COMPANION ANIMAL PRACTICE Being non-invasive, Doppler

ultrasonography is more
suitable than angiography
for the initial investigation
of a patient with suspected
vascular abdominal disease

Doppler ultrasound examination

in dogs and cats
2. Abdominal applications CHRIS LAMB

THIS article, the second of a three-part series on the role of Doppler ultrasonography in the investigation
of diseases in dogs and cats, discusses the applications of Doppler ultrasound in the abdomen. Part 1
(In Practice, April 2005, pp 183-189) described the Doppler principle and the different Doppler techniques
used for diagnosis. The applications of Doppler ultrasound in the assessment of cardiac diseases will be
discussed in Part 3, to be published in the next issue.

REVIEW OF THE DOPPLER PRINCIPLE

Chris Lamb is Senior

Lecturer in radiology
As discussed in Part 1, Doppler ultrasound techniques are
in the Department based on the principle of the Doppler shift – that is, a
of Veterinary Clinical
Sciences at The Royal
change in the frequency of sound that is observed when
Veterinary College the source is moving relative to the observer. A familiar
(RVC). He is a example of the Doppler shift is the change in pitch of the
diplomate of both the
American College of siren on a passing ambulance or police car, which is high (A)
Veterinary Radiology on approach, then becomes suddenly lower as the vehicle
and the European
College of Veterinary moves away. In medical ultrasound, this principle may
Diagnostic Imaging. be used to detect and measure flow of blood because red
blood cells (RBCs) reflect ultrasound waves, producing
echoes that can return to the transducer. The echoes
returning from moving RBCs will have a higher frequen-
cy than the original ultrasound pulse if the RBCs are mov-
ing towards the transducer and a lower frequency if the (B)
RBCs are moving away from the transducer (see right).
Origin of the Doppler shift in blood vessels. (A) 5 MHz
ultrasound beam reaching red blood cells (RBCs) moving
away from the transducer. (B) Echoes originating from
APPLICATION OF DOPPLER TECHNIQUES these moving RBCs have an altered frequency because
TO THE ABDOMEN the ultrasound waves are either bunched together
(ie, wavelength is reduced in the same direction as flow)
or spaced out (ie, wavelength is increased in the opposite
The various Doppler techniques that are used to examine direction to flow). A transducer facing the approaching RBCs
will receive echoes with a frequency greater than 5 MHz,
the abdomen were described in Part 1 and are sum- whereas a transducer facing the retreating RBCs will receive
marised in the table below. Continuous wave Doppler is echoes with a frequency lower than 5 MHz

SUMMARY OF DOPPLER TECHNIQUES

Continuous wave Doppler Pulsed wave Doppler Colour Doppler Power Doppler

Quantitative assessment of blood flow ++ + + –

Global view of blood flow within an organ – – ++ ++

In Practice (2005) – Not used, + Moderately useful, ++ Optimal method

27, 238-247

238 In Practice ● MAY 2005


(A) Dorsal two-dimensional,
grey-scale image of the
spleen obtained from the left
flank showing the normal
appearance of the
parenchyma and a vein
at the medial aspect.
(B) Corresponding colour
Doppler image shows flow (A)
(blue) in veins within the
parenchyma of the spleen
and in the large vein. The
red/green (aliased) signal
in small branching vessels
within the spleen represents
arterial flow. Far more splenic
vessels can be seen using
colour Doppler than are (B)
visible in the grey-scale image
Power Doppler image of the cranial abdomen of a cat
with jaundice. The ability to identify blood flow aids
the recognition of dilated extrahepatic bile ducts, which
contain no flow signal (arrow). gb Gallbladder
used far less for examining the abdomen than it is for
examining the heart. The smaller sample volume used in
pulsed wave Doppler and the ability to calculate flow
velocity at wider angles of insonation (ie, the angle
between the direction of blood flow and the ultrasound
beam) make it better suited to examination of abdominal
blood vessels than continuous wave Doppler. Colour
Doppler and power Doppler are useful for examining
parenchymal organs for signs of abnormal blood flow
and may be used to guide a quantitative examination of
specific vessels by pulsed wave Doppler.
Most abdominal applications of Doppler ultrasonog-
raphy involve the assessment of flow in blood vessels.
Small animals are far less prone to vascular diseases than
humans. Nevertheless, there are several important condi-
tions in dogs and cats that result in abnormal blood flow
or abnormal blood vessels. Although angiography is
considered to be the definitive method for the diagnosis
of most vascular conditions, Doppler ultrasonography
has the advantages of being non-invasive and requiring
no patient preparation or anaesthesia. These features
make it more suitable for the initial investigation of a
patient with suspected vascular disease. Even when vas-
cular disease is not suspected, Doppler ultrasonography
may be incorporated into a two-dimensional, grey-scale
ultrasound examination of the abdomen to gain addition-
al anatomical information about the organs and to distin-
guish blood vessels from other tubular structures (as
illustrated by the images on the left).
The use of pulsed wave or colour Doppler in the
abdomen is technically demanding for a variety of rea-
sons. First, many abdominal vessels have a longitudinal
alignment but must be examined from windows on the
lateral or ventral aspects of the abdominal wall, which
tends to result in a roughly perpendicular orientation of
the ultrasound beam to the direction of flow. This is a
problem because a wide angle of insonation reduces the
Doppler shift and makes any measurements less accurate
(see Part 1). The angle of insonation may be minimised
by placing the transducer at an acute angle to the body
wall (see below); however, this may reduce the contact
area of the transducer or lead to interference by the
ribs. Second, examination of relatively small vessels
requires the use of small, accurately positioned sample
volumes and careful adjustments to machine settings.
Breath motion, particularly in panting dogs, makes it
more difficult to position accurately a Doppler sample
volume and the movement of tissues can cause spurious,
high amplitude Doppler signals that drown the signals
from blood vessels. This is particularly troublesome
when attempting to perform a power Doppler assessment
of a parenchymal organ, such as a kidney. Examination
of deeply situated vessels may also be compromised by
intestinal gas, which obstructs the ultrasound beam.
Given that optimal Doppler examination of the
abdomen can be more difficult than a two-dimensional,
grey-scale ultrasound scan, the author recommends that
expertise is gained in more basic ultrasound techniques
before attempting Doppler studies.

Pulsed wave Doppler

examination of the
abdominal aorta of a dog. A
sample volume (indicated by
short parallel white lines) has
been positioned over the
centre of the vessel and, by
placing the transducer at an
acute angle to the body wall,
the angle of insonation
(circled in red) has been
reduced to 63°. Normal
pulsatile flow with a peak
systolic velocity of 2 m/second
is observed

240 In Practice ● MAY 2005

 (A)
(B)
NORMAL PATTERNS OF BLOOD FLOW
IN ABDOMINAL VESSELS
The direction, velocity and character of flow in the major
abdominal vessels aids their identification and forms a
basis for the diagnosis of conditions that alter flow.
Arteries are readily identified by their pulsatile flow. The
aorta normally has a high amplitude, pulsatile flow with a
peak systolic velocity in the range of 1 to 2 m/second (see
A, above). Transient flow reversal during diastole is a fea-
ture of a high impedance artery such as the aorta; in con-
trast, the branches of the abdominal aorta have a lower
impedance and persistent diastolic flow (see B, above).
Resistive index (RI) is a term used to describe imped-
ance in arteries. RI is calculated from the peak systolic
and end-diastolic frequency shifts, as follows:
∆fsys – ∆fdia
RI =
∆fsys
The aorta will normally have a higher RI than an
artery with lower impedance.
Veins have non-pulsatile flow with a lower average
velocity than arteries. The caudal vena cava has variable
flow in a rather complex pattern (see A, below) since the
rate of blood flow is affected by changes in intracardiac
and intrapleural pressure, which are usually out of sync
because the heart rate and respiratory rate are different.
Normal portal blood flow is relatively slow and uniform
(see B, below) because the portal vein has intestinal
(A)
(B)
Examples of pulsed wave Doppler spectra in veins. Flow in
the caudal vena cava (A) is variable and irregular because
it is influenced by intracardiac and intrapleural pressures,
which are out of sync in most animals. Blood flow in the
portal vein (B) has a low, relatively uniform velocity
In Practice ● MAY 2005
(left) Examples of pulsed wave Doppler spectra in arteries.
(A) In the abdominal aorta, flow is pulsatile with peak
velocity in the range of 1 to 2 m/second. There is transient
flow reversal (arrow) at end-systole caused by elastic recoil
of the walls of the aorta. (B) Peak flow velocities are lower
in the branches of the abdominal aorta (in this case, the
hepatic artery) and there is persistent end-diastolic flow.
(above) The resistive index (RI) – a measure of impedance
in arteries – is calculated from the peak systolic (∆fsys) and
end-diastolic (∆fdia) frequency shifts (see text)
capillaries at one end and hepatic sinusoids at the other;
hence, it is insulated from the variable pressures and
flow that normally exist in arteries and systemic veins.
The average velocity of blood flow in the portal vein is
approximately 15 cm/second in healthy, unsedated dogs.
Pulsed Doppler ultrasound examination of blood ves-
sels is often performed using a small sample volume
positioned in the middle of the vessel in order to avoid
any spurious, high amplitude echoes from the vessel
walls. In many normal vessels, the RBCs flow at a range
of velocities, with the fastest flow occurring in the centre
of the vessel and slower flow along the walls – so-called
laminar flow (see Part 1). A Doppler spectrum obtained
from the centre of a vessel exhibiting laminar flow will
be relatively narrow and will represent the maximum
frequency shift, which may be used to determine the
peak flow velocity. An alternative approach uses a
Effect of varying sample
volume size for pulsed wave
Doppler measurement of flow
velocity in a blood vessel
exhibiting constant laminar
flow. The velocity profile of
the vessel is indicated by the
arrows, and the direction of
the ultrasound beam by the
dotted line. (A) A small sample
volume placed at the centre
of the vessel produces the
maximum frequency shift (fD),
which may be used to
calculate peak velocity. (B) A
large sample volume spanning
the entire vessel produces a
wider range of frequency
(A) (B) shifts, which may be used to
calculate average flow velocity
sample volume large enough to encompass the entire
vessel, so collecting echoes from all flowing blood. This
produces a wider Doppler spectrum. This method (called
uniform insonation) may be used to determine the aver-
age flow velocity within the vessel, and this value could
then be used to calculate flow rate:
Flow rate = Average flow velocity x Cross-sectional area of vessel x 60
(ml/minute) (cm/second) (cm2)
However, Doppler ultrasound has many potential
sources of error and tends to be an inaccurate method for
measuring flow in blood vessels. Therefore, it is rarely
used for this purpose.
241
INVESTIGATION OF ABDOMINAL
CONDITIONS USING DOPPLER ULTRASOUND

Thrombosis and infarction

A thrombus is an intravascular solid or semisolid struc-
ture composed of fibrin and blood cells that tends to
obstruct blood flow. The three factors that predispose to
thrombus formation are known as Virchow’s triad:
namely, a hypercoagulable state; vascular stasis; and
damage to the vascular endothelium. There are many
potential causes of thrombosis, which may be divided
into local and systemic conditions: the former include (A) (B)
damage to the vascular endothelium (eg, by indwelling
Thrombosis of the splenic vein in a shar pei with protein-
vascular catheters), trauma, endocarditis, parasites losing nephropathy as a result of amyloidosis. (A) Two-
and neoplastic invasion of blood vessels; the latter dimensional, grey-scale image of the spleen showing
include hyperadrenocorticism, autoimmune haemolytic echogenic material in one of the splenic veins (arrow).
(B) Corresponding colour Doppler image showing flow
anaemia and renal disease. The most common form of in veins within the spleen and around the material in the
abdominal thrombosis in small animals is aortic splenic vein; this indicates that the thrombus is not causing
a complete obstruction
thrombosis, which occurs most frequently in cats with
cardiomyopathy.
Ultrasonographically, the combination of static
echoes within a vessel lumen and lack of a Doppler
signal is diagnostic of a thrombus (see below). However,

(A) (B)

Adrenal neoplasm invading

the caudal vena cava in a
dog. (A) Dorsal two-
dimensional, grey-scale
image showing an echogenic
mass within the caudal vena
cava (cvc). The left kidney
(LK) occupies the near field.
Longitudinal power Doppler image of the caudal
(B) Corresponding power
abdominal aorta of a cat with thrombosis secondary to
Doppler image showing
cardiomyopathy. There is a flow signal in the aorta (Ao)
evidence of flow in the
that ends abruptly near the middle of the image. To the
kidney and mass, but a lack
right of this point, the aorta (arrows) is filled with
of flow in the caudal vena
hypoechoic material, which is consistent with thrombus (T)
cava. (C) Pulsed wave
formation. Part of the caudal vena cava (CVC) is visible
Doppler spectrum acquired
below the aorta
from the caudal vena cava
confirms lack of normal
flow. There is a weak,
some thrombi are virtually anechoic, so are not visible in intermittent low velocity (C)
two-dimensional, grey-scale ultrasound images and are signal above the baseline,
which in this instance indicates caudal flow. There is
recognised by the lack of a Doppler signal alone. In a high background noise level, which reflects the high
these cases it is important that the ultrasound machine amplification needed to pick up the weak flow signals.
This dog had no signs of pelvic limb congestion; hence,
settings are correct and that optimal images of the affect- collateral venous drainage must have developed (probably
ed vessels are obtained; otherwise the lack of a Doppler through the vertebral venous plexus) to compensate for
the obstruction of the caudal vena cava
signal due to poor technique could be misinterpreted as a
sign of thrombosis.
Finding a thrombus in an abdominal vessel aids
understanding of the prevailing pathophysiology and enlarged, diffusely hypoechoic spleen may be observed
may be a key diagnostic sign. On the other hand, finding by two-dimensional, grey-scale ultrasonography in
a thrombus may make no difference to patient manage- dogs with splenic infarction – and also in those with
ment if the thrombus affects a non-critical organ, if it is infiltrative diseases, such as lymphoma. These condi-
not actually obstructing flow or if the patient has already tions may be distinguished by Doppler examination of
compensated for the effects of vessel obstruction – as the splenic veins, with a lack of flow supporting a diag-
illustrated by the images above right. nosis of infarction. Localised splenic infarction, which
Infarction occurs following interruption of blood flow may be a subclinical finding, often appears ultrasono-
to an organ or part of an organ. For example, infarction graphically as segmental hypoechoic regions in the
of the spleen may occur as a result of obstruction of periphery of the spleen that lack blood flow (see
splenic veins due to thrombosis or splenic torsion. An page 244).

In Practice ● MAY 2005 243

 Splenic infarction
in a greyhound with
autoimmune haemolytic
anaemia. (A) Sagittal two-
dimensional, grey-scale
image of the spleen
showing a peripheral
hypoechoic, roughly
diamond-shaped zone
at its lower aspect.
(B) Corresponding power
Doppler image showing
flow in numerous small
blood vessels within the
spleen but a lack of Doppler
signal in the hypoechoic
zone. No clinical signs were (A) (B)
associated with this lesion

Power Doppler image of the left kidney of a normal dog.
Interlobar and cortical vessels are visible. The technique
of power Doppler is particularly appropriate for assessing
organ vascularity because of its sensitivity to flow in small
vessels
The kidney is an example of a highly vascular, acces-
sible organ that is well suited to Doppler examination.
Power Doppler examination of a normal kidney empha-
sises the high degree of vascularisation (see above).
Renal infarction, which is potentially life-threatening,
can occur as a sequela to systemic conditions causing
thrombosis or local lesions such as pyelonephritis. Focal
or regional defects in perfusion compatible with infarcts
may be identified by power Doppler in dogs with chron-
ic nephritis. Perfusion deficits may be observed in parts
of the kidney with signs of scarring on the two-dimen-
sional, grey-scale ultrasound scan or may be observed in
the absence of any convincing grey-scale abnormalities
(see below). It is interesting to speculate that routine
power Doppler examination of the kidneys would
increase the sensitivity of detecting renal lesions. There
is evidence that this is true in children with pyelonephri-
tis, but there are no reports in the veterinary literature of
similar studies in small animals.
Portosystemic shunting
Ultrasonographic signs in dogs with congenital portosys-
temic shunts (PSS) include a small liver, reduced visibil-
ity of intrahepatic portal vessels, and urinary calculi.
Definitive diagnosis depends on the identification of an
anomalous blood vessel draining portal blood into the
caudal vena cava (or sometimes the azygos vein).
Congenital intra- and extrahepatic PSS are usually visi-
ble using two-dimensional, grey-scale ultrasonography;
hence, Doppler is not usually necessary for diagnosis
(see top of page 245).
Congenital PSS usually take the form of a single
large-calibre vessel, whereas acquired PSS have multiple
small extrahepatic shunting vessels that generally occur
in the retroperitoneum near the kidneys (see page 245).
Acquired PSS develop in response to persistently
increased portal pressure (ie, portal hypertension), which
itself is the result of lesions in the liver or portal vein
that obstruct portal blood flow. Most dogs with acquired
PSS have hepatic fibrosis or cirrhosis, hence this condi-
tion has a poor prognosis.
Pulsed wave Doppler may be used to demonstrate the
abnormal portal blood flow that occurs in animals with
PSS, as illustrated at the bottom of page 245. Congenital
PSS represent a low resistance path for blood to bypass
the liver – more than 90 per cent of portal blood flow
usually goes through this type of shunt – and they
expose the portal vein to the variable pressure that nor-
mally exists in the caudal vena cava. As a result it is
common for dogs with congenital PSS to have increased
and abnormally variable portal flow. In contrast to dogs
with congenital PSS, dogs with acquired PSS tend to
have a reduced portal blood flow velocity. Hepatofugal
(ie, reversed) flow in the portal vein may be observed
in animals with relatively severe portal hypertension.
Variations in portal flow may also be observed follow-

Example of how power

Doppler may aid the
identification of renal lesions.
(A) Dorsal image of the left
kidney of a labrador
undergoing investigation for
weight loss. There is a subtle
heterogeneous echotexture
and lack of clear
corticomedullary distinction
affecting the caudal pole
(to the right of the image).
(B) Corresponding power
Doppler image showing a
marked reduction in
perfusion of the caudal pole.
The perfusion deficit is more
severe than suggested by the (A) (B)
grey-scale findings

244 In Practice ● MAY 2005


(A)
(C)
ing feeding. In normal dogs, postprandial portal flow
velocity is increased. In dogs with portal hypertension,
preprandial portal flow may be reduced and postprandial
flow may be reversed – presumably because the capacity
of the liver is insufficient to accommodate the increase
Ultrasonographic appearance
of multiple acquired
portosystemic shunts in a
dog with portal hypertension.
(A) Dorsal two-dimensional,
grey-scale image of the
caudal pole of the left kidney
(LK) and adjacent
retroperitoneum in which
several small irregular
hypoechoic structures,
consistent with vessels, are
visible (arrows). (B) Colour
Doppler image confirms
flow in these vessels.
Reproduced, with permission,
from Lamb and Daniel (2002)
In Practice ● MAY 2005
Use of colour Doppler
in dogs with congenital
portosystemic shunts.
(A) Transverse two-
dimensional, grey-scale
image obtained from a right
intercostal window in a
labrador retriever with an
intrahepatic (right divisional)
portosystemic shunt. The
shunting vessel is wide and
tortuous, and clearly visible.
(B) Corresponding colour
Doppler image confirms the
presence of flow through the
(B) shunt. (C) Transverse two-
dimensional, grey-scale
image obtained from a right
intercostal window in a
Yorkshire terrier with a
congenital extrahepatic
portosystemic shunt. The
curved shunting vessel is
visible at the point at which
it drains into the caudal vena
cava (cvc). (D) Corresponding
colour Doppler image
confirms the presence of flow
through the shunt into the
caudal vena cava. The aorta is
visible as a red/orange
Doppler signal on the left of
the image. In each of these
dogs, diagnosis was possible
(D) based on the grey-scale
ultrasound image alone
in portal flow that occurs after feeding. Therefore, it is
worth noting the time of a Doppler examination relative
to feeding and taking postprandial measurements of
portal flow if preprandial measurements were considered
borderline.
LK
(A) (B)
Examples of Doppler spectra
obtained from the portal
vein. In a normal, unsedated
dog (left), portal flow is
relatively uniform. Portal
hypertension (top right)
results in reduced flow,
in this instance to a mean
velocity of 5 cm/second.
In dogs with congenital
portosystemic shunts
(bottom right), flow may
be increased and variable.
Reproduced, with permission,
from Lamb and Daniel (2002)
245
 (A) (B)
Portal hypertension in a young boxer with hepatic cirrhosis. (A) Transverse ultrasound image of the
liver obtained using a right intercostal window, showing a diffuse, uneven increase in echogenicity.
This appearance is consistent with hepatic fibrosis but does not suggest a specific diagnosis.
(B) Dorsal image showing marked dilation of the portal vein (PV). (C) Pulsed wave Doppler examination of the portal vein reveals lack of flow, compatible
with portal hypertension. The only Doppler signal is a result of movement of the vessel when the dog breathes, rather than any portal blood flow
The ability to detect abnormalities in portal blood flow
velocity aids the diagnosis of PSS in animals in which a
shunting vessel is not found on ultrasonography. It is
worth attempting to measure portal blood flow velocity in
dogs with clinicopathological evidence of hepatic insuf-
ficiency because portal hypertension can occur in ani-
mals that show only relatively minor abnormalities of
the hepatic parenchyma on two-dimensional, grey-scale
Use of colour Doppler for the reassessment of an
intrahepatic portosystemic shunt in a lurcher with
persistently elevated serum bile acids following surgery to
attenuate the shunt. (above) Transverse two-dimensional,
grey-scale image obtained from a right intercostal window
showing a central-divisional intrahepatic portosystemic
shunt. The site of shunt attenuation is visible as a slightly
irregular narrowing (arrow) between the intraheptic portal
vein (pv) and the caudal vena cava (cvc). A dilated hepatic
vein drains into the caudal vena cava at the top of the
image. (below) Corresponding pulsed wave Doppler
spectrum confirms the persistence of high amplitude,
high velocity turbulent flow through the shunt
246
(C)
ultrasound images (see above). In these cases, a tentative
diagnosis may be based on the Doppler measurements.
Doppler ultrasound is also a useful non-invasive method
for reassessing animals that have undergone surgery to
attenuate a congenital PSS. It helps to determine if persis-
tent or recurrent clinical signs after surgery are the result
of persistent flow through the original shunt or the devel-
opment of acquired PSS (see below left).
Altered renal arterial blood flow
Abnormal renal blood flow may be detected by Doppler
ultrasound as a change in the RI of intrarenal vessels.
Intrarenal RI is usually measured using a small sample
volume positioned over the interlobar or arcuate arteries
(see image at the top of page 247). Intrarenal RI values
in normal, unsedated dogs are typically in the range of
0·55 to 0·72. Renal disease can change the RI; for exam-
ple, intrarenal RI is one of several criteria used to assess
animals at risk of rejecting their renal transplants.
Measurement of RI has also been used to aid diagno-
sis of urinary obstruction, since urinary obstruction
causes a decrease in renal blood flow which may be
detectable before any dilation of the renal pelvis
becomes evident. This is relevant because early diagno-
sis and treatment of urinary obstruction will help to
minimise kidney damage. An intrarenal RI >0·70 or
increased RI during diuresis are considered criteria for
obstruction in humans. The use of an 0·70 threshold is
moderately accurate for urinary obstruction in dogs (see
below). Further work is required to determine if the
accuracy of this test can be improved by refinements
such as repeat RI measurement after administration of a
diuretic. Many factors complicate the use of intrarenal
RI measurements for diagnosis, including the patient’s
age, heart rate and blood pressure, and concurrent renal
disease. Sedatives reduce the intrarenal RI, which also
Abnormally high
resistive index (RI)
as a result of urinary
obstruction. (top) Pulsed
wave Doppler spectrum
obtained from the left
RI = 0·79 kidney of a dog with
ipsilateral ureteral
obstruction caused
by a calculus. The RI is
increased above the
normal range.
(bottom) The pulsed
wave Doppler spectrum
from the contralateral
kidney is within normal
RI = 0·60 limits
In Practice ● MAY 2005
complicates the interpretation of results. When attempt-
ing quantitative blood flow measurements, it is better to
avoid sedating the patient if possible.

Ureteral jets
Peristalsis of the ureters transports urine in a series
of boluses that squirt into the bladder from the
ureterovesicular junctions. This phenomenon may be
observed ultrasonographically as ‘ureteral jets’, provid-
ing there is a difference between the specific gravity of
ureteral and bladder urine. For diagnostic purposes, the
visibility of ureteral jets may be enhanced by filling the
bladder with sterile water or saline of lower specific
gravity than the ureteral urine. An alternative strategy,
which avoids the need for catheterisation, involves
allowing the dog to urinate, withholding water for sever-
al hours to ensure that the bladder urine is concentrated,
and then allowing the dog access to water so that more
dilute ureteral urine is produced. Administering a diuret-
ic has a similar effect. Measurement of intrarenal
Ureteral jets are also visible in two-dimensional, resistive index in a young
labrador with urinary
grey-scale ultrasound images as a series of small ectopic. Conversely, the lack of a ureteral jet in an incontinence. (top) Dorsal
echogenic foci streaming periodically from the incontinent animal may be interpreted as a sign that the image of the left kidney
showing dilation of the
ureterovesicular junctions. In colour or power Doppler ipsilateral ureter is ectopic (see below). renal pelvis and ureter.
images, the ureteral jets appear as flame-like flashes of A sample volume (indicated
colour on the dorsal aspect of the bladder neck (see by two parallel white lines)
has been positioned
below). When a ureteral jet is observed, it confirms that over the renal cortex.
the ipsilateral kidney is producing urine, that there is no (bottom) Corresponding
pulsed wave Doppler
ureteral obstruction and that the ipsilateral ureter is not spectrum showing a
series of arterial pulses.
Measurements of peak
systolic and end-diastolic
velocity produce a resistive
index of 0·57, which is
within the normal range

References
LAMB, C. & BOSWOOD, A.
(2005) Doppler ultrasound
examination in dogs and cats.
1. The principles. In Practice
27, 183-189
Ultrasonographic appearance of an ectopic ureter. This LAMB, C. R. & DANIEL, G. (2002)
transverse colour Doppler image shows a normal left Diagnostic imaging of dogs
Normal appearance of ureteral jets. This transverse power ureteral jet. No right ureteral jet was observed over a period with suspected portosystemic
Doppler image of the urinary bladder shows focal flashes of several minutes. A focal anechoic rounded structure shunting. Compendium on
of colour issuing from both ueterovesicular junctions. adjacent to the right side of the bladder neck (arrow) is the Continuing Education for
In real-time, ureteral jets are intermittent and may be dilated right ureter, which was ectopic and drained into the the Practicing Veterinarian
out of sync with each other urethra 24, 626-635

In Practice ● MAY 2005 247