[Click to edit the title]

E.I. Medical Imaging Portable Ultrasound Solution Blog

Mia Varra

Recent Posts

How Vets Should Explain Ultrasound Images to Their Equine Clients

Posted by Mia Varra on Mon, Jul 22, 2013 @ 04:00 AM

 By: Susan Hoffman

“What am I Seeing?” Explaining an Ultrasound Image to Your Equine Clients

equine ultrasound pregnant

As an equine veterinarian, you’re trained to understand what you see on an ultrasound machine, but your equine client may be baffled by the images. They may not even know what ultrasound imaging actually is or does, or its value as a diagnostic tool. We asked E. I. Medical Imaging’s Dr. Erika Wierman for some tips about explaining ultrasound images to horse owners.


Tell your client what ultrasound is and how it works.


In a nutshell, ultrasound machines use sound waves to produce images. So, tell your client the technology relies on painless, noninvasive, high frequency sound waves which are inaudible to the human ear and harmless to their horse. As the sound passes through their horse’s body, assure your client it causes no unpleasant sensation, but it does produce echoes that can identify the distance, size, and shape of internal organs and tissues.

Explain why ultrasound imaging is a good diagnostic tool.

Your client may know that performing an ultrasound is “de rigueur” during a mare’s pregnancy, but he may not be sure exactly why! Let him know ultrasound scans are the best way to confirm if his mare is pregnant and to see if her fetus is developing properly. You can also let your client know that ultrasound machines reveal potentially dangerous situations such as multiple fetuses or abnormalities in the uterus that aren’t identifiable with palpation alone.

Black and white sheds light.

How to read ultrasound
In our Technicolor world, your client might be surprised to see that ultrasound images are in shades of black, white and gray. You are comfortable with this monochromatic visual, but the typical horse owner may be skeptical about contemporary technology that isn’t using full, living color!  Tell him that light and dark are all you really need to see on the monitor, because the intensity of the returning signal translates into a level of brightness on the screen.  The more dense the tissue, the brighter the image; so fluid appears black, dense materials such as bladder stones appear bright white, and the internal organs and structures will appear varying shades of grey.  This baseline information will help your client to begin to understand what the ultrasound image means.

Use the “fruit analysis” to explain orientation.

How to explain ultrasound
Believe it or not, a simple orange is a great visualization aid for explaining how an ultrasound machine’s transducer works. Ask your client to think about an orange sliced from stem to navel; then sliced horizontally across the diameter. The rings and segments look totally different depending upon the slicing orientation. Use this visualization technique to help your client understand by altering the placement of the ultrasound’s probe, you can “visually slice” the internal organs in whatever orientation you need to obtain the information you seek.

ibex ultrasound orange slice

 

 

ibex orange slice 2
Keep it simple.


Many horse owners have a keen interest in equine physiology and it’s safe to say that goes double for people who breed their mares. But, don’t mistake that fascination with any great depth of veterinary knowledge. You know how organisms function, but take care not to overwhelm your client with all the details. Instead, point out basic, recognizable structures such as the beating heart of a fetus, the unique shape of a kidney, or flecks of pus floating around in an abscess.

Create a keepsake.


What proud mama or papa doesn’t want to show ultrasound images of junior-in-the-making to absolutely everyone else they know?  The same goes for a lot of horse owners, especially those who simply can’t wait until next spring to see their new colt or filly born.  Your client will really appreciate a video loop, disc or printouts of images taken during his horse’s ultrasound procedure. Don’t hesitate to circle remarkable findings in red magic marker and provide a congratulatory note. You may be surprised how much your client cherishes the images!

veterinary ultrasound keepsake

Dr. Erika Wierman would love to talk to you more about how an Ibex Portable Ultrasound System can help you in your practice and how it can change the way you can service your clients and the patients they love.  For a free demonstration of what a portable ultrasound can do for your practice, contact us.

 

Click Here For A Free  Ibex® Portable Ultrasound Demo

Tags: explaining ultrasound images, equine pregnancy ultrasound, Equine Ultrasound, how to read an ultrasound image

Benefits of Using The Ibex® Ultrasound to Bovine Fetal Aging

Posted by Mia Varra on Fri, Jul 12, 2013 @ 04:00 AM

written by: Mia Varra and Dr. Paul Chard


beef ultrasound paul chardIn the heat of the summer when all your time, energy and effort is devoted to raising and bailing hay, combining corn, fencing and keeping clean cool water flowing for your cattle it's hard to think that it's time to start preg checking. But we all know how the time flies, especially in the busy summer.

Using ultrasound to preg check heifers and cows is an invaluable money making management practice for any herd. Finding females in your herd of cattle that did not breed early will completely pay for the extra cost of using ultrasound and allow you to make management decisions with those cull animals right now! 

Another benefit of using ultrasound to pregnancy detect your cows is increasing your knowledge of what's coming down the road. My husband and I started using ultrasound to group our cows in the Fall on corn stalk fields and winter pasture in smaller more manageable groups for calving. We sorted these smaller groups by determining the fetal age of the calf at preg check time. This allowed us to get the absolute most out of our low cost Fall feed and to have smaller more manageable groups to calve. This has proven to pay our cow-calf operation back in profit and labor. 

We've learned from trial and error that as our veterinarian, Dr. Paul Chard, preg checks using the Ibex® ultrasound, he calls out "Pregnant" or "Open" he also adds the fetal age so that we can sort them into pens as the cow or heifer comes out of the chute. This pregnant female will now be managed through the next 6-9 months by this fetal age group sort.

If you are a bovine veterinarian and looking to improve your knowledge and skills in fetal aging with your portable ultrasound, here are a few tips from Dr. Chard.

 

How is this information (i.e. fetal age) best used by the cattleman?


Most producers have recognized that reproductive efficiency has a very direct impact on their herd profitability. Many operations are opting for a shorter calving season (45-60 days). This helps to increase weaned calf uniformity and eliminate less productive individuals. These operations will often cull cows that will calve later and therefore wean a smaller and less valuable calf. It is essential to have accurate fetal ages in order to ensure that these culling decisions are based on solid information.


If you were training a veterinarian or intern how to properly fetal age, what steps would you go about to teach them?


The first step in learning how to properly age pregnancies is to gain a decent amount of manual palpation experience so that the mechanics of entering a cow and maneuvering around the anatomy is familiar. I firmly believe that the only way to establish that an individual is non-pregnant is to scan the entire reproductive tract starting from the cervix with the body of the uterus and down each uterine horn to the tip. Only then can you truly be sure that the uterus does not contain a pregnancy. This maneuver does require some amount of skill in manipulation of the reproductive tract. There is little value in providing ultrasound pregnancy exam as a service to beef producers if your accuracy of finding non-pregnant animals isn't 100 percent. Each pregnant animal that is misdiagnosed as open will cost the producer several hundred if not thousands of dollars, may cause an unnecessary loss of life and will get the veterinarian fired.

With a basic understanding of ultrasound technology, the trainee should then review captured sonogram images and videos to familiarize themselves with fetal anatomy targets of interest as well as what normal looks like in various stages of gestation. The trainee should also become familiar with gestation tables that are used for fetal aging in various stages of gestation.

bovine ultrasound fetal aging

 

The next step is for the trainee to actually ultrasound some cattle with the trainer observing the live ultrasound images. This is best done with the trainee using a portable ultrasound with the trainer observing by simultaneous wired headset monitor or by using a wireless monitor. The wireless monitor is truly the best and most efficient way of training as the trainer does not have any physical interference with the trainee but can give audible directions. The wireless monitor also allows an otherwise reluctant producer to observe first hand the images that the inexperienced trainee is generating. This is a teaching opportunity for the trainer veterinarian to build trust with the client and the trainee.

Initially it is easiest for a new trainee to start with cattle that are somewhere between 45 and 90 days in gestation so that there is a reduced amount of required physical manipulation and the entire pregnant uterus is easily reachable in the pelvic canal. Several hundred head of cattle are required for a new trainee to become proficient at fetal aging, but with proper equipment, trainee preparation and coaching the learning curve is very steep.


Why do you use crown measurement?


I use fetal head diameter to determine fetal age in most cases because it is the most accurate measurement across the widest range of gestation in cattle. The head is the easiest place to capture a consistent measurement of the same anatomical position on every fetus.

 
Does fetal aging require more time in each cow for examination? Approximately how long does it take to examine every cow?


Fetal aging does require more slightly time than just calling "bred/open". I argue that this difference is negligible if you are comparing "open/bred" to fetal aging while assessing fetal viability to ensure accuracy in both cases. Time required for a proper ultrasound pregnancy exam depends greatly on other circumstances such as ultrasound equipment, cattle restraint equipment, cattle temperament and cattle handling skills of the crew that you are working with. While wearing my IBEX portable ultrasound with InSite headset monitor the actual amount of time that I spend in the cow is somewhere between 10 and 30 seconds for a complete fetal aging and viability exam. This quite often allows me enough time to also operate my portable hydraulic chute and not be holding up the flow of cattle.


Any final comments or tips to give a ultrasounder that may be “guessing” fetal age instead of measuring or using the grid to age?


I use the full-screen grid for measuring head diameter for fetal aging with great efficiency and accuracy. I think that there is a great enough advantage in accuracy over guessing that I owe it to my clients to use this technology.

 More videos of bovine crown fetal aging ultrasound by Dr. Paul Chard:

 Bovine Fetal Crown

Bovine Fetal eye

Bovine fetal nostril and nose

Bovine Fetal Crown

Bovine Fetal Crown

 

Click Here For A Free  Ibex® Portable Ultrasound Demo

Tags: Bovine fetal aging using ultrasound, cattle preg check, benefits of bovine ultrasound, bovine fetal aging, beef cattle ultrasound, beef cow ultrasound, beef heifer ultrasound

Dr. Paul Chard Discusses Benefits of Using Portable Ultrasound

Posted by Mia Varra on Mon, Jul 08, 2013 @ 01:35 PM

written by: Mia Varra

bovine ultrasound, cow ultrasound

I had the pleasure of visiting with my friend and beef veterinarian Dr. Paul Chard in Brush, Colorado today about why he invested in portable ultrasound and how he feels it helps his practice be more profitable and provide better services to his beef herd customers. 

Q. How long have you been using a portable ultrasound?


A. Since 2003


Q. Why did you first decide to add portable ultrasound to your bovine practice?


A. I recognized that there is a need for efficient and accurate early pregnancy diagnosis in beef cow-calf operations. I knew that portable ultrasound would be a fantastic practice builder and would greatly expand my capabilities as an ambulatory large animal vet.

Q. How many beef cows do you preg check every year?


A. Typically 10,000 to 15,000 and in spite of the decreasing US beef herd I have continued to do more and more ultrasound pregnancy exams each year.


Q. What are the main benefits of using ultrasound in a pregnancy diagnosis in a beef operation?


A.1. Early and accurate pregnancy diagnosis.

Faced with the current drought conditions and high feed costs, producers will see a great cost savings by removing open or late pregnant animals earlier. Feed and forage costs are absolutely the number one expense for beef producers in the US right now.


2. I am able to assess fetal viability with a great degree of accuracy.

There are several key items that I assess in every pregnancy that is early enough in gestation to reach the appropriate anatomy: fetal heartbeat, appearance of fluid surrounding the fetus, appearance of fetal membranes, overall appearance and echogenicity of the fetus and general anatomical correctness. I find abnormal pregnancies often enough to make it worth the effort. If we are able to remove these abnormal pregnancies from the herd, the producers is spared the cost of feeding a non-producing cow all fall and winter and potentially the costs associated with difficult birthing of a deformed calf. In herds that may be experiencing infectious causes of reproductive failures we are able to remove problem animals sooner and reduce exposure to the rest of the herd. Many of these fetal viability assessments are impossible with manual palpation.


3. In the last several years early pregnancy ultrasound has offered several marketing advantages for beef producers developing replacement heifers.

The greatest advantage has been seen when marketing the open heifers in late summer rather than winter. These open heifers generally sell as yearlings instead of heiferettes which always translates to a more valuable animal. Heifers that have been determined to be pregnant by ultrasound seem to be more desirable by most producers which also should translate to greater perceived value. Another marketing strategy for some more progressive heifer developers has been to sell heifers sorted in groups by ultrasound fetal sexing. Heifers pregnant with bull calves are more desirable to producers looking for a calf to market as a terminal animal. Heifers pregnant with heifers calves are more desirable to producers looking to quickly grow their cow herd by raising the greatest number of females that their operation can sustain.

4. Ultrasound is less invasive for the cattle and for the veterinarian as there is less uterine manipulation required than manual palpation.

I spend less time with my arm in the animals which translates to reduced chance of causing problems with the pregnancy and greatly reduces the wear and tear on my body. These benefits are greatly exaggerated when I am able to use the ICE extension and not even place my hand in the cattle. Hopefully I will be able to continue in my work with less pain and injury throughout my career thanks to this technology.

 

Here at E.I. Medical Imaging we want to help you with your veterinary practice.  Just like Dr. Chard, perhaps it is time for you to invest in your practice by purchasing an Ibex® Portable Ultrasound System in order to be more profitable, and provide services needed by your clients and patients. If you want to schedule a free demo of the system or if you w3ant to speak with a representative about how you can begin to be more profitable, please contact us.

Click Here For A Free  Ibex® Portable Ultrasound Demo

Tags: benefits of bovine ultrasound, E.I. Medical Imaging, Veterinary Business, veterinary practice, beef cattle ultrasound, preg check ultrasound

Palpation vs. Ultrasound: Use Common Sense Economics

Posted by Mia Varra on Thu, Jun 13, 2013 @ 12:05 PM


bovine ultrasound heifer

It is summer time here in Nebraska and we recently began our breeding season, but I took some time to check out some of the latest industry publications that have piled up on my desk and ran across an article last week prepared by Oklahoma State University Extension titled, “Preg” check and cull replacement heifers early. After reading through the article I had to take a moment of time to put down some of my thoughts and opinions on the subject. I am disappointed when I read these articles as they seem outdated, old fashioned and behind the times. My opinion here carries with it some bias obviously, as I work here at E.I. Medical Imaging and I see portable ultrasound as progressive and cutting edge technique for ranchers and veterinarians practicing in the beef producer industry.

The article identified some basic and important points about the importance of culling heifers in a beef production process but I believe they are behind the times and not using common sense where innovation and technology can be used in management decisions. Using a different approach and more innovative technique will have even greater impact on saving money and running a more profitable cattle business! Looking at the article is specifically states:

“As the bulls are being removed from the replacement heifers, this would be an ideal time to call and make arrangements with your local veterinarian to have those heifers evaluated for pregnancy in about 60 days. In two months, experienced palpaters should have no difficulty identifying which heifers are pregnant and which heifers are not pregnant (open). Those heifers that are determined to be "open" after this breeding season, should be strong candidates for culling. Culling these heifers immediately after pregnancy checking serves three very economically valuable purposes.”

I would present another option using the technology and innovation of a portable ultrasound used by either the beef producer or by the practicing veterinarian. Their 60 day evaluation is not efficient and does not provide the best situation for heard management. Pregnancy evaluation can be done using ultrasound at 30 days post breeding. Using this preferred method over the referenced method means saving a month of feed by managing or culling the open heifer 30 days earlier. This is the best return on your investment or the other ROI, return on innovation. Using this technique of scanning with an ultrasound 30 days EARLIER than the referenced old fashion technique of arm palpation at 60 days provides cost savings of 30 days per head can be summed up depending on your region and yearly fluctuations of costs. As a simple example of today’s figures you can easily calculate an average of $2-$4/day of feed cost saved. Using the figure of 1000 head at a savings of $4/day with 10% open would be $12K saved in using ultrasound 30 days sooner than palpation!

Other areas that can be discussed using this more progressive and innovative technique of using ultrasound over the older practice of palpating your herd in your herd management are the extra benefits of detecting twins, fetal sexing and viable heat beat to name a few and there are many other management benefits. I am disappointed that this out-of-date information is coming from a university organization that should be publishing the most current and progressive information for our industry. In today’s beef industry we can use technology advances like portable bovine ultrasound to make a real difference in management and profit.

 

Written by: Mia Varra, E.I. Medical Imaging

Click Here For A Free  Ibex® Portable Ultrasound Demo

Tags: heifer ultrasound, benefits of ultrasound palpation, palpation compared to ultrasound, preg check beef heifers, Bovine ultrasound, Palpation vs. Ultrasound, beef heifer ultrasound

How Often Should My Veterinarian Ultrasound My Pregnant Broodmare?

Posted by Mia Varra on Tue, May 21, 2013 @ 03:10 PM

ultrasound mare

Written by: Dr. Erika Wierman, E.I. Medical Imaging

How Often Should Your Veterinarian Ultrasound Your Pregnant Broodmare?


So you've decided to breed your mare! This can be a very exciting time, but it can be overwhelming as well. The process is at times frustrating if you encounter fertility issues, and can be expensive even when everything goes perfectly. Once your mare is bred, routine ultrasound exams should be scheduled. The following is a list of exams that your veterinarian may wish to conduct:

14 day equine ultrasound

14 Day Equine Ultrasound taken with the Ibex® Portable Ultrasound

1.) 14 day Equine Ultrasound - Two weeks post ovulation will be your mare's first pregnancy check. At this point the embryonic vesicle will look like nothing more than a small (~1.5cm) fluid-filled round structure in the uterus. The purpose of this exam is essentially two fold; it confirms pregnancy and allows for early identification of twins. In the first couple weeks of pregnancy, the embryo is moving, unattached, throughout the uterus. Approximately 17 days post-ovulation, it implants into the uterine lining, where it will grow to term. Therefore, it is important that twins be identified prior to the 17th day so that they can be manually separated and one of them terminated (mares are rarely able to carry twins to term, so most often one is sacrificed early to give the other the best chance at survival). If twins are identified after implantation occurs, reduction can become more difficult for the veterinarian and may put the other embryo at risk as well.

2.) 21 day Equine Ultrasound - Because most pregnancy loss occurs early in a mare's gestation, a 3-week pregnancy check can be very useful in identifying embryos that are not developing normally. During this exam, the veterinarian will likely measure the embryo and evaluate the appearance of the fluid within it to determine how viable the pregnancy looks. In the thoroughbred industry, for example, when early foals are preferred and the goal is to have a mare pregnant as early as possible, these frequent exams allow the veterinarian to closely monitor the success of the pregnancy.

28 day equine ultrasound

 28 Day Equine Ultrasound

3.) 28 day Equine Ultrasound - At four weeks post-ovulation, a recognizable fetus and fetal membranes are visible. Most importantly, a heart beat can be seen. This is an important milestone; a strong heart beat (along with normal size and fluid characteristics) is a good indicator that a pregnancy is healthy. This exam may be variable; it may be done as early as 25 days or late as 35 days.

4.) 45 day Equine Ultrasound - By about 40 days of pregnancy, structures called "endometrial cups" have formed in the placental attachment to the uterus. These structures secrete hormones that stimulate the ovaries to produce progesterone in order to maintain the pregnancy. Even if the pregnancy is lost after this point, the endometrial cups will remain and the mare will not return to a normal estrous cycle until they are sloughed at about 120 days. Therefore, this exam lets the veterinarian know that all is well at this critical point. A pregnancy that looks questionable at an earlier exam may be terminated prior to 40 days in order to ensure that the mare can be brought back into season and rebred.

5.) 60 day Equine Ultrasound - Fetal gender determination ("fetal sexing") is a service that is rapidly increasing in demand. A veterinarian skilled in this technique can identify the gender of a fetus with remarkable accuracy at approximately 60 days gestation.

Many veterinarians like to do a "fall check" between 90 and 180 days; this generally involves rectal palpation of the uterus and/or ballotment of the fetus (this is essentially a gentle bouncing of the uterus during rectal palpation. The fetus can be detected as it floats up and down in the fluid-filled uterus). Rectal ultrasound is not generally done at this point, as the fetus is deep enough in the abdomen that it is often not visualized. A couple of exceptions can be made; a mare that is at risk of placentitis might be examined with rectal ultrasound to evaluate the placental attachments, and trans-abdominal ultrasonography may be used to evaluate a pregnancy that is too late-term to visualize rectally.

There may be considerable variation in these exams depending upon the practitioner, the mare involved, and the importance placed on the timing of the pregnancy. Talk with your veterinarian about the frequency of exams that he or she recommends for your mare.

 New Call-to-Action

Tags: veterinary ultrasound, equine pregnancy ultrasound, horse ultrasound, mare ultrasound, how many ultrasounds

Veterinary Practice Tips; Should You Send an E-Newsletter?

Posted by Mia Varra on Thu, May 02, 2013 @ 08:45 AM

written by: Susan Hoffman

Should You Send an E-Newsletter to Your Clients?


veterinary eNewsletter ultrasound


In a word, YES! That is, if you’re committed to publishing content your clients will want to read, so they don’t look upon your newsletter as just another piece of junk-mail. You should commit to distribution on a regular basis, too—monthly or quarterly—because while “content is king, frequency is queen,” as the saying goes.



 

Set Goals


Think of what you want your newsletter to accomplish. Do you want to announce new practice services, personnel or equipment? Do you need to remind your clientele it’s time for annual vaccines or exams? Are you running any seasonal specials and want to offer a limited-time coupon? Is there any “buzz” about a new equine health threat in your region that you want to address? A good rule of thumb for newsletters—printed or electronic—is to create content your readers will see as practical, timely and useful.


For example: You want to promote your new equine ultrasound equipment.

equine vet enewsletter


• In ad, you might focus on the equipment’s features and benefits, and include a picture of the ultrasound apparatus.

Equine ultrasound, mare pregnancy ultrasound


• In a newsletter, you could recap a short, problem–solution case study demonstrating how the equine ultrasound equipment helped a client, and include a picture of the apparatus in use. You could encourage your clients to contact you if they ever have a similar issue with their horse and how this ultrasound technology helps you deliver better service to them. You could also include a hyperlink to an online, informative video.

See the difference? The e-newsletter may be a bit of an advertisement in sheep’s clothing, but if it honestly contains relevant news and information your clients can use, they’ll look forward to reading every word and viewing the photos or videos. They’ll appreciate your efforts to help educate them. You’ll really pique their interest if you ask them for feedback. What a relationship-builder!


Design and Distribution


E-newsletters need to be inviting to the eye on any typical desktop computer, iPad or even a Smartphone. They should also be consistent with your other marketing and communications pieces, to support your practice’s “brand.” If you don’t have a creative resource in your practice who handles design for you, there are preformatted and customizable templates a-plenty available through the major e-newsletter design and distribution businesses like Constant Contact. Simply Google the words “e-newsletter design” and you’ll see lots of affordable options. These companies also offer metrics reports so you can see which clients accessed your e-newsletter, clicked through to your website, etc. Of course, you’ll need to provide these services with an up-to-date email client list, so your fist step, even before creating your e-newsletter, should be to contact every client to make sure you have their current contact information.

 

Click Here it sign up for the E.I. Medical Imaging eNewsletter

 New Call-to-Action

Tags: Equine enewsletter, veterinary enewsletter, tips to writing a veterinary enewsletter, veterinary ultrasound, horse ultrasound, mare ultrasound, Equine Ultrasound

Portable Ultrasound: Using Communications to Improve Client Compliance

Posted by Mia Varra on Thu, Apr 11, 2013 @ 03:08 PM

ultrasound mare, equine ultrasound

written by: Susan Hoffman


Whether you prefer to talk, text or tweet, your communication style and skills can have a huge effect on your clients’ compliance and patient outcomes.  It seems simple enough—you tell your client what treatment he or she needs to do, or what medicine the horse should get, and your instructions will be carried out to the letter, right? Maybe not!  But, modifying your communications technique can work wonders for improving client compliance.   

AAHA studies prove the point. Almost ten years ago, the American Animal Hospital Association (AAHA) Compliance Study, “Path to High-Quality Care, 2003,” revealed that communication failures were responsible for a large amount of client noncompliance. The 2009 follow up study reiterated that not only must your communication skills be up to snuff, but your use of communications tools and frequency of communications can greatly improve compliance. 

Flash forward to 2013, and it’s a no-brainer that brushing up your “barnside manner” combined with using today’s arsenal of traditional and state-of-the art communications tools can greatly enhance compliance.    

Try these communications skills and tools to improve client compliance:  

1.  Use a flexible approach to gain your client’s trust.


For some clients, this may be as simple as showing empathy for them or their horse. Other people need their egos stroked, so conferring with them about what they know about a particular disease appeals to their sense of self worth. The key to gaining your client’s trust and influencing their behavior is to assess their personality and work with it to gain their buy-in for your recommendations.  

2. Build a collaborative relationship, with “we” not “I”.    


Which of these two statements is more likely to produce the results you want:  “I recommend you get your horse’s teeth floated,” or, “We should float your horse’s teeth to improve his acceptance of your bit.”?  The latter is the correct answer. One practice in the 2003 AAHA study doubled its compliance by switching from “I” to “we” and communicating the benefit of compliance.

3. Once, twice, three times is the charmer.


 It’s hard to remember everything someone tells you, let alone when you are under stress, and what horse owner doesn’t stress out when their best friend and/or investment is sick or injured?  A great way to break through the haze and improve compliance is to communicate with your client multiple times. Back up your verbal instructions with an email. Follow up with a short phone call, or have an administrative person in your practice call the client to review recommendations. Send a letter that recaps your diagnosis and recommendations. Or, use combinations therein. The more touch points, and the more often you use them, the better.

4. Take advantage of technology.


“There’s an app for that.”  Well, maybe there’s not a Smartphone app for compliance, but today it’s easier than ever to monitor and reinforce your recommendations using a variety of communications tools.  You can use a combination of “snail mail” and email to remind your clients it’s time to vaccinate their horse.  You can ask your client to send you a 30-second video so you can see how a sick or injured horse is progressing.  Direct your client to YouTube videos that show how to correctly wrap a leg or administer eye drops. It doesn’t take much time or effort to text a short message to a client’s Smartphone.  And, for those clients who eschew technology altogether and think a “USB zip drive” is a fancy name for a Quarter Horse, you can always rely on printed educational pamphlets and newsletters to back up your in-person visits and calls.     

5. Attend clinics and conferences.


These conferences will have speeches, sessions and workshops focusing on communications and client compliance.
•    International Veterinary Communication Institute, November 9 – 11, 2012   in Orangeville, Ontario, Canada, and November 3 - 6, 2013, in St. Louis, Missouri.
•    American Association of Equine Practitioners Annual Convention, December 1 – 5, 2012, Anaheim, California.

The bottom line is, if you use all your communications skills and tools to your advantage, you’ll improve compliance, which in turn can improve patient outcomes, and could result in increasing average daily transaction fees and practice productivity.


New Call-to-Action

Tags: communicate with clients, veterinary client communication

Bovine Ultrasound: Follicular vs. Luteal Cysts

Posted by Mia Varra on Wed, Mar 27, 2013 @ 01:15 PM

By: Ryan Giles

 bovine ultrasound, cow ultrasound

Accurate diagnosis and treatment of ovarian cysts are important aspects of proper reproductive management for any dairy herd. While the negative effects of ovarian cysts on normal estrous cyclicity, conception, and prolonged calving intervals are evident; determining which type of cyst is on an ovary (follicular, luteal, or even a cystic corpus luteum) can be difficult. Diagnosis of each type is important as the proper treatment for follicular and luteal cysts differs, and use of ultrasound is the best tool for achieving this.

Let’s characterize each type of ovarian cyst and describe the benefits of ultrasound to diagnose them.

 

Follicular Cysts

Development of follicular cysts in cows occurs when a follicle reaches the ovulatory size (about 17 to 19 mm), but fails to ovulate leaving a large persistent follicular structure on the ovary. A single follicular cyst or multiple cysts can form on the ovary (s). Length of time for the anovular follicle to persist on the ovary before it’s considered a follicular cyst is usually at least 10 days. There are various classifications of a “true follicular cyst”, but a classic identifying feature is a follicular structure on the ovary that is at least 25 mm in size in the absence of any corpus luteum. The appearance of follicular cysts is clear using ultrasound with the large cystic structure having a very thin outer wall with black fluid extending to its outer edges as shown in the image below.

 Bovine cyst 1

 

 

As you can see, diagnosis of this type of cyst is clear with use of an ultrasound, and the presence of a second follicular cyst is evident on the left side of the ovary as well. Rupture of these cysts is quite easy from rectal palpation, which can traumatize the ovary leading to hemorrhaging, and possible adhesion formation on the ovary. The less invasive approach of using an ultrasound can reduce the chances of rupturing follicular cysts, and also is extremely effective to determine whether the cyst is active or benign. Palpating any other structure on an ovary is extremely difficult when a cyst is present, so many times an active corpus luteum is not found on the ovary along with the cyst. An example of this is shown below where the cyst is very prominent on the left side of the ovary, but can be classified as benign due to the corpus luteum sitting to the right of it.

 ultrasound bovine ovary luteal cysts

 

While the causes of follicular cysts are unclear, their development has been linked to genetics, nutritional factors of under- or over- feeding, high milk production (increased steroid metabolism), and stress. However, there is a major theory for how the above factors may cause the formation of follicular cysts. An ovulatory follicle begins to produce large amounts of estradiol, which targets the hypothalamus of the brain and triggers the initial cascade to cause ovulation. It’s believed that there is poor communication within this cascade that inhibits ovulation leading to follicle persistence and follicular cyst development.

Hormonal treatment of a follicular cyst with GnRH (human chorionic gonadotropin has also been used) will generally cause the cyst to luteinize and subsequent treatment with prostaglandin F2α will resolve the luteinizing cyst by triggering luteolysis.

 

 


Luteal Cysts

 

Luteal cysts are believed to develop from follicular cysts that have continued to develop into their later stages. They often progress into luteal cysts by forming a thicker wall of luteal tissue around their outer edges as shown in the image below. You can also see a very slight bit of white “cobwebs” within the lumen of the luteal cyst where the cyst appears to be attempting to further luteinize.

 

 Bovine ultrasound ovary cyst

 

With luteal cysts originating from follicular cysts, the same mechanisms for follicular cysts development described above exist for luteal cysts. The major distinguishing factor between the two is that luteal cysts partially luteinize. Luteal cysts can also have different appearances on the ultrasound depending on the rate of luteinization. This is apparent in the next two images below depicting more examples of luteal cysts. You can see in this first image that luteinization has occurred along the bottom rim of the cyst and again the cobwebs of fibrous tissue are attempting to luteinize the rest of the cyst, but the upper portion of the lumen is still fluid-filled.

 

 

cow ultrasound ovary

 

This second image is a luteal cyst (on the right side of ovary) in its early stages where the thin outer walls of the cyst still resemble that of a follicular cyst, but the cobwebs are apparent throughout the lumen as the cyst attempts to luteinize. You can see a second cyst on the left side of the ovary as well.

 

 

Bovine ultrasound cysts


A major advantage of ultrasound when dealing with these cysts is its ability to distinguish a luteal cyst from that of a very young corpus luteum (day 5 or 6 of the estrous cycle). An early corpus luteum will also have a fluid-filled lumen and cobwebs as it continues to luteinize. Using rectal palpation, it is extremely difficult to palpate an early corpus luteum let alone distinguish it from a luteal cyst as they both have similar palpable features, but can be more clearly differentiated with an ultrasound. An early corpus luteum is depicted below and you can see the difficulties in palpating the difference between this and a luteal cyst.

 

 Bovine Ultrasound corpus luteum

 

Since luteal cysts invariably have luteal tissue and produce progesterone, the best treatment for resolving them is administration of prostaglandin F2α to initiate luteolysis. Because some early luteal cysts are not yet responsive to prostaglandin F2α, another approach includes treatment with GnRH first and then prostaglandin F2α in order to further luteinize the cyst with GnRH and then administer prostaglandin F2α to resolve it.

For further bovine ultrasound training, contact http://bovinetraining.com/.

All ultrasound images above were taken with the Ibex Portable Ultrasound and MC8.0MHz transducer.

 

New Call to action    

 

 

Tags: cow ultrasound, Bovine ultrasound, ultrasound bovine cyst

Let demand dictate a veterinary ultrasound equipment purchase

Posted by Mia Varra on Thu, Mar 21, 2013 @ 03:13 PM

 Buy Animal Ultrasound


By; Amanda  Bertholf

When it comes to the right time to buy equipment, like a veterinary ultrasound, consider letting demand for your ultrasound services dictate your equipment purchase.

Scott Larsen, DVM, owner of Larsen Veterinary and Embryo Transfer in Valentine Neb.,

ROIsays he tries to be forward thinking about what he could do with the equipment right away, and then he considers how much room for growth there would be with the new purchase. “I am not one to leverage equipment,” he says. “If I can’t pay for it, I don’t need it.”

 


Of course, doing your homework before a big purchase is important, and so is knowing what’s available. Are all the bells and whistles necessary, or is this a luxury you can do without? “Paying for something that will help you make money is not a bad investment obviously, but I don’t want that hanging over my head,” Larsen says. “I usually try to get by with a little less and build that portion of the business. Then when I have the business established, I trade up for the equipment.” 



When you’re considering return on investment, look at how much revenue you’d generate with the equipment in a set period of time, or how many procedures you’d need to conduct to completely pay for it. “As far as reproductive ultrasound goes, that was a procedure I could do at a time of year that my practice was slow, therefore ROI was relatively fast because I was not sacrificing other work for ultrasound,” Larsen says. “What started eight years ago as a time filler has turned into my No. 1 profit center.”

(Dr. Paul Chard of Cattleman's Resource Inc., Brush, CO demonstrates the Ibex's Arm-Free I.C.E. "Ibex Customizable Extension" at preg check time.)


Larsen says the most common procedures he performs are bovine ultrasound for pregnancy and fetal sexing. He checks for pregnancy at about 90 days of gestation. Over the last couple of years, the percentage of his herds that use ultrasound on the adult cows has drastically increased. “I use it to group the herd into calving windows so they can be better managed,” he says. “Not only does it save in feed costs, but it has also has eliminated scours.” The savings in scours treatments and vaccines more than covers the cost to ultrasound, and it allows Larsen to generate more income off the producers, rather than looking for new ones. “In the sense, the use of hands-free ultrasound is becoming a large part of my practice and it’s allowing me to stretch out the per head investment in ultrasound machines and probes into more cattle.”

 




Tags: Bovine ultrasound, Arm-free bovine ultrasound, Arms free bovine ultrasound, portable bovine ultrasound

IBEX® Portable Ultrasound Used To Teach At Veterinary School

Posted by Mia Varra on Wed, Mar 13, 2013 @ 05:24 PM

E.I. Medical Imaging is committed to education and is excited to see the IBEX playing a role in educating youth in the veterinary career path. The IBEX portable ultrasound is a critical part of teaching Navajo students in this Arizona veterinary teaching school.

Click the picture below to watch a video.

 

 

 

 

Navajo Vet School

 

 

 

Request An IBEX® Demo

Tags: portable ultrasound, Ibex veterinary school, ibex, navajo veterinary school

Search Our Site

Don't Miss the News! Sign Up to receive Emails of New Blog Posts!

HELP US CELEBRATE OUR 30TH ANNIVERSARY

describe the image

30th Anniversary 30% OFF Coupon Winners

MAY 2014

Beau Bosma

JUNE 2014

Tisha Ebling

JULY 2014

Richard Kinyon

AUGUST 2014

Nicole Hjelle

SEPTEMBER 2014

Lincoln Montgomery-Rodgers

OCTOBER 2014

Frank Beckwith

NOVEMBER 2014

Rachael Weiss

DECEMBER 2014

Sarah Grose

JANUARY 2015

Will Oliver

FEBRUARY 2015

Gib Mouser

MARCH 2015

Allen Rushmer

APRIL 2015

Brett Remund