Frequency and Number of Ultrasound Lung Rockets (B‐lines) Using a Regionally Based Lung Ultrasound Examination Named Vet Blue (Veterinary Bedside Lung Ultrasound Exam) in Dogs With Radiographically Normal Lung Findings

Abstract

Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B-lines, representing interstitial edema) versus dry lung (A-lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A-lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B-lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8-view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left-sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6-19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74-100%) in those with left-sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions.

Investigation of focused cardiac ultrasound in the emergency room for differentiation of respiratory and cardiac causes of respiratory distress in dogs

“…Ultrasonography of the lungs can identify changes consistent with interstitial edema. The sensitivity of this test for identification of left‐sided congestive heart failure is high but the specificity may be affected by false positives associated with other severe interstitial or alveolar lung diseases, such as pneumonia 13,14 . In a prior report, ECC clinicians were able to identify pericardial and pleural effusion and differentiate left atrial enlargement from normal left atrial size following a prescribed FOCUS training course 15 .…”

“…The sensitivity of this test for identification of left-sided congestive heart failure is high but the specificity may be affected by false positives associated with other severe interstitial or alveolar lung diseases, such as pneumonia. 13,14 In a prior report, ECC clinicians were able to identify pericardial and pleural effusion and differentiate left atrial enlargement from normal left atrial size following a prescribed FOCUS training course. 15 However, the clinical utility of FOCUS to differentiate cardiac from non-cardiac causes of respiratory distress has not been investigated in veterinary patients.…”

Utility of Lung Ultrasonography for Detection of Pleural Adhesions in Dogs

“…To examine pleural adhesions on the left side, the animal was placed in a right lateral recumbent position and shaved from the 1st to 13th ribs on the left thoracic wall. Similar to a previously reported method, B‐mode imaging was used, and the transducer was pressed perpendicularly to the left thoracic wall such that the reference marker faced the caudal side. The transducer was kept in a fixed position when placed on the chest of the dog.…”

Diagnosis of Aelurostrongylus abstrusus verminous pneumonia via sonography-guided fine-needle pulmonary parenchymal aspiration in a cat

“…Thoracic sonography revealed many B-lines (comet tail artifact, a subtype of reverberation artifact) with intermittent, well-defined, small (2–3 mm), hypoechoic nodules, intermittent irregular pleural margins and multifocal, intermittent, variously sized (2–4 mm) ‘shred’ signs (Figure 2). 2–4 The cat was sedated (dexmedetomidine 4.7 μg/kg IM). Following aseptic preparation of the clipped skin, percutaneous ultrasound-guided fine-needle aspiration of the sonographically affected lung parenchyma was performed.…”