
Cert. IVUSS
Director SE NJ Mobile Associates/ Founder/Ceo SonoPath.com