1. Ultrasound of the Kidneys
Wendy Blount, DVM
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2. Transition Adjustments
Depth – relatively superficial on the right, left varies
Frequency – varies MHz (higher for smaller pets)
deeper penetration for large dogs comes at the expense of detail
May need lower frequency than bladder and gut
Gain and Contrast – usually no change from liver & spleen
TGC – adjust as needed
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3. Landmarks for Kidneys
Left Kidney – location variable – caudal to left costal arch
Spleen serves as an acoustic window
Caudal to the stomach
Dorsal and medial to the spleen, caudal to the spleen head
Right Kidney - usually cranial & dorsal to the left kidney
Follow the caudate lobe of the liver caudally until you find it
Or start at the dorsal aspect of the right costal arch, rocking the probe cranially
Caudal to pylorus & liver, adjacent to the duodenum
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4. Landmarks for Kidneys Left Kidney – location variable
Spleen serves as an acoustic window
Caudal to the stomach
Dorsal and medial to the spleen
Right Kidney - usually cranial & dorsal to the left kidney
Follow the caudate lobe of the liver caudally until you find it
Or start at the dorsal aspect of the right costal arch, rocking the probe cranially
Caudal to pylorus & liver, adjacent to the duodenum
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5. Landmarks for Kidneys Left Kidney – location variable
Spleen serves as an acoustic window
Caudal to the stomach
Dorsal and medial to the spleen
Right Kidney - usually cranial & dorsal to the left kidney
Follow the caudate lobe of the liver caudally until you find it
Or start at the dorsal aspect of the right costal arch, rocking the probe cranially
Caudal to pylorus & liver, adjacent to the duodenum
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6. Landmarks for Kidneys Left Kidney – location variable
Spleen serves as an acoustic window
Caudal to the stomach
Dorsal and medial to the spleen
Right Kidney - usually cranial & dorsal to the left kidney
Follow the caudate lobe of the liver caudally until you find it
Or start at the dorsal aspect of the right costal arch, pointing the probe cranially
Caudal to pylorus & liver, adjacent to the duodenum
Free PowerPoint Templates

7. Landmarks for Kidneys Left Kidney – location variable
Spleen serves as an acoustic window
Caudal to the stomach
Dorsal and medial to the spleen
Right Kidney - usually cranial & dorsal to the left kidney
Follow the caudate lobe of the liver caudally until you find it
Or start at the dorsal aspect of the right costal arch, pointing the probe cranially
Caudal to pylorus & liver, adjacent to the duodenum
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8. Image Views Sagittal Views (4 for each kidney)
Medial– “Dumbbell View”
Mid-Sagittal, Fan Medial - Renal Sinus & Pelvis
Mid-Sagittal, Fan Lateral – “Tomato View”
Lateral
Transverse Views (3 for each kidney)
Cranial Pole
Mid-Transverse - Renal Sinus & Pelvis (renal pyramid/crest)
Caudal Pole
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9. Image Views Sagittal Views (4 for each kidney)
Medial– “Dumbbell View”
Mid-Sagittal, Fan Medial - Renal Sinus & Pelvis
Mid-Sagittal, Fan Lateral – “Tomato View”
Lateral
Transverse Views (3 for each kidney)
Cranial Pole
Mid-Transverse - Renal Sinus & Pelvis (renal pyramid/crest)
Caudal Pole
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10. Scanning
Left Kidney
Sagittal
Views
Medial
“Dumbbell View”

11. Scanning
Left Kidney
Sagittal
Views
Medial
“Dumbbell View”

12. Scanning
Left Kidney
Sagittal
Views
Medial
“Dumbbell View”

13. Scanning
Left Kidney
Sagittal
Views
Medial
“Dumbbell View”

14. Scanning
Left Kidney
Sagittal
Views LK
Medial
“Dumbbell View”

15. Mid-Sagittal – Fan Medial
Scanning
Left Kidney
Sagittal
Views
Mid-Sagittal – Fan Medial
Renal Sinus
& Pelvis

16. Mid-Sagittal – Fan Medial
Scanning
Left Kidney
Sagittal
Views
Mid-Sagittal – Fan Medial
Renal Sinus
& Pelvis

17. Mid-Sagittal – Fan Medial
Scanning
Left Kidney
Sagittal
Views
Mid-Sagittal – Fan Medial
Renal Sinus
& Pelvis
Medial
(renal sinus/pelvis)

18. Mid-Sagittal – Fan Lateral
Scanning
Left Kidney
Sagittal
Views
Mid-Sagittal – Fan Lateral
“Tomato View”
Renal Diverticuli

19. Mid-Sagittal – Fan Lateral
Scanning
Left Kidney
Sagittal
Views
Mid-Sagittal – Fan Lateral
“Tomato View”
Renal Diverticuli

20. Mid-Sagittal – Fan Lateral
Scanning
Left Kidney
Sagittal
Views
Mid-Sagittal – Fan Lateral
“Tomato View”
Renal Diverticuli

21. Scanning
Left Kidney
Sagittal
Views
Lateral
Cortex

22. Scanning
Left Kidney
Sagittal
Views
Lateral
Cortex

23. Scanning
Left Kidney
Sagittal
Views
Lateral
Cortex

24. Scanning
Left Kidney
Sagittal
Views
Lateral
Cortex

25. Scanning Transverse Views Mid-Transverse Left Kidney “C”
Renal Sinus & Pelvis

26. Scanning Transverse Views Mid-Transverse Left Kidney “C”
Renal Sinus & Pelvis

27. Scanning Transverse Views Mid-Transverse Left Kidney “C”
Renal Sinus & Pelvis

28. Scanning Transverse Views Mid-Transverse Left Kidney “C”
Renal Sinus & Pelvis LK

29. Scanning
Left Kidney
Transverse
Views
Cranial
Pole

30. Scanning
Left Kidney
Transverse
Views
Cranial
Pole

31. Scanning
Left Kidney
Transverse
Views
Cranial
Pole

32. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

33. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

34. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

35. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

36. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

37. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

38. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

39. Scanning
Left Kidney
Transverse
Views
Caudal
Pole

40. Scanning the
Mid-Abdomen (gut)
will be covered
in the next
section

41. Scanning
the Right Kidney
Sagittal
Views
Medial
“Dumbbell View”

42. Scanning
the Right Kidney
Sagittal
Views
Medial
“Dumbbell View”

43. Scanning
the Right Kidney
Sagittal
Views
Medial
“Dumbbell View”

44. Scanning
the Right Kidney
Sagittal
Views
Medial
“Dumbbell View”

45. Sagittal Views Medial Scanning the Right Kidney “Dumbbell View” Medial
(poles symmetrical)

46. Mid-Sagittal – Fan Medial
Scanning
the Right Kidney
Sagittal
Views
Mid-Sagittal – Fan Medial
Renal Sinus
& Pelvis

47. Mid-Sagittal – Fan Medial
Scanning
the Right Kidney
Sagittal
Views
Mid-Sagittal – Fan Medial
Renal Sinus
& Pelvis

48. Mid-Sagittal – Fan Medial
Scanning
the Right Kidney
Sagittal
Views
Mid-Sagittal – Fan Medial
Renal Sinus
& Pelvis
Medial
(renal sinus/pelvis)

49. Mid-Sagittal – Fan Lateral
Scanning
the Right Kidney
Sagittal
Views
Mid-Sagittal – Fan Lateral
“Tomato View”
Renal Diverticuli

50. Mid-Sagittal – Fan Lateral
Scanning
the Right Kidney
Sagittal
Views
Mid-Sagittal – Fan Lateral
“Tomato View”
Renal Diverticuli

51. Mid-Sagittal – Fan Lateral
Scanning
the Right Kidney
Sagittal
Views RK
Mid-Sagittal – Fan Lateral
“Tomato View”
Renal Diverticuli
Mid sagittal

52. Scanning
the Right Kidney
Sagittal
Views
Lateral
Cortex

53. Scanning
the Right Kidney
Sagittal
Views
Lateral
Cortex

54. Scanning
the Right Kidney
Sagittal
Views
Lateral
Cortex

55. Scanning
the Right Kidney
Sagittal
Views
Lateral
Cortex

56. Transverse Views Mid-Transverse Scanning the Right Kidney
Renal Sinus & Pelvis

57. Transverse Views Mid-Transverse Scanning the Right Kidney “Reverse C”
Renal Sinus & Pelvis

58. Transverse Views Mid-Transverse Scanning the Right Kidney “Reverse C”
Renal Sinus & Pelvis

59. Transverse Views Mid-Transverse Scanning the Right Kidney “Reverse C”
Renal Sinus & Pelvis
Mid (renal sinus/pelvis)

60. Scanning
the Right Kidney
Transverse
Views
Cranial
Pole

61. Scanning
the Right Kidney
Transverse
Views
Cranial
Pole

62. Transverse Views Cranial Pole Scanning the Right Kidney RK

63. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

64. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

65. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

66. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

67. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

68. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

69. Scanning
the Right Kidney
Transverse
Views
Caudal
Pole

70. Scanning
the Right Kidney
Transverse
Views RK
Caudal
Pole
Caudal pole

71. Goals of Kidney Ultrasound
Video
Academy of Veterinary Imaging: dorsal recumbency
Goals of Kidney Ultrasound
Anatomy
Size
Symmetry
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72. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
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73. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
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74. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Incomplete scan - medial and lateral
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75. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Right Kidney – Sagittal – Medial to Lateral
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76. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Right Kidney – Sagittal – Medial to Lateral
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77. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Right Kidney – Sagittal – Medial to Lateral
Incomplete scan- lateral and caudal
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78. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Right Kidney – Sagittal – Medial to Lateral
Interference from gas in duodenum
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79. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Right Kidney – Sagittal – Medial to Lateral
Transverse scan (R or L) – Cranial to Caudal
Only if abnormal
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80. Telemedicine Videos Left Kidney – Sagittal – Lateral to Medial
Right Kidney – Sagittal – Medial to Lateral
Transverse scan (R or L) – Cranial to Caudal
Only if abnormal
Lack of gel and air in colon, and lack of gel
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81. Acknowledgments Stephanie Lisciandro, ACVIM (Internal Medicine)
Chapter 5: Focused or COAST3 – Kidneys Focused Ultrasound Techniques for the Small Animal Practitioner Editor Greg Lisciandro
Bob Cole, ACVR
Auburn University
The Academy of Veterinary Imaging
2409 Avenue J, Suite C Arlington, TX (800)

82. Acknowledgments John Mattoon, Danelle Auld, Thomas Nyland
Chapter 4: Abdominal Ultrasound Scanning Techniques Small Animal Diagnostic Ultrasound Editors Nyland and Mattoon – 3rd Edition 2014
Thomas Nyland, John Mattoon, Eric Herrgesell. Erik Wisner
Chapter 9: Urinary Tract Small Animal Diagnostic Ultrasound Editors Nyland and Mattoon – 3rd Edition 2014
John P. Graham, MVB, MSc, DVR, MRCVS
Diplomate, ECVDI, Diplomate, ACVR Diagnostic Imaging in Dogs and Cats Nestle Purina – Clinical Handbook Series