VETERINARY SUPPORT ASSISTANT

DIPLOMA COURSE

ASSIGNMENT TWELVE

DIAGNOSTIC TESTS USED BY VETS

Overview and learning outcomes

Overview

• Radiography
• Ultrasound
• Radiography or ultrasound?
• MRI scanning in animals
• Blood tests
• Urine tests

Outcomes

• Have a basic understanding of how and when radiography and ultrasound are used in
veterinary practice

• Be able to identify the pros and cons of both radiography and ultrasound scans

• Understand how MRI scanning is used to diagnose animals’ conditions

• Understand why blood and urine tests are done

• Be able to understand what different blood and urine test results mean

• Know how to take a free catch urine sample from a dog and cat

Veterinary Support Assistant Diploma Course – Assignment Twelve – Page 1

 RADIOGRAPHY

Radiography is an incredibly useful and important diagnostic tool for vets. It can be used to diagnose
a wide variety of different diseases and conditions in animals, anything from bone fractures and
pregnancy to foreign bodies in the stomach and cancer. It is one of the most commonly used
diagnostic tools in veterinary practice.

An x-ray is a form of electromagnetic radiation. This is similar to light rays, except they have a much
higher energy. The body and its tissues cannot absorb the high energy, and it passes through it.
Dense tissues like bone absorb some of the radiation, so less radiation in that area reaches the film.
The black areas on an x-ray are the exposed areas where the radiation has got through the animal’s
body and hit the film. The white areas are where the dense tissues have absorbed the radiation, so
less radiation will hit the film and be less exposed. x-ray radiation is not harmful in small doses, so it
is quite safe for the animals.

Generally, an animal will be sedated or anaesthetised, as this allows vets and veterinary nurses to
position the animal properly, and it guarantees the animal remains still while the x-ray is being taken.
It is incredibly important that the animal stays still, otherwise you will get useless, blurred images.

The amount of x-rays used in one exposure is decided by measuring the thickness of the animal in
the area you wish to take an x-ray of. A cassette containing the film is placed under the animal in the
area that you are interested in. These cassettes come in a variety of different shapes and sizes
depending on what you want to x-ray. The x-ray machine is usually fitted on a mechanical arm that
can be moved around, so it points in exactly the right spot. Once everything is positioned, the staff
will then move to a safe area, usually behind a lead shield, and a button is pressed to take the x-ray.

The exposed film is then processed, normally by the veterinary nurse, in the darkroom using an x-ray
developer machine. It usually takes about five to ten minutes to develop. Once this has been carried
out, the x-ray film is passed to the vet so he/she can review it. Normally more than one x-ray is taken
of the same spot, but from a different angle. This is so the vet gets a full look of the entire area, and
also because sometimes things can be missed by one x-ray, but can be clearly seen from an x-ray
taken from a different angle.

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Above I have explained a standard x-ray procedure. But there are more specialised radiographic
techniques. An example of this would be a barium radiograph. This is used to look at abnormalities
in the animal’s gastrointestinal tract. It involves the animal having to swallow a chalky liquid called
barium. This shows up white on an x-ray, so as it passes through the gastrointestinal tract, the vet can
clearly see where the barium is going. Doing this will reveal problems like tumours, polyps, ulcers
and blockages. Barium is a type of x-ray contrast. There are many different types of contrast, and
some can be put into the bloodstream, spinal cord, bladder and joint spaces, which can all help aid
the vet to make the correct diagnosis. If the vet is unsure of what they are seeing on an x-ray film,
they can even send it away to the specialist vets for them to make a diagnosis.

X-rays are an invaluable tool that reveal what cannot be seen from the outside.

Ultrasound

Some diseases and conditions in animals can be diagnosed by using an ultrasound machine.
Performing ultrasound scans is painless and non-invasive, but the machines are very expensive and
they need a highly skilled vet to be able to use them.

An ultrasound machine uses sound waves to penetrate the body’s tissue, a bit like the way an x-ray
machine will use x-rays, but because it uses sound waves and not radiation, it is totally safe.

The sound waves are transmitted at a very high frequency; higher than we can hear. Depending on
the density of the tissue that the sound waves hit, they will reflect back a greater or lesser amount of
sound. The machines probe will transmit and listen for this sound, and depending on the amount of
sound it is hearing, the computer inside the machine will analyse the amplitude and time delay of
these returning sound waves to produce an image of the animal’s body on the machine’s screen. This
handheld probe is placed over the area that the vet wishes to see.

Tissues and fluids will reflect the sound very well, so they will look like bright shapes on the screen.
Gas, bone and air will prevent the transmission of the sound waves, so they will look like black
shadows on-screen. The pulses of sound and the images are relayed backwards and forwards about
thirty times per second. This means that the image is constantly moving, so the vet can actually see
the animal’s organs functioning. This can give the vet far more information about the organ than the
standard x-ray can. An electrocardiogram is an ultrasound scan of the heart, which shows the heart as
it is pumping. This allows the vet to scrutinise all the parts of the heart and decide whether they are
working efficiently or not.

An ultrasound machine can also be used to see bladder and kidney stones, pockets of fluid, cancers,
obstructions or pregnancy, and they can use the ultrasound machine to measure the thickness of
organ walls. In pregnancy the vet is able to see the heartbeats of the foetus. All the images from the
ultrasound machine can either be stored in its memory or printed out on a special printer.

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Before an animal undergoes an ultrasound scan, the area in which the vet wants to look at will have
to be shaved, as the animal’s coat traps air and deflects the waves. Also, a special gel is applied on
the shaved area, which blocks out the air and creates a better contact between the probe and the
animal’s skin. Sometimes if the animal is very wiggly it may have to be sedated.

Tissue biopsies can be taken using an ultrasound machine to guide the biopsy needle to exactly the
right place, so a small sample of tissue can be taken.

Radiography or ultrasound?

Both ultrasound and radiography are very important diagnostic tools in veterinary practice, but they
are totally different technologies, and each has its own advantages and disadvantages. A vet will
make their decision on which to use, depending on the type of injury or condition, the location of the
problem and the type of information that the vet would like. Sometimes the vet may decide to do
radiographs as well as an ultrasound scan.

Ultrasound advantages

• Ultrasound is non-invasive, as it uses sound waves to produce an image.

• Ultrasound images are in real-time, so you can see movement like blood flow, the heart
beating and fluid movement.

• It is possible to biopsy tissue guided by an ultrasound scan. By doing this the vet can take a
sample very accurately.

• The vet can accurately measure the thickness of parts of the body with an ultrasound scanner.

Ultrasound disadvantages

• You need a veterinary surgeon who is highly skilled in ultrasound scanning, as the images
can be difficult to interpret.

• Ultrasound cannot penetrate deeply into the body, or through bone, and they cannot cover a
wide area.

• Ultrasound waves are upset by gas, and cannot show actual images of the organs lying behind
the lower intestines, as these are normally filled with gas.

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Radiography advantages

• X-rays can penetrate deep into the body and provide a clear image of bones and gas-filled
organs. It also can provide a wide viewing area.

• X-ray machines are commonly available at veterinary practices.

• They are fast, efficient ways of examining bones and joints.

X-ray disadvantages

• There is a very small radiation risk to staff. There are laws and regulations that control the
use of x-ray machines, and the staff will have to protect themselves with lead aprons and
screens from exposure to the radiation.

• Radiographs only show a snapshot in time, they cannot show an organ moving.

MRI scanning in animals

MRI stands for Magnetic Resonance Imaging. It is a very sophisticated form of scanning an animal.
It is similar to radiography and ultrasound, but it provides far more detail. Where an ultrasound or x-
ray will show the size, texture and the shape of an organ, an MRI scan will show exactly what the
inside of each organ or tissue looks like. MRI scans are very expensive, and are normally used for
diagnosing problems with the brain and spinal cord, but are sometimes used for bone and joint
problems.

The MRI scanner uses magnetic fields to create images of the animal’s body. Basically, the animal is
placed inside a giant magnet, which sends out radio waves into the body. When the magnet is turned
off, the body will release the radio waves, and this will be picked up by a very sophisticated
computer, which will then turn the waves into an image of the body.

These machines cost a staggering amount of money, so normal veterinary practices don’t usually
have one available. Therefore an animal needing this scan will be sent to a specialised referral
hospital; in another recent example, there has been a MRI scanning unit placed on the back of an
articulated lorry, which will move around from veterinary practice to veterinary practice, allowing
the vets in those practices to use them. Sometimes human hospitals will allow veterinary practices to
use their scanners at night-time. I have been involved with this a number of times, and I can tell you
that it is very odd taking a dog to human hospital!

Normally the animal is given a general anaesthetic so that the scan can be done with the animal
completely still; the scan can take a couple of hours to do.
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 BLOOD TESTS

Blood tests are widely used in veterinary practices today. They are used to diagnose a variety of
different diseases and conditions in animals. The results of a blood test are measured against normal,
average values of healthy animals. These figures differ widely in different species of animals. Also,
blood results can be influenced by several medications and whether the animal has eaten recently or
not.

The sample is usually taken from an animal’s leg or neck, and is usually a two-person job, with one
person holding the animal and raising the vein, and the other person using a needle and syringe to
take a sample from the vein. This can be a tricky procedure to master, and it takes a lot of experience
to be good at it.

A complete blood count

This is a blood test that is often used to give the vet information about the different types of blood
cells currently flowing round an animal’s body. A red blood cell count, a white blood cell count and
haemoglobin check are important tests to determine the health of the animal, as red blood cells are
used to transport oxygen around the body, and the white ones fight infection. Therefore, a low red
blood cell count would mean the animal may be anaemic, whilst a high white blood cell count could
mean that the animal has an infection or virus. Platelets are in their blood and help the blood to clot.
So if a platelet count is low, this could indicate a bone marrow autoimmune disease.

PCV is short for Packed Cell Volume, and this tells the vet the percentage of red blood cells in the
blood. It is sometimes known as hemotocrit.

Biochemistry blood tests

These look at the amounts of different types of chemicals that are in the blood. The most commonly
tested for are:

• Glucose
This tests the blood sugar level. If it is high, this can suggest diabetes or stress.

• Total protein
This can tell us about the efficiency of the animal’s immune system.

• Calcium
Abnormal levels of calcium can suggest kidney failure, poisoning or cancer.

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 • Albumin
A low level of albumin would suggest liver damage.

• Sodium
This increases with dehydration.

• Cholesterol
High cholesterol levels may suggest hyperthyroidism, kidney disease or diabetes.

• Alkaline phosphatase
A high level of this would suggest a liver problem, hormonal imbalance, or bone disease.

• Amylase
High levels of amylase can suggest a pancreas problem.

• Creatinine
A high-level of creatinine suggests kidney or muscle damage.

• BUN
A high-level of BUN suggests kidney problems.

• Phosphorus and potassium

High levels of these may suggest kidney failure.

URINE TESTS

‘Urine analysis’ is the correct term to use for urine testing. It is an essential tool for vets to diagnose
diseases and conditions. It can be used to find all sorts of conditions, from diabetes and infections, to
kidney failure.

How to take a urine sample

There are several different ways of doing this.

• Catheterisation
o A vet can pass a small tube into the bladder via the animal’s genitals. An animal
would normally have to be sedated to do this.

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 • Aspiration
o The vet can use a needle and syringe to directly extract a urine sample from the
bladder through the cat’s abdominal wall.

• Free catch
o This is where either the owner or a veterinary nurse collects the urine from a litter
tray. Let’s look at this technique in more detail.

Procedure for a free catch urine sample from a cat

Use a clean, dry litter tray and place some non-absorbent cat litter in the bottom, just enough to cover
it. Place the litter tray with the cat and make sure that the cat has access to water. Sometimes it is
better to cover the cat’s cage to allow the cat a little more privacy. Check the litter tray about every
half an hour to see if the cat has urinated. Once it has, transfer the urine from the litter tray into a
urine sample container.

Procedure for a free catch urine sample from a dog

First of all you need to find a shallow bowl; ideally a kidney dish, but I have known people to use
small frying pans for this job. It needs to be small enough to fit between the dog’s hind legs (if it is
female) as it is urinating. Make sure that the bowl or dish is clean and dry. Take the dog for a walk
on a lead, and when the dog cocks its leg or starts to squat, gently slide the bowl under the stream of
urine to obtain a sample. You need to do this subtly, as it can put the dog off from urinating if you
suddenly thrust a dish at its genitals. You also need patience. It may take several tries to obtain the
sample. When you have it, transfer the sample into a clean urine sample container.

If the urine sample is not going to be tested straight away, it should be stored in a refrigerator, as this
slows down the growth of the bacteria in the urine, and this bacteria can give false test results.

Different types of urine tests

Visual examination

Firstly, you should look at a urine sample. You need to look at its colour and consistency; is it clear,
yellow or amber? Is it cloudy? Can you see bits floating around in it, like crystals?

Specific gravity

A specific gravity test, or more commonly known as the SG, lets the vet know how concentrated the
urine is. A very low concentration may suggest that the animal has kidney failure.

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Dipstick

A dipstick test is a quick way to get lots of information from the animal’s urine. Basically, it is a long
strip with different-coloured squares on it. These coloured squares will turn different colours
depending on what’s in the urine. The person doing the test will then compare the colours to a chart,
which will then convert the colour into a value. These dipstick strips can test for all sorts of things. I
have listed some of the common ones below.

pH

This tests how acidic or alkaline the urine is. The animal’s diet will affect this, but it is a good
indicator of the animal’s kidney function. Also, if their urine has crystals in it, you will be able to tell
what the crystals are by knowing the pH. Some crystals only grow in acidic urine, and some only in
an alkaline one. You can also detect conditions like kidney failure, diabetes, dehydration and urinary
obstructions.

Protein

The protein levels of the dog’s urine will give the vet an idea of how efficiently the kidneys are
working.

Glucose

Finding a large amount of glucose in the urine usually means that the animal has diabetes.

White blood cells

As you know, white blood cells are used to fight infection. A high level of white blood cells would
indicate that the dog has an infection in its bladder or kidneys. It is trickier with female animals, as
they can often have white blood cells in their urine samples from their vagina.

Cultural sensitivity

If white blood cells are being found in the urine, sometimes the vet may send the urine for a cultural
sensitivity test. This is usually done at an external laboratory, where they will grow the bacteria in
the urine and then test it with different antibiotics to see which antibiotic kills that particular bacteria.
This information is then passed on to the vet, so they know which is the best antibiotic to give to the
animal.

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Microscopic examination

First of all, the urine sample is spun down in a centrifuge. This will allow the veterinary nurse to
separate the sediment from the rest of the urine. This is because for a microscopic examination, the
bit we are interested in is just a sediment. The types of things you will be looking for in sediment of
the urine are abnormal cells, red and white blood cells, casts, bacteria, sperm, and crystals.

TUTOR TALK: You have now come to the end of this assignment. Answer the questions
relating to the work that you have just covered and return them to the College for marking.

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Veterinary Support Assistant Diploma Course – Assignment Twelve – Page 10

STUDENT NOTES: Please use the space below for recording what you consider to be
any pertinent information or notes. You may find it helpful to refer back to it later on!

Veterinary Support Assistant Diploma Course – Assignment Twelve – Page 11

STUDENT NOTES: Please use the space below for recording what you consider to be
any pertinent information or notes. You may find it helpful to refer back to it later on!

Veterinary Support Assistant Diploma Course – Assignment Twelve – Page 12