Seeing inside your pet to make a diagnosis

Digital Radiography at Oak Tree

Radiology-Desk  | Edinburgh Vets

Some time ago, we left the traditional black and white gelatin films in the past, where they belong, and are now on our second digital solution. We are proud to offer you direct digital radiography, the same technology on offer at modern teaching hospitals like the Royal Infirmary of Edinburgh.

As you will know, an x-ray used to be a black and white film and going digital allows many more shades of grey, meaning more can often be seen in the image, compared to a film x-ray. The first digital systems, called CR or Computerised Radiology used a reusable digital “film” read by a scanning machine line by line and was certainly a step forward. DR or Digital Radiography uses a fixed sensor with millions of tiny sensors to directly capture the image and send it to the computer. To give you an idea a penny would cover over 16,000 sensors each contributing it’s own tiny dot making up a hugely detailed image. All in about four seconds!

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  • BXkkk1bBh_B_300px  | Edinburgh Vets

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The advantages for you and your pet include:

1) Quality of image. Digital Radiography (DR) is currently state of the art and is the gold standard. You see the direct image, whereas a computerised image from the reusable film (CR) is a bit like a photocopy of a photocopy and whilst a step up from films, our digital system produced images, often of jaw dropping quality. I (Alistair) have always been an enthusiastic radiologist, gaining a Royal College of Veterinary Surgeons Postgraduate Certificate in the subject, early in my career and I rarely miss the opportunity to sit in on a x-ray reading seminar at conferences. I would be proud to display the images we now take at Oak Tree, as being equal to those on display from much bigger facilities and veterinary schools.

2) No delay. As soon as the equipment is turned on, we are ready to take the radiograph. With an old fashioned wet film processor, 15-20 minutes is needed for the fluids to warm up, even longer with manual processing, still seen in some veterinary practices. With our new system, your pet’s image is on the big high-resolution FDA approved viewing monitor – Food and Drug Administration in America who approve medical equipment in the US.

3) Fewer exposures. As the software can view many more greys, a potentially light or dark image is automatically adjusted so we can see what we need to, whereas with a film, what you see is what you get and would need to be repeated. Often a film taken for bone is too dark for the soft tissues and a film taken for soft tissues is too white for bone. With digital you can see both properly, through the contrast controls.

4) Lower dose. We have been able to reduce the x-ray settings converting to digital. Although all x-rays involve a minute radiation risk, any reduction has to be welcome.

5) A digital image can be copied to a disc or emailed. This means we can send a copy of your pet’s x-rays to a specialist anywhere in the world. There are now emerging telemedicine services, meaning a difficult x-ray can be viewed, somewhere in the world, by a certified expert and a report given electronically within the hour, at a cost, of course.

6) Environmentally sensitive. We no longer need to buy and store films or buy and dispose of chemicals, which include silver salts which are potentially hazardous to the environment. A saving in things and a saving in fuel for delivery and collection mean a significant reduction in carbon footprint over the long term.

What’s the downside?

You could purchase and service a pretty swish car for what we have invested going digital, so there is not a financial saving at present. However, I am sure you would rather see your money being invested in your pet’s care, enabling a better quality service to be provided, rather than continuously spent on consumables to throw away.

Some Examples

Dog Thorax (Chest)

This a CR picture which is good
1st  | Edinburgh Vets
2nd  | Edinburgh Vets
This a DR picture which looks great!
This is the sort of detail achievable with digital
3rd  | Edinburgh Vets
Do you see what is wrong on this DR image?

Follow each of the toes down from the carpus (wrist) down to the claws
On the outside toe (the one furthest from the dew claw), next to the left marker, you will see the first short bone called a phalynx has broken into multiple fragments.

Bladder stones
4th  | Edinburgh Vets
There were more than 60 stones in the bladder of this dog on a CR image. They were removed surgically.
The horizontal row of whitish blobs is, in fact, faeces and is normal for a dog fed on raw chicken!

Here are the stones
5th  | Edinburgh Vets
Rabbit Skull
6th  | Edinburgh Vets
Note the long incisor (front) teeth on the CR image, the big gap and then the molars and how long the roots are. All of these teeth grow continuously through the rabbit’s life. The gap between the teeth is known as a diastema.

Pregnant cat with a kitten
7th  | Edinburgh Vets
If you look carefully in the abdomen, you can see the skeleton of an unborn kitten.

Cat’s jaw showing a bone infection
8th  | Edinburgh Vets
This CR picture of an elderly cat, with many of the teeth missing, shows a big swelling on the chin both in the bone and soft tissues overlying. Although consistent with a tumour, this animal fortunately had a bad infection which responded very well to a long course of antibiotics. The diagnosis was made by taking a biopsy (a sample) of the bone using a special circular scalpel.

Follow up x-ray for an Orthofoam MMP TTA Procedure
9th  | Edinburgh Vets
This is the follow up post op image from a patient having had the Orthofoam MMP TTA Procedure for a cruciate ligament failure a few weeks previously. The triangular titanium wedge can be clearly seen as well as the locating pin and tension relieving staple. This patient went on to make a good functional recovery. The procedure is discussed in the cruciate page and the patient has done extremely well.

Cat who swallowed multiple hair elastics
10th  | Edinburgh Vets
You can see both the metal joiners and the fabric of the elastic bands with the resolution of digital.
Here’s the cat with his collection of hair bands.

Cat with hair bands
cat1  | Edinburgh Vets
This case also features on our endoscopy page with a video.

Dog who ate enough grass to fill her stomach
12th  | Edinburgh Vets
You can see the stomach is packed full of some sort of material, food or vegetation. On endoscopy we could see it was packed with blades and stems from a coarse grass. Twelve hours of patient endoscopy and this is what we recovered, without surgery.

grass  | Edinburgh Vets
Grass is never a square meal for your dog!
The dog who lost seven stones in a single day
14th  | Edinburgh Vets
This was the result of an investigation of a patient who had vomited intermittently over a few days. As you can see there is a collection of stones in the stomach and one near the other end. They were removed endoscopically and the video can be seen here. After seven stones and some grass was removed, we did a check x-ray to make absolutely sure that we had not missed one.