1) What are your prices?
See the link on the services page: “Fees and discounts.” If you still have questions, please contact email@example.com or call/text 541.912.2454
2) Do you offer weekend appointments?
For ultrasound, yes. In urgent weekend cases, please text 541.912.2454. There is an additional emergency fee of $100 during Sunday and evening hours (after 6 pm). There is no emergency fee between the hours of 9-6 on Saturdays.
3) What areas do you service?
All of central Oregon within 60 minutes of Bend, including Bend, Tumalo, Sisters, LaPine, Sunriver, Redmond, Terrebonne, Prineville, and Madras.
4) How do ultrasounds work?
The referring clinic will schedule with their client via the website scheduling program for a time that works for all parties. A room that can be darkened, an electrical outlet, an assistant trained in animal restraint, and an exam table will be necessary for the ultrasound. Please schedule at a time that these necessities will be available. Dr. Gray will arrive at the scheduled time, and will usually call 5-10 minutes in advance of the appointment to allow the animal to be shaved and sedated. When the ultrasound is completed, Dr. Gray will round with the referring vet on findings. The referring vet should be ready to make a decision about the plan moving forward including fine needle aspirates, sending images to specialists, etc. Dr. Gray will then email a summary of findings OR the specialists’ report to the clinic within 24 business hours. An invoice will be sent to the clinic by email, with a due date of 30 days post receipt.
8) Can the owner be present for the ultrasound?
Sure! However, they should be counseled to remain still and quiet and allow the staff to restrain their pet. Nervous or agitated owners need to be asked to wait in the lobby. Dr. Gray should be prepared ahead of time for the owner’s presence, and the referring veterinarian is still responsible for communicating findings and plan going forward.
9) How long do ultrasounds take?
This depends largely on the patient. In a tractable, sedated patient, an abdominal ultrasound takes 15-30 minutes. In a fractious or agitated patient, it may take much more time to obtain quality images. Echocardiograms usually take approximately 30-45 minutes, again dependent on the cooperation of the patient. Owners, if present, should be provided with a chair.
10) What sedation protocol do you recommend?
Whatever the clinic and referring doctor is most comfortable with! Many clinicians find a titration of propofol to be the easiest quick sedation for procedures such as fine needle aspirates. For general abdominal scans, a combination of butorphanol and dexdomitor (low dose, less than 5 mcg/kg) can be given IV or IM. For geriatric or very ill patients, butorphanol alone given IV can work very nicely. For cardiac scans, no sedation is preferred, however butorphanol (+/- midazolam) can be successfully used to help very nervous patients relax. Please talk to Dr. Gray in advance if you wish to discuss appropriate sedation protocols.
11) I thought sedation wasn’t needed for ultrasounds! Why do you recommend it?
In human emergency medicine, there was a study showing significant missed pathology when FAST ultrasounds were completed on wiggly children without sedation. The same thing occurs in our pets. Motion, panting, tensing of the abdomen, pain, and vocalizing all decrease the quality and detail of the images we obtain. Panting often leads to significant aerophagia, resulting in such a gas filled stomach that the pylorus, pancreatic body, duodenal papilla, and right limb of the pancreas are not even visible. For that reason, although ultrasound can be done without sedation, the results are often much better with sedation. In the end, it is the call of the owner and the referring veterinarian.