Radiography of Conscious Animals

Re: Radiography of Conscious Animals

lisa phillips — Tue, 06 Apr 2010 17:12:05 GMT

can't remember last time I did concious xray - will be years ago though.

can't think of any situation where it is better to risk your own health for the sake of a patient that is too sick to have some sort of sedation.

acp/torb for dogs and diazapam/ketamine for cats works well

apart from the H+S aspect concious pictures are always rubbish quality, (too much movement blur and impossible to get good positioning ) so you end up guessing on a diagnosis anyway half the time!!

Re: Radiography of Conscious Animals

listhestar — Sun, 04 Apr 2010 21:20:41 GMT

[quote user="Nicola Moss"] was wondering how much radiography of conscious animals people are carrying out in small animal practice?[/quote]

Our practice deals with alot of greyhound, We tend to use sandbags to xray hocks etc esp as any sedation or Ga is less than ideal after they have raced. The dogs are splinted up anyway and just tend to lie down and let you get on with it.

Otherwise try and do sedation or ga as sometimes quicker and better qaulity pics at the end. If its life and death then try and get a quick picture as most things are obvious if causing that much problem and most animals tend to give in to sandbags if that poorly.

Lisa

Re: Radiography of Conscious Animals

Vikki Moran — Fri, 02 Apr 2010 08:39:53 GMT

It's only since i've had the problem that i've worked somewher ethat had a thyroid guard!

Re: Radiography of Conscious Animals

Vikki Halliday LLB — Thu, 01 Apr 2010 13:12:13 GMT

I just had to restrain a bulldog for xray there, as its sedation had begun to wear off and O was trying to get a good straight elbow picture. Yes I would have preferred to GA, but not able to do so today.

Have to say though, after the post above, I also reached for the thyroid guard...........

Re: Radiography of Conscious Animals

Vikki Moran — Thu, 01 Apr 2010 10:30:20 GMT

i should perhaps point out that I used to be quite cavalier about it (as I too thought I didn't want any kids - here I am 2 loater...).

but the reproductive system isn't the only issue.

I will be at BSAVA congress all next week, and will be quite happy to show anyone my Thyroidectomy scar. This follows the very ra[id growth of a thyroid carcinoma, which i found when my first child was 5 months old. wasn't a fun experience. I'm all clear now, thankfully spotted it early, and threw a big enough tantrum at my GP that they took me seriously, when I said I didn't want to wait until it became a physical obstruction.

I cannot say for certain that my thyroid cancer was caused by radiation exposure, I don't know, but I certainly wasn't particularly careful for the first few years I worked in practice, nor in the 8 years before that when i was working as a veterinary "nurse" for a less than safety conscious vet, and as a student.

in human hospitals, they don't tend to gown up their patients, because they aren't used to having patients who are exposed to radiation on a daily basis. if you tell them that you do, and tell them that you have a radiation safety record, they are supposed to, and are supposed to give you a log of the radiation they use so that you can inform your designated radiation safety provider (or whatever they call themselves!)

Re: Radiography of Conscious Animals

Charlotte Marshall — Wed, 31 Mar 2010 23:12:47 GMT

I do take a few conscious Xrays but rarely have to hold an animal. It tends to be the quick check for an fb in a fairly calm animal or some such.

I actually think manual restraint can be more stressful for a dyspnoeic animal and potentially precipitate a crisis. I tend to use acp/torb in dogs as mentioned above and midazolam and ketamine in cats in those cases.

Mind you I recall having Xrays of a broken leg myself and was not given a gown to cover the rest of me, they certainly seemed not to be concerned about scatter reaching anything important!

Re: Radiography of Conscious Animals

Vikki Halliday LLB — Wed, 31 Mar 2010 19:14:03 GMT

I used to be a little cavalier and restrain a proportion of animals for xray myself, where time, finances or clinical picture meant sedation was difficult. However, then I thought I would never have children, and now I have one, which slightly changes things.

I only restrain them now if any form of sedation/anaesthesia might cause the animal to become so depressed that it compromised their safety, and this only really ever relates in real terms to severely dyspnoeic cats or dogs.

I generally find the radiographs of most things are never adequate without at least deep sedation, and prefer to do most under GA.

I have never asked anyone else to restrain animals, if I have done so it was always my decision to put myself at risk, (potentially stupidly with hindsight).

I would always now try and use some form of chemical restraint, and if an animal did require restraint, I wear two aprons!

( I realise the words "horse" and "bolted" might be appropriate, )

Re: Radiography of Conscious Animals

Evelyn Barbour-Hill — Wed, 31 Mar 2010 16:43:57 GMT

[quote user="Kevin Castle"]

[quote user="Hanna Bennett"]Most of my nursing/vet staff are of childbearing/producing age be they male or female so sensibly won't restrain manually[/quote]

I'm sure fertility and reproduction can be affected by radiation but there are many other harmful effects of radiation. Thyroid glands, bone marrow etc etc are all sensitive to radiation and it is foolish to expose yourself to something just because you can't see it! People that manually restrain will pay for it in later life. An animal's life vs my life?

[/quote]

It depends what dose you get by restraining manually.

Re: Radiography of Conscious Animals

Kevin Castle — Wed, 31 Mar 2010 15:03:44 GMT

[quote user="Hanna Bennett"]Most of my nursing/vet staff are of childbearing/producing age be they male or female so sensibly won't restrain manually[/quote]

Re: Radiography of Conscious Animals

Michael Woodhouse — Wed, 31 Mar 2010 00:58:01 GMT

I did give it buprenorphine & carprofen first, if it makes you feel any better. Just a quick DV and a lateral. Less painful than manipulation. I wasn't especially bothered about positioning.

Re: Radiography of Conscious Animals

Gillian Mostyn — Tue, 30 Mar 2010 23:04:44 GMT

[quote user="Michael Woodhouse"]a collie dog with a # pelvis[/quote]

with concious radiography? OUCH!

Re: Radiography of Conscious Animals

Hanna Bennett — Tue, 30 Mar 2010 17:54:02 GMT

we find patience, sandbags and a big bulldog clip on the back of the neck to make them feel like they are scruffed will do for the poorly animals. Think these are often vomiters which I am looking for a foreign body so may give a little bit of a premed if not working. Most of the time conscious rads give poor quality x-rays so prefer to get good ones if poss.

Suspected CHF workups get acp/torb i/v as per Mike Martin which usually works very nicely. Any dyspnoeic cat I think is more likely to die if restrained so oxygen first then ket/val i/v or i/m usually works. If i'm checking for pups left i'd rather ultrasound than x-ray (think that thread was exhausted recently).

The old partner used to do hip scores by manually extending the legs himself - got some lovely straight hips but not sure I'd condone it! Most of my nursing/vet staff are of childbearing/producing age be they male or female so sensibly won't restrain manually.

Re: Radiography of Conscious Animals

Dexter Smith — Tue, 30 Mar 2010 16:42:01 GMT

I tend to do more now than I used to, in the knowledge that my germ cells are well past their sell-by date now anyway. Only on the co-operative patients though - the first sign of resistance out comes the chemical cosh. It is often much quicker to knock them down and get the job done, and conversley I find the worse condition the animal's in - especially cats, the less likely they are to feel comfortable in the position you want them in and the more likely they are to put up a fight and make matters worse.

I don't let anyone else do them concious though.

Re: Radiography of Conscious Animals

emma o'connor — Tue, 30 Mar 2010 15:38:34 GMT

We do the occasional xray without sedation or ga, but endevour to use sandbags or xray gowns to restrain the patients and with this approach we can manage most animals without resorting to holding them manually.

Emma

Re: Radiography of Conscious Animals

Hannah Wynne Richards — Tue, 30 Mar 2010 12:33:40 GMT

I do quite a lot, but ALWAYS hold them myself-I would never ask a nurse to do so, especially if of reproductive age. Since I'm 50 + then it's not so relevant to me

Wynne

Re: Radiography of Conscious Animals

Michael Woodhouse — Tue, 30 Mar 2010 00:23:59 GMT

Personally I do very little radiography, and what I do tends to be weekend OOH type things which I do often do conscious. Recently I have done a bitch to check if any pups left, just restrained with sandbags, an asthmatic cat in a box with a film in first, and a collie dog with a # pelvis. The last dog I did under GA was a hip score.

We have some home made sandbags made from old tractor inner tubes that are quite long and heavy and seem to keep dogs immobilised better than anything you can buy.

Re: Radiography of Conscious Animals

Vikki Moran — Mon, 29 Mar 2010 22:39:02 GMT

i can't actually remember the last conscious one i did.

If I suspect there may be a compromised lung, i use a DV first, before going for a lateral, so i know i'm not going to suffocate the patient by lying it down laterally.

I think where i have cases that i think might die under GA I usually question the necessity (on the animals behalf) of taking a radiograph anyway. It's great to get a diagnosis, but if the patient is likely to die just so i can say "yes this dog DID have pulmonary congestion" well, is that ethically correct?

dunno.

I just haven't been in that situation for ages.

actually though, thinking about it, i did do a conscious one on a puppy that had been "stood on" recently. but more to confirm the extent of injuries justified PTS and also because it was suspicious that the puppy had been kicked rather than stood on, and i wanted some hard evidence of injuries in case there was any repercussions later.