ISSN 2398-2985      

Abdominal radiography

Jreptile

Introduction

  • Many exotic animals present to the veterinary clinician for non-specific clinical signs of ill-health, including lethargy, depressed demeanor, and anorexia. Abdominal or coelomic radiography may form part of the initial diagnostic investigation in these cases.
  • Certain presenting conditions such as abdominal pain, abdominal/coelomic distension and/or masses, vomiting/regurgitation, dysuria, dystocia may suggest abnormalities of the abdominal/coelomic organs (including but not exclusive of the gastrointestinal, urinary, or reproductive tract), and thus abdominal/coelomic radiography would be of value in these cases.
  • When clinical history and physical exam may indicate that there are high probabilities that the problem is found in the abdominal/coelomic cavity, for example when the clinical history indicate pregnancy or foreign body.

Uses

  • Imaging of the abdominal or coelomic cavity forms part of the veterinarian’s initial diagnostic investigation when disease process(es) pertaining to abdominal or coelomic viscera are suspected:
    • Gastrointestinal tract including the liver.
    • Spleen.
    • Urinary tract: urolithiasis Cystic calculi most commonly seen in captive chelonians with suboptimal husbandry and chronic dehydration.
    • Reproductive tract.
    • Identification of gravidity or dystocia Pre- / post-ovulatory stasis .
    • Abdominal masses .
    • Radiography is usually a readily accessible and inexpensive imaging modality for most veterinarians and clients, therefore is often the primary imaging modality. 

Advantages

  • Non-invasive.
  • Relatively straightforward and affordable procedure, using equipment available to the majority of veterinarians.
  • Readily performed and interpreted compared to ultrasonography Ultrasonography overview or other advanced imaging techniques.
  • Can be performed in many reptiles without sedation/anesthesia. No restraint or only mild restraint using adhesive tape is required, particularly when assessing for gross changes such as a foreign body or for signs of gravidity. However, more detailed examination of some organs may require some level of chemical immobilization.
  • Often forms part of the initial database when an animal presents with non-specific signs of disease.

Disadvantages

  • Abdominal radiography is rarely diagnostic for diseases associated with the abdominal endocrine organs such as the adrenal glands or the pancreas.
  • Adjunctive diagnostic imaging modalities such as ultrasonography, may be required to fully assess the morphology in the organ of interest, eg hepatomegaly, splenomegaly, cystitis, prostatomegaly, confirmation of gravidity early in the gestation period.
  • Some reptiles require specific positioning techniques to obtain diagnostic orthogonal views:
    • Radiographic units that allow vertical and horizontal beam projection should ideally be used to limit displacement artifact of the reptilian viscera and allow more accurate assessment of any fluid lines .
    • Chelonians typically require positioning on a raised platform for a vertical beam, dorsoventral view, horizontal beam craniocaudal view, and horizontal beam lateral view for full assessment . Without a platform, the limbs and head/neck can remain superimposed over the coelomic cavity for horizontal beam views, regardless of whether sedation/anesthesia is used.
    • Snakes should be fully extended to eliminate spinal curvatures associated with normal muscular contractions and limit distortion of coelomic viscera. Placement within an acrylic tube may be sufficient for this purpose, otherwise sedation or general anesthesia is required .
  • Coelomic radiography in most snakes requires serial films and familiarity of radiographic anatomy is required for localization of the radiographic beam. Accurate labeling of the serial films is essential to relate a radiographic finding with a specific body system or viscera.
  • Coelomic radiography in some reptiles may have limited diagnostic value:
    • Reptiles generally have minimal diffuse fat around their visceral organs, thus coelomic contrast is relatively poor compared to mammals. This can be further exacerbated in underweight or lean animals.
    • The heavily keratinized skin, scales or osteoderms of reptiles can additionally contribute to poor contrast/visualization of coelomic viscera .

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Varies depending on the underlying etiology.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Ludewig E et al (2012) Clinical technique: digital radiography in exotic pets - important practical differences compared with traditional radiographyJ Exotic Pet Med 21 (1), 71-79 ResearchGate.

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