Let’s say your pet’s been off her food for a few days. X-rays, labwork and physical examination have been less than completely rewarding. Still, everything points to something amiss with her liver. Ten or twenty years ago we would’ve jumped right into her abdomen to take a look-see. In today’s world? We’d order an ultrasound.
Ultrasound is a means of seeing what lies beneath the surface by sending sound waves into it and registering an image that corresponds to the way the waves bounce off the structures within it. It’s neat. And it can be incredibly helpful. But it’s not so easy to do as the ultrasound technician or doc typically makes it look.
Sure, a baby looks just like a baby when the ultrasound probe is aimed just right, but that’s a far cry from interpreting the vagaries of normal kidney morphology or that of abnormal liver tissue. And yet this tool is so cool an expert handler can render surgery unnecessary in cases for which we once considered it the only way to know what lurked beyond our field of vision.
But an ultrasound often carries a hefty price: anything from $50 to $500 according to my vet sources from California and Oregon to Chicago, New York and Miami. The differences in prices for this service vary less by region than they do based on the individual veterinarian performing it, his or her equipment and the type of ultrasound exam that’s offered (reproductive, abdominal, chest or extremity).
In general, ultrasounds for reproductive examinations are least expensive. In these, the vet is looking for something pretty obvious: Are fetuses present or not? Are their hearts beating or not? That’ll be fifty bucks, please—in the least pricey places. The specialized vet establishments and tonier practices will often price it out as an abdominal ultrasound—for $250-$500, depending on your luck.
The price differential in these cases often has more to do with the price of the equipment utilized. For pregnancy exams providing the most basic information, a minimally functional ultrasound machine is acceptable. These run anywhere from $5,000 to $10,000 for used equipment. At a high-end hospital, this equipment can cost as much as $200,000. And while that kind of quality can be unnecessary for basic "are they there or not?" preg checks, it can make a huge difference in evaluating minor changes in organs and evaluating the chambers of the heart.
But there’s a lot more than equipment and luck involved in a thorough, expert examination of the chest or abdomen on ultrasound. Internists, radiologists, cardiologists (for the chest) and oncologists are the specialists most likely to offer more expensive services in the upper range (I’ve seen $200 to $500 per area or cavity, depending on the specific specialist). They do multiple ultrasounds every day. They know what they're looking at.
In many cases, ultrasound technicians (who may be either human-schooled and vet cross-trained or veterinarians who just love ultrasound) are the providers of ultrasound services. They may even be better at this diagnostic procedure than specialized vets (with the possible exception of vet radiologists, who are typically considered the undisputed experts in this field). After all, they spend their entire careers doing these studies.
The best of these ultrasound vets or techs work in conjunction with specialists to arrive at a diagnosis. Their services tend also to be priced at $200-$500 per area, depending on the quality of their equipment and the degree of their specialist assistance and their expertise.
Then there are the generalist practitioners who take an interest in ultrasound, possess the appropriate equipment, and offer more than the basic reproductive examination most of us can manage given any sort of functioning ultrasound machine.
Some of these practitioners are good at ultrasounds—very good. They have good equipment, sometimes great equipment. Most have taken advanced coursework in ultrasonography. The very best of these will even forward their findings to specialists (usually a radiologist) to interpret these images for them. They usually charge anywhere from $100-$400 per cavity depending on the quality of their equipment, degree of proficiency and utilization of a specialist for interpretation.
Then there are the hacks—vets who have access to a machine and presume to know what they’re looking at but really have little expertise. They’re also often willing to charge you over $200 just to turn on the ultrasound machine—in spite of their inexperience. All the others are worth their fees; these are the ones you need to look out for. So ask the basic questions:
1-Do you have specialized training in ultrasound techniques?
2-What kind of ultrasound machine do you have (a laptop with a USB probe is usually worth a lot less than a modern, free-standing machine)?
3-Do you have a board-certified specialist interpreting these results?
This tends to help you decide whether your money’s best spent here or at the specialty hospital, where you know your ultrasound will be evaluated by someone with a higher degree of training in this arena.
Ultrasounds can be priceless if they help you avoid surgery and arrive at a diagnosis. They’re also immensely valuable when they tell you what’s NOT there, even if they can’t help you reach a definitive conclusion. But neither of these goals is reliably achievable unless you have the right provider using the right equipment. Consider this as you make your decision on your pet’s next ultrasound-invoking healthcare crisis.
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Patty - what sort of credentials would a DVM who is trained in ultrasound have specifically?
Alex February 9th, 2008 10:32:00 AM
I once chatted with my vet about this:
He told me that when he worked in the US (he worked in the NJ area), he would automatically forward the scan to vet radiologists to get another opinion, and he misses the fact that here (in Israel) he doesn't have such a service available.
On the other hand, we both agreed that it wouldn't be easy to get people here to pay for such services (and this is a pretty up-scale clinic). Not that ultrasound machines cost any less here than in the US (on the contrary).
Xslf February 9th, 2008 11:19:00 AM
I wonder if pet insurance covers this?
And this question is really a ruse to remind you that you were going to do a post on health insurance. I've been waiting with bated breath. (or more accurately my dog Dixie has.)
Larry February 9th, 2008 12:10:00 PM
Locally, there is a vet that travels with his equipment and does scans- I want to say they start at $250 a pop. My vet hospital that my cats go to- which I consider top-of-the-line owns it's own ultrasound equipment and I can get a basic scan for $50-$75. My personal vet whom I adore is actually specializing in ultrasound- so that makes matters even better!
Trish February 9th, 2008 12:33:00 PM
My vets clinic has an ultrasound machine but has a board certified radiolgist that travels to the clinic once or twice a week for the ultrasounds. Bo's abdominal ultrasound (cat) in December was $255.
Jenny February 9th, 2008 03:50:00 PM
I didn't even know about the USB ultrasounds. How much difference would there be between the readings from a USB US and a 'free-standing machine' US if they were performed and read by someone with certification?
Sherri February 9th, 2008 08:33:00 PM
Alex: No credentials other than certification of completion of one of a large number of ultrasound courses. Unfortunately, the companies that sell you the ultrasound machine are often ready to hand out these certificates once you complete a 14-hour course. And that's not nearly enough. But that desn't mean I can't use an ultrasound machine and provide some value (even though I've only taken a short course). I can find my way around an abdomen pretty well. If I can email my images with my notes to a radiologist, this kind of ultrasound can be quite valuable. Than there's a vet I know 2 miles away who has NO certification but has excellent equipment and does tons of ultrasounds because he loves to do them. He's got great skills--but no proof of it anywhere on paper.
Someone certified in human ultrasound who also works on animals will have human certification--and this is gnerally a great indicator (as long as they'v been working on animals with a veterinarian for a solid amount of time--at least 6 months or so). All internists, oncologists, radiologists and cardiologists graduating after 1990 will typically have excellent ultrasound skills.
Unfortunately, it's a bit like the Wild West when it comes to ultrasounds in vet medicine. Because ultrasound techniques aren't covered indepth in all vet schools, because many clinics still don't treat ultrasound as a basic skill (as with X-rays, for example), and because no uniform certification exists (as for humans), it will remain a problem for owners trying to determine whether they're getting their money's worth or not.
I hope that clarifies things somewhat.
Dr. Patty Khuly February 10th, 2008 11:49:00 AM
Sherri: These neat little USB attached probes interest me for my level of skill because I can easily determine whether fluid is present in a mass or whether there are stones in a bladder. High-contrast type of images are reasonably achievable for simple things like this with one of these devices. They certainly have their place. But fine differences in contrast are difficult to discern with these so far. The new free standing machines are far superior in their ability to provide sharp images needed to make the difficult diagnoses ultrasounds are famous for--especially if you plan to send the images to a radiologists. Many will laugh you off if you try to send such technically rudimantary pictures.
Dr. Patty Khuly February 10th, 2008 11:53:00 AM
Larry: I am working on my pet insurance post. After my son's birthday party, OK? I'm freaking out with all my household single mom duties right now. Count yourself lucky I've got a cache of posts ready to go out once or twice a day for now!
Dr. Patty Khuly February 10th, 2008 11:55:00 AM
Thanks Dr. Patty. The original information in this post, plus your answer in the comments will help me with decision making about ultrasounds should one ever be ordered (for my pets, or perhaps even one of us humans, if those USB US's are used on humans too).
Sherri February 12th, 2008 04:35:00 PM
The USB ultrasound probes are FDA certified and are being used in many applications, today. There are many types of probes and specifications so I'd not worry about if it's a USB probe, but rather if the person using it knows what they are doing and are using the right equipment for the application. Using a low-frequency probe for cat imaging is just plain stupid, for example, but if the user and sales people don't understand what ultrasound is and does, it will be used and will look lousy. I have seen images with USB probes (~$5000 systems) that rival those from $25,000+ systems. They are scanning probes, however, not arrays so it's hard to compare them to a $500,000 system hospitals use!
Dave April 12th, 2008 09:47:00 PM
I have a cat who is positive for FIV and is very very sick. I finally found a vet who didn't just write this poor kitty off, but who worked with me, examined the cat again and took x-rays, the helped me to understand what was going on with my cat at this point. Cat is bone thin, not eating and the recommendation is to "put him down" due to poor quality of life. The only recommendation made was to have an ultrasound done on the cat to see exactly what's going on (x-rays showed so much fluid in the abdomen that no organs were visible, but the vet does feel a large mass in the kidney area). Bottom line - I want to have the ultrasound done so I know beyond a shadow of a doubt that there is nothing else I can do for my cat. But I don't want to put him thru much more trauma - this poor little thing has been thru enough. What do they have to do to him to perform the ultrasound? And do you think it's worth it at this point....?
Jan Prater April 18th, 2008 11:24:00 AM
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Emma Christie February 20th, 2009 07:33:14 AM
Is there any difference between human cardiac ultrasound systems and veterinary ultrasound systems? The prices are greater for the human ones, but it seems like the higher frequency probes can be used on both? If this is the case, why not buy vet ultrasounds which generally are more affordable?
Dave August 16th, 2009 12:28:23 AM
Thanks for the information
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