ABSTRACT: The author discusses the role nurses play in the useful diagnostic tool, ultrasonography, to include problems encountered and equipment needed.

My first encounters with veterinary ultrasound were at my first practice, while training. Andrew Holloway would come in once a week, as we didn’t have an ultrasound machine or a veterinarian with Andrews expertise. The more I helped and watched the scans, the more 1 enjoyed it and saw what a useful tool ultrasonography is in practice.

I think the nurses role is important to complement that of the vet when scanning, as correct handling and positioning of the patient is crucial. We must remember some of the animals can be very unwell, so proper care should be taken.

Where possible, sedation is invaluable because the less the animal moves, the better the picture you achieve. It is also more pleasant for animals with painful abdominal conditions. With patients that cannot have sedation owing to illness, or heart problems in which safe sedation is not always possible, correct handling is vital. I always make sure the patient has something soft to lie on for comfort – in my opinion, a Vetbed is best.

Technique and equipment

The vet will begin the ultrasonography procedure with the patient in right lateral recumbency and the animal’s back towards the nurse. I will then hold the front legs in my right hand and hind legs in my left hand (Figure 1).

Figure 1: Begin with the patient in right lateral recumbency and the animal's back towards the nurse

I do sometimes find it necessary with fractious cats to hold their scruff in my right hand and keep hold of their hind legs; although in these instances it is advisable to ask another nurse to help, if possible. Large breeds of dog can be difficult to hold, so I usually ask for help with these too.

When not sedated, patients can be tense at first, but if everything is kept calm in the room they invariably start to relax.

As nurses helping with ultrasound, it is very useful to the vet if we make sure all necessary equipment is ready before starting. Figures 2 & 3 show everything you should need for ultrasonography.

Figures 2 & 3: Nurses should make sure all necessary equipment is ready before commencing ultrasonography

 Obviously an ultrasound machine is a must, and ultrasound gel provides better contact between the probe and the patient’s skin. Hair clippers are important as clipping is essential to prevent air from becoming trapped and compromising the ultrasound image – sometimes it is not necessary when there is already a convenient bald patch!

A stethoscope is essential for monitoring purposes, especially in cases which are very ill or sedated. For echocardiography, an ECG machine is useful, especially for cases such as draining a pericardial effusion. 

The clinical history, hospitalisation sheet, blood results and other reports are useful to have to hand for reference purposes; and a towel can be useful with fractious cats, as it provides the nurse with protection from sharp claws.

Cotton wool and spirit to wipe any grease away from the surface of the skin, once clipped, also helps provide a better contact with the probe. There should be syringes available for taking samples, and 1-inch needles, which are best for taking ultrasound guided aspirates. A Trucut biopsy needle and histology pot should also be made ready for taking ultrasound guided biopsies, together with different sized pots for collecting fluids.

It is important to make sure that patients are fasted, and allowed to urinate and defecate prior to the ultrasound – except patients for urinary tract investigation, in which cases a full bladder is helpful.

Case in point

I have been fortunate to see many amazing ultrasounds, but my most memorable case has to be a young Bengal cat with a pulmonic stenosis – a congenital heart condition that restricts blood flow through the pulmonary artery, the vessel which takes blood to the lungs for oxygenation. Cardiac ultrasonography – or echocardiography – is particularly interesting, especially when carried out with a machine with Doppler capabilities, which allows the examining vet to determine the speed and direction of blood flow.

Returning to the young Bengal cat – once she had scratched my arms to shreds – she went on to have successful keyhole surgery called balloon valvuloplasty. This involves passing a specially designed balloon-tipped catheter via a vein in the neck or back leg into the heart and then through the narrowed valve. After angiographic studies, this sausage-shaped balloon is momentarily inflated to stretch the defective valve, allowing it to open normally.


Ultrasound is a beneficial tool to have in practice. It is vital, however, also to have a vet and nurse with a special interest in ultrasonography in order to generate the full benefits of the technique and to make optimal use of the ultrasound machine. 


Helen Turner RVN SQP

Helen has been qualified for six years. She has been a head nurse for three years in a busy small animal practice in Buckinghamshire and says she was fortunate enough to work with Andrew Holloway when training, thereby becoming very interested in ultrasound and its benefits. Helen is a keen horse rider and eventing competitor.

To cite this article use either

DOI: 10.1111/j.2045-0648.2011.00110.x or Veterinary Nursing Journal Vol 26 pp 393-394

• VOL 26 • November 2011 • Veterinary Nursing Journal