IVPOCUS Clinical Vignette – AFAST and Fluid Scoring in a Heart Disease German Shepherd or Not?

IVPOCUS Board Member Laurent Sakarovitch of France explains his approach to a German Shepherd with a history of heart disease that arrives collapsed. After physical examination he does and AFAST and then returns for a Focused Spleen. After finding the splenic mass, thoracic radiography is performed and obvious pulmonary metastasis are found. The updated approach for Global FAST is to perform AFAST followed by a Focused Spleen as routine. With recent studies by our IVPOCUS President, Greg Lisciandro, DVM, DABVP, DACVECC, Vet BLUE has been shown to exceed 3-view thoracic radiography for the detection of alveolar-interstitial edema (Ward et la. JVECC 2018), pulmonary contusions (Dicker et al. In Press JVECC 2019) and lung metastasis (Kulhavy et al. 2015). A LINK to current publications is available at https://fastvet.com/publications-references-validating-fastvet-techniques/

Based on clinical research of which he has been involved, Dr. Greg Lisciandro now advocates staging all splenic mass cases with and without hemoabdomen with a Global FAST Approach (combining AFAST, TFAST and Vet BLUE) for immediate survey for obvious metastasis and thus a better means for presentation to the client as whether or not the patient is (no obvious metastasis on Global FAST) or is not (obvious metastasis – liver, pericardial effusion/heart, pleural effusion, lung) a surgical candidate. Thank you Dr. Sakarovitch for sharing this case!


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