USE OF ULTRASOUND TO DIAGNOSE DIAPHRAGMATIC RUPTURE IN DOGS AND CATS

Twenty-one cats and six dogs that presented to a first-opinion clinic with signs of dyspnea and muffled cardiac auscultation received ultrasonography to look for signs of diaphragmatic rupture. The presence or absence of diaphragmatic rupture was subsequently determined on the basis of unequivocal radiographic signs, surgical findings, or necropsy. Consistent findings in animals with diaphragmatic rupture were irregular or asymmetric cranial aspect of the liver and abdominal viscera in the thorax. Accuracy of ultrasonography was 25/27 (93%). One false-negative result occurred in a cat with a chronic diaphragmatic rupture in which adhesions between the liver and lung simulated the appearance of an intact diaphragm. One false-positive result occurred in a dog with an abscess involving the left lung and pleural cavity, which was misinterpreted as the stomach. The results of this study support use of ultrasonography in animals with suspected diaphragmatic rupture.     

ULTRASONOGRAPHIC CHARACTERISTICS OF THE CISTERNA CHYLI IN EIGHT DOGS AND FOUR CATS

Ultrasonography of the cisterna chyli has been used in humans to diagnose increased lymphatic flow or lymph flow obstruction and to guide percutaneous embolization of the thoracic duct via the cisterna chyli. The aim of this study was to describe the ultrasonographic characteristics of the dorsal portion of cisterna chyli in dogs and cats with chylous ascites or chylothorax and in a group of healthy dogs and cats. The aorta and the cranial mesenteric artery were used as anatomic landmarks. Ultrasonography was performed before and 2 h after a fatty meal in healthy dogs and cats. The visualized structure was confirmed to be a dilated cisterna chyli at necropsy in a dog with chylous ascites. The confirmed or presumed cisterna chyli was consistently detected using ultrasonography in nonfasted healthy animals and clinically affected animals and appeared as an anechoic tubular structure, without detectable flow, at the right dorsolateral aspect of the aorta. It had a similar ultrasonographic appearance in patients with chyloabdomen and in nonfasted healthy dogs and cats. There was considerable overlap in diameters of the cisterna chyli for affected and healthy animals. The shape and size of the cisterna chyli in an individual animal were variable during the same ultrasound examination and between different examinations. This study demonstrated the appearance of the presumed dorsal portion of the cisterna chyli by ultrasonography and might provide useful preliminary data for further studies into the feasibility of ultrasound‐guided injections or aspirations of the cisterna chyli in dogs and cats.     

SONOGRAPHY OF THE MUSCULOSKELETAL SYSTEM IN DOGS AND CATS

Sonography of the musculoskeletal system in dogs and cats was undertaken to evaluate the application of this imaging procedure in orthopedics. In most of the patients a 7,5 MHz linear transducer was used because of its flat application surface and its resolving power. The evaluation of bone by sonography is limited, but sonography can provide addition information regarding the bone surface and surrounding soft tissue. Ultrasound is valuable for assessing joint disease. Joint effusion, thickening of the joint capsule and cartilage defects can be identified sonographically. It is also possible to detect bone destruction. Instabilities are often identified with the help of a dynamic examination. Soft tissue abnormalities of the musculoskeletal system lend themselves to sonographic evaluation. Partial or complete muscles or tendon tears are able to be differentiated and the healing process can be monitored. Most of the diseases that are in the area of the biceps or the achilles tendon, such as dislocation of the tendon, old injuries with scarification, free dissecates in the tendonsheath, tendinitis and/or tendosynovitis can be differentiated by sonography. In addition, with clinical and laboratory findings, it is often possible to make a correct diagnosis with ultrasound in patients with abscesses, foreign bodies, hematomas, soft tissue tumors and lipomas.     

PERIRENAL EFFUSION IN DOGS AND CATS WITH ACUTE RENAL FAILURE

Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.     

DOPPLER ULTRASOUND OF THE PROSTATE IN NORMAL DOGS AND IN DOGS WITH CHRONIC LYMPHOCYTIC-LYMPHOPLASMOCYTIC PROSTATITIS

The prostate gland of 11 normal dogs and five dogs with histological confirmed chronic lymphocytic or lymphoplasmocytic prostatitis were imaged with grey-scale and Doppler ultrasound. Three vessel types (prostatic artery, capsular artery and parenchymal artery) were identified with color Doppler and the resistive index and maximum and minimum velocities were measured with pulsed wave Doppler. No differences between normal dogs and dogs with prostatitis was identified in either grey-scale ultrasound or in any Doppler parameters measured. Regardless of histologic diagnosis, acepromazine (0.05 mg/kg IV) caused a significant decrease in capsular artery maximum and minimum velocities and prostatic artery resistive index. This study establishes normal Doppler ultrasound parameters for the intact male canine prostate gland. Additional studies are necessary to further evaluate the clinical utility of Doppler ultrasound in canine prostatic diseases.     

UTILITY OF MAGNETIC RESONANCE IMAGING FOR DISTINGUISHING NEOPLASTIC FROM NON-NEOPLASTIC BRAIN LESIONS IN DOGS AND CATS

The aim of this study was to identify magnetic resonance (MR) signs that aid differentiation of neoplastic vs. non-neoplastic brain diseases in dogs and cats. MR images of 36 dogs and 13 cats with histologic diagnosis of intracranial disease were reviewed retrospectively. Diagnoses included 30 primary and three metastatic brain tumors, 11 infectious/inflammatory lesions, three vascular, one degenerative disease, and one developmental malformation. Upon univariate analysis of 21 MR signs, there were seven that had a significant association with neoplasia: single lesion (P = 0.004), shape (P = 0.015), mass effect (P = 0.002), dural contact (P = 0.04), dural tail (P = 0.005), lesions affecting adjacent bone (P = 0.008), and contrast enhancement (P = 0.025). Increasing age was also found to be associated with neoplasia (P = 0.0001). MR signs of non-neoplastic brain diseases in dogs and cats were more variable than those of brain neoplasia.     

RADIOGRAPHIC APPEARANCE OF CONFIRMED PULMONARY LYMPHOMA IN CATS AND DOGS

Herein we describe the thoracic radiographic appearance of confirmed pulmonary lymphoma. Patients with thoracic radiographs and cytologically or histologically confirmed pulmonary lymphoma were sought by contacting American College of Veterinary Radiology members. Seven cats and 16 dogs met the inclusion criteria, ranging in age from 4 to 15 years. Method of diagnosis was via ultrasound‐guided cytology (four), surgical biopsy (two), ultrasound‐guided biopsy (one), and necropsy (16). Radiographic findings varied but ranged from normal (one) to alveolar (six) and/or unstructured interstitial infiltrates (11), nodules and/or masses (eight), and bronchial infiltrates (four). Additional thoracic radiographic findings included pleural effusion and lymphadenopathy. The results of this evaluation indicate a wide variability in thoracic radiographic abnormalities in cats and dogs with pulmonary lymphoma.     

RETROSPECTIVE ANALYSIS OF BRAIN SCINTIGRAPHY IN 116 DOGS AND CATS

We performed a retrospective study of 100 dogs and 16 cats with planar brain scintigraphy and histopathologically established diagnoses from a total of 485 studies performed from 1976 to 1992. Necropsy (112) or surgical biopsies (4) diagnoses were categorized in two ways: first as focal brain disease, diffuse brain disease or normal; second as either neoplastic, non-neoplastic or normal. A radiologist reviewed brain scintigrams and categorized the studies as focal areas of increased accumulation, diffuse or poorly localized areas of increased accumulation, or normal. We calculated for this population of 116 animals that focal brain scintigrams had 75% sensitivity and 90% specificity for any focal brain disease. The sensitivity and specificity of a focal scintigraphic lesion for a brain tumor was 72% and 82% respectively. The sensitivity and specificity of a diffuse or poorly localized scintigraphic lesion as a test for diffuse brain disease was 40% and 88% respectively.     

CELLULAR FEATURES OF SONOGRAPHIC TARGET LESIONS OF THE LIVER AND SPLEEN IN 21 DOGS AND A CAT

Target lesions are seen in ultrasound images of the liver or spleen as nodules or masses with a hypoechoic rim and a hyperechoic or isoechoic center. To assess the diagnostic significance of finding a target lesion, the cytologic and/or histopathologic findings were reviewed in a series of 21 dogs and a cat that had hepatic and/or splenic target lesions noted during abdominal ultrasonography. Twelve of 16 hepatic target lesions and 5 of 7 splenic target lesions were malignant. In this series, the finding of one or more target lesions in the liver or spleen had a positive predictive value for malignancy of 74%; for the finding of multiple target lesions in one organ, the positive predictive value for malignancy was 81%. Benign lesions associated with target lesions were nodular hyperplasia of the liver and spleen, pyogranulomatous hepatitis, cirrhosis, and chronic active hepatitis.     

ULTRASONOGRAPHIC DIAGNOSIS OF PORTOSYSTEMIC SHUNTING IN DOGS AND CATS

The value of ultrasonography was evaluated in 85 dogs and 17 cats presented with a clinically suspected portosystemic shunt (PSS). A PSS was confirmed in 50 dogs and nine cats (single congenital extrahepatic in 42, single congenital intrahepatic in 11, and multiple acquired in six). Six dogs and one cat had hepatic microvascular dysplasia, and 29 dogs and seven cats had a normal portal system. Ultrasonography was 92% sensitive, 98% specific, and had positive and negative predictive values of 98% and 89%, respectively, in identifying PSS, with an overall accuracy of 95%. When a PSS was identified with ultrasonography, extrahepatic, intrahepatic, and multiple acquired PSS could be correctly differentiated in 53/54 patients (98%). The combination of a small liver, large kidneys, and uroliths had positive and negative predictive values of 100% and 51% for the presence of a congenital PSS in dogs. The portal vein/aorta (PV/Ao) and portal vein/caudal vena cava (PV/ CVC) ratios were smaller in animals with extrahepatic PSSs compared with animals with microvascular dysplasia, intrahepatic PSSs and those without portal venous anomalies (P<0.001). All dogs and cats with a PV/Ao ratio of < or = 0.65 had an extrahepatic PSS or idiopathic noncirrhotic portal hypertension. Dogs and cats with PV/Ao and PV/CVC ratios of > or = 0.8 and > or = 0.75, respectively, did not have an extrahepatic PSS. Reduced or reversed portal flow was seen in four of four patients with multiple acquired PSSs secondary to portal hypertension. The presence of turbulence in the caudal vena cava of dogs had positive and negative predictive values of 91% and 84%, respectively, for the presence of any PSS terminating into that vein.     

COMPUTED TOMOGRAPHY OF PRIMARY INFLAMMATORY BRAIN DISORDERS IN DOGS AND CATS

A retrospective study of 22 animals with histologically confirmed, primary inflammatory brain disease was undertaken to determine the value of computed tomography in such patients. The histologic diagnosis was confirmed at necropsy in 18 patients and by surgical biopsy in four. All affected animals had neurologic deficits; the most common presenting complaint was seizures. Abnormalities were identified on computed tomography images in 21 of the 22 patients. The abnormalities included ventricular changes, falcial deviation, edema, focal changes in parenchymal opacity, focal contrast enhancement, periventricular contrast enhancement, and a ring-like pattern of contrast enhancement. Many lesion types identified in this study, such as falcial deviation, changes in parenchymal opacity, and ring-pattern enhancement, have previously been associated with neoplasia. The abnormalities correlated well with the lesion localization predicted by neurologic examination and confirmed by surgery or necropsy. Although computed tomography findings were often judged to be compatible with inflammatory disease, they did not predict the type of pathologic process. The findings suggest that computed tomography is valuable in the evaluation of animals with primary inflammatory brain disorders, but differentiation of neoplasia from non-neoplastic diseases is not always possible.     

ENDOSCOPIC ULTRASONOGRAPHY FOR THE DIAGNOSIS OF INTRATHORACIC LESIONS IN TWO DOGS

Endoscopic ultrasound was developed initially in humans to overcome limitations of conventional ultrasound in examining certain internal organs due to intervening bone or air-filled structures. Endoscopic ultrasound has been used most widely in investigation of the gastrointestinal tract in humans, but many intrathoracic applications as well as endoscopic ultrasound-guided techniques have recently been described. Mediastinal and pulmonary structures can be examined with endoscopic ultrasound since a high frequency ultrasound probe can be brought into close contact with the areas of interest via a transesophageal approach. The purpose of this report is to describe the application of endoscopic ultrasound as an aid in the diagnosis of intrathoracic disease in the dog. Two dogs, one with a history of prior esophageal foreign body extraction, the other with apathy, weakness and dyspnea were referred for further investigation. Both dogs had caudal intrathoracic soft tissue opacities diagnosed radiographically, but their origin and nature were difficult to determine. Conventional ultrasound was limiting in both dogs due to their location and superimposition of gas-filled structures. With endosonography lesions were characterized more completely. We have found endoscopic ultrasound to be an elegant diagnostic tool for the investigation of radiographically detected intrathoracic lesions in the dog whose origins are difficult to determine or do not lend themselves to investigation by conventional ultrasound. Endoscopic ultrasound provides valuable diagnostic information complementary to that provided radiographically which aids in therapeutic planning. Endoscopic ultrasound was also more sensitive for detecting mediastinal lymphadenomegaly than radiography in one of the dogs. An additional advantage of endoscopic ultrasound is the fact that US-guided tissue sampling can be performed during the examination.     

IOHEXOL PLASMA CLEARANCE IN HEALTHY DOGS AND CATS

Iohexol plasma clearance as a measure of glomerular filtration was determined in 31 dogs and 19 cats after an intravenous (i.v.) bolus injection. All animals were healthy and privately owned. Serial blood samples were taken before and up to 4 h after tracer injection. Iohexol plasma concentration was determined using X-ray fluorescence. A plasma tracer elimination curve was generated and clearance was calculated by dividing the injected dose by the area under the curve estimated using a two-compartment pharmacological model. Clearance was normalized to body weight (BW), body surface area (BSA), and extracellular fluid volume (ECFV). Mean, SD, and coefficient of variation of plasma clearance, before and after normalization, were calculated. Linear regression analyses were performed between body size and normalized plasma clearances. No significant linear relation was found between BSA and clearance normalized to BSA in dogs, and between BSA, BW, ECFV and clearance normalized to BSA, BW, and ECFV in cats. The optimal method for normalization of iohexol plasma clearance in dogs was by using BSA. In cats, all three methods tested were considered satisfactory. Normalization to BSA appears to be superior to normalization to BW and ECFV in dogs, and can be recommended for clinical use.     

PREVALENCE AND SIGNIFICANCE OF AN ULTRASONOGRAPHIC COLONIC MUSCULARIS HYPERECHOIC BAND PARALLELING THE SEROSAL LAYER IN DOGS

The muscularis layer of the canine colon has been reported to appear homogeneously hypoechoic on ultrasonography. A hyperechoic band in the muscularis layer paralleling the serosal surface has been observed by authors in routine canine abdominal ultrasound examinations. The purpose of this prospective and retrospective cross‐sectional study was to determine the prevalence of this lesion, characterize its ultrasonographic and postmortem histologic features, and correlate its presence with clinical signs of gastrointestinal disease. In the prospective study, all dogs that underwent routine abdominal ultrasonography by one of two observers during a 4‐week period were included without any exclusion criteria. One observer reviewed ultrasound images and recorded the presence or absence of this lesion and its distribution, e.g. focal (< 2 cm long) or diffuse (> 2 cm long). In the retrospective study, all dogs that had both abdominal ultrasonography and necropsy from January 2011 to December 2013 were included without any exclusion criteria. Histologic examinations were performed by two observers and Masson's trichrome stain was used to identify fibrous collagen. Prevalence for the hyperechoic band was 32% in the prospective and 4.8% in the retrospective sample populations, respectively. The hyperechoic band appeared as diffuse, focal, or a combination of both. Histologic sections were available for six dogs. In a few cases, the lesion corresponded to the presence of fibrous tissue in the myenteric plexus or in the tunica muscularis. None of the dogs had a history of diarrhea. Findings supported the hypothesis that a colonic muscularis hyperechoic band paralleling the serosal layer in dogs could be a normal variant rather than a marker of disease.     

ULTRASONOGRAPHIC FINDINGS IN DOGS AND CATS WITH GASTROINTESTINAL PERFORATION

A retrospective study was performed to evaluate the sonographic features of gastrointestinal (GI) perforation in dogs and cats. Sonographic findings in 19 animals (14 dogs and 5 cats) included regional bright mesenteric fat (19), peritoneal effusion (16), fluid-filled stomach or intestines (12), GI wall thickening (11), presence of free air (9), loss of GI wall layering (9), regional lymphadenopathy (8), reduced GI motility (7), pancreatic changes (4), corrugated intestines (4), presence of a mass (3), presence of a foreign body (3), and mineralization of the gastric wall (1). In 14 patients, "perforation" was listed as a differential diagnosis by the sonographer. Abdominal radiographs and radiographic reports were available for 14 patients. Radiographic findings were decreased serosal detail (12), free air (8), peritoneal contrast medium (1), and suspected foreign body (1). GI perforation was listed as radiographic diagnosis in eight patients, seven of which had evidence of pneumoperitoneum, and one had leakage of contrast material on an upper GI study. In 9/14 patients with radiography, "GI perforation" was listed as a sonographic diagnosis. In three patients in which free air was diagnosed sonographically, radiographs were either not available (2) or the presence of free air was not detected at presentation (1). Peritoneal fluid analysis was performed in nine patients, five of which were identified as septic inflammation, and the remaining four were classified as neutrophilic inflammation with no etiologic agent identified. The histologic or surgical diagnoses were as follows: three intestinal surgical dehiscence; one percutaneous endoscopic gastrostomy tube site leakage; one duodenal adenocarcinoma; one ileocolic lymphoma; one trichobezoar; one ascarid impaction; and one bobby pin foreign body. In the remaining 10 patients, a focal area of gastric/intestinal ulceration or transmural necrosis with perforation was identified without evidence of an underlying cause.     

WHOLE BODY COMPUTED TOMOGRAPHIC CHARACTERISTICS OF SKELETAL AND CARDIAC MUSCULAR METASTATIC NEOPLASIA IN DOGS AND CATS

Muscular metastatic neoplasia has been reported to be rare in domestic animals, however previous studies were based primarily on necropsy findings. The purpose of this retrospective study was to describe whole body computed tomography (CT) characteristics of confirmed muscular metastases in a cohort of dogs and cats presented for oncology evaluation. Medical records of 1201 oncology patients were reviewed. Included animals underwent pre and postcontrast whole body CT, and CT‐guided tru‐cut biopsy or fine needle aspiration of one or more metastatic lesions. Twenty‐one dogs and six cats met inclusion criteria, representing 2.08% of all canine oncology patients and 3.1% of all feline oncology patients. Mean age was 9.6 years. Postcontrast CT characteristics included well‐demarcated, oval‐to‐round lesions with varying enhancement patterns: ring enhancing (n = 16), heterogeneously enhancing (n = 8), or homogeneously enhancing (n = 5). Five animals showed concurrent and varying nodular patterns. In seven cases (five dogs and two cats), one single muscular nodule was observed. In 20 cases, two or more lesions were observed. In two cases, cardiac hypodense nodules were observed in the postcontrast CT, while appearing isodense in the precontrast study. Necropsy confirmed neoplasia in both of them. Locations of muscular metastases included epaxial/paraspinal muscles of the cervical, thoracic, and lumbar spine (n = 18), superficial muscles of the thoracic wall (n = 13), scapular/shoulder region (n = 3), hind limb (n = 3), and abdominal wall muscles (n = 1). Findings supported the use of pre and postcontrast whole body CT for oncologic staging in dogs and cats, especially for primary tumors characterized by a high metastatic rate.     

RETROSPECTIVE ULTRASONOGRAPHIC EVALUATION OF ADRENAL LESIONS IN 26 DOGS

A review was performed of ultrasonographic findings in 26 dogs with confirmed adrenal lesions. Adrenal shape, size, echogenicity, laterality, and the presence of vascular invasion were evaluated. Histopathologic diagnoses were obtained in all dogs. Adrenal lesions were confirmed as pheochromocytomas (9), adenocarcinomas (6), a poorly differentiated blastoma (l), bilateral adrenal metastases of a carcinoma (l), adenomas-one of which was bilateral-(4) and hyperplasia (6). Size and shape were extremely variable and not specific to lesion type. There was a tendency for pheochromocytomas (7), adenocarcinomas (5) and poorly differentiated blastoma (1) to be rounded masses. Adenomas (4), hyperplasia (7) and adrenal metastases (2) presented predominantly as nodules. No specificity in echogenicity was noted. Mineralization and bilaterality were present in both benign and malignant lesions. Vascular extension or the presence of a thrombus were suggestive but not specific signs of malignancy. Based on our prelimiary study, ultrasonography is an effective method for localizing adrenal lesions and is helpful in assessing their extension. However, no definitive differentiation between benign and malignant lesions was possible using ultrasonographic criteria alone.     

DOPPLER ULTRASONOGRAPHIC ESTIMATION OF RENAL AND OCULAR RESISTIVE AND PULSATILITY INDICES IN NORMAL DOGS AND CATS

Resistive index (RI) and pulsatility index (PI) are indirect measurements of blood flow resistance that may be used to evaluate vascular changes in renal and ophthalmologic diseases. To our knowledge, no reports are available describing values for renal and ocular PI index in the unsedated dog and ocular RI and PI indices in the unsedated cat. The purpose of this study was to measure normal values for both intrarenal and ocular RI and PI within the same subject in unsedated clinically normal dogs and cats. Twenty-seven dogs and 10 cats were considered healthy by means of physical examination, CBC, biochemical profile, urinalysis, and ultrasonography. Systolic blood pressure was measured by Doppler ultrasonography. Intrarenal and ocular arteries were scanned by pulsed Doppler ultrasonography to calculate RI and PI. No significant differences were noted between the values obtained for the right vs. the left kidney and eye. The upper values of these indices were calculated as mean+2 standard deviations resulting in 0.72 and 1.52 for dog renal RI and PI; 0.7 and 1.29 for cat renal RI and PI; 0.76 and 1.68 for dog ocular RI and PI; and 0.72 and 1.02 for cat ocular RI and PI.     

RADIOGRAPHIC DIAMETER OF THE COLON IN NORMAL AND CONSTIPATED CATS AND IN CATS WITH MEGACOLON

Radiographs of 50 cats with no history of gastrointestinal disease were evaluated to establish a normal reference range for radiographic diameter of the feline colon. Thirteen cats with constipation and 26 with megacolon were also evaluated and compared with the normal cats to characterize the accuracy of the reference range and to identify a cutoff to distinguish constipation from megacolon. A ratio of maximal diameter of the colon to L5 length was the most repeatable and accurate measurement. A ratio <1.28 is a strong indicator of a normal colon (sensitivity 96%, specificity 87%). A value >1.48 is a good indicator of megacolon (sensitivity 77%, specificity 85%).     

TISSUE HARMONIC ULTRASOUND FOR IMAGING NORMAL ABDOMINAL ORGANS IN DOGS AND CATS

Normal cats (n = 38) and dogs (n = 40) were imaged with fundamental ultrasound and tissue harmonic ultrasound. Images of the liver, gall bladder, spleen, left kidney, urinary bladder, and jejunum were collected in all animals. Images of the left adrenal gland were collected in all dogs. All normal cats and dogs had improved imaging with tissue harmonic ultrasound. The number of organs with improved conspicuity ranged from one to all organs imaged. The most common organ to have improved conspicuity was the jejunum (100% of dogs and 89% of cats). Significant improvement by tissue harmonic ultrasound was seen in images of gall bladder (p = .05) and left adrenal gland (p = .02) in dogs, and spleen, urinary bladder, and intestinal images (p = .01) in cats. Significant improvement was seen in tissue harmonic ultrasound images of the gall bladder in dogs weighing greater than 16 kilograms (p = .03) and in the images of the urinary bladder of dogs weighing less than 16 kilograms (p = .02). These data suggest that image quality improvement of normal organs using tissue harmonic ultrasound is consistent but not predictable. The exception was the jejunum, where improvement was seen in all dogs. Sonographers should be cognizant of the potential benefits of tissue harmonic ultrasound.