Bovine ultrasound can be faster than palpation

Q. Are you using ultrasound for both dairy and beef cattle?

A. This area of the country is mostly dairy, but I also work for one excellent registered Angus herd. Dairy clients tend to be most interested in identifying open cows as soon as possible and finding out if pregnant cows are carrying twins. Beef clients tend to be more interested in fetal aging and fetal sexing. My focus is on reproduction, but ultrasound can be used for many diagnostic purposes and for carcass evaluation in beef cows.

Dr. Jill Colloton

I pick up a new client almost weekly even though I do very little advertising. There have been many articles about ultrasound in the lay press in recent years and clients understand the advantages.

Q. Is it difficult to get your clients to accept ultrasound?

A. Although ultrasound has been used in cattle since the early '80s, it was still a pretty novel technology for routine bovine use in 1995. At that time, there was also very little training available, so my partner and I felt unsure of our ability. Our solution was to offer ultrasound to almost all our regular herdcheck clients at a reduced rate until we felt more comfortable with the technology. We told our clients that we would raise the fee once we felt confident and that they could choose whether or not to continue using ultrasound at that time.

These twins are 26-day fetuses in opposite uterine horns.

When we reached that point only one client elected to go back to palpation. Most had become quite convinced that the additional information provided by ultrasound was well worth the extra fee.

Q. In what ways did you have to convince them of its usefulness as a diagnostic tool?

A. These days many dairy and beef producers understand the benefits of ultrasound, but for those who don't, "seeing is believing". Ultrasound is a wonderful educational tool because clients can see what is going on inside the cow. When they see an early embryonic death in progress, it helps them understand why pregnancy rechecks are important. When they see a luteal cyst and a follicular cyst, they understand why different treatments might be used. Clients also appreciate early pregnancy/open diagnosis, twin diagnosis, better diagnosis of pathology, earlier diagnosis of early embryonic death and better ovarian diagnosis.

This ultrasound image depicts a fluid-filled luteal cyst. Note the thick wall of the cyst, compared to the image showing follicular cysts.

Fetal sexing has always been important to registered breeders, but even commercial clients are interested in fetal sexing because they can use that information as a cull decision tool for marginal cows.

Q. Does ultrasound help or hinder your time efficiency on a farm call?

A. I can acquire more units of information with ultrasound in the same amount of time it would take to palpate a cow. And, of course, I can diagnose some things that cannot be palpated at all -- fetal gender and pregnancies under 30 days.

Large follicular cysts on both ovaries. Note the thin walls as compared to the luteal cyst.

Q. Do larger operations tend to be more progressive when it comes to accepting ultrasound as a diagnostic tool?

A. The answer is yes and no. The larger operations tend to have the pull to demand ultrasound services and may have less loyalty to a veterinarian who does not offer ultrasound.

Normal corpus luteum and small follicle on the same ovary.

Smaller commercial operations may desire the service, but loyalty to their veterinarian may keep them from seeking the service elsewhere if that person doesn't offer it.

Smaller registered breeders who need fetal gender diagnosis will usually bring in an outside veterinarian for ultrasound if their regular veterinarian doesn't offer the service.

Q. How do you charge clients for the service?

A. I charge an hourly rate to reward my efficient clients. Whether fees are based on an hourly or piecemeal basis, setting the ultrasound fee about 25 percent above the standard fee for services is reasonable and seems to be well-accepted by clients.

Q. Has it enhanced practice revenue?

A. The first year my partner and I had a unit we made enough extra income to pay for it. This was a bit surprising since we weren't using it much and also weren't charging extra during the first part of that year while we were learning. Additional income climbed quickly in following years. This was partly due to the higher fee and partly due to picking up new clients. Making ultrasound profitable is as simple as getting the unit out of the truck and using it.

This ultrasound image depicts a normal 45-day pregnancy on the left of the image and the corpus luteum on the right.

Q. What future applications could possibly emerge with ultrasound use?

A. As we learn more about how ovarian structures behave and appear during various stages of the estrus cycle, I think we may be able to more closely predict stage of cycle and optimal time to begin synchronization programs.

Ultrasound machine quality is getting better all the time, so we may be able to do pregnancy/open diagnosis even earlier in the future. We are also learning more about using ultrasound for other diagnostic uses such as fatty liver disease and mammary disease.

Q. What are common questions you get from veterinarians about ultrasound use?

A. Will it slow me down? Initially, ultrasound use may slow-down a busy practitioner. But once a veterinarian becomes proficient, he or she will scan at least as fast as they can palpate. And they will be collecting more units of information in the same amount of time. With excellent cow delivery, I can scan up to 80 head per hour in lock-ups, 60 per hour in a chute and 40 per hour in a tie stall barn. Just like palpation, speed depends more on cow delivery than on exam time. Like any new skill, training helps.

• Will it help my clients enough to justify the extra expense, especially with milk prices so low? Will it pay for me? I'm a really good palpator -- will ultrasound really be better?

The answers to all of these questions are yes. Ultrasound is pretty humbling for those of us (myself included) who thought our palpation skills were wonderful.

Ovarian structures and cases of early embryonic death can be especially surprising. Finding twins is much easier with ultrasound and requires less manipulation of the amniotic vesicles.

Research has shown that palpation is a poor diagnostic tool for uterine health status – ultrasound is much more useful. Ultrasound is a better tool for fetal aging because the fetus itself is measured instead of the variable amniotic vesicle. And certain things like very early pregnancies and fetal gender simply cannot be palpated.

• How do I choose an ultrasound unit?

Look for a unit with excellent image quality sold by a company with a good reputation for service. Consider attending a class that will have different units available to compare head-to-head. If you're a member of the American Association of Bovine Practitioners or the Society for Theriogenology send a message to their "listserves" to find out what units other practitioners are using.

Try several units and select the one you like best regardless of price. There are many good portable units on the market that eliminate the need for a cart and power supply. Used units can be a good deal, but insist on trying the unit before purchase.

• Will clients be buying their own ultrasound units and doing their own exams?

Only if they desire the service and can't find a veterinarian who offers it. Ultrasound is not a "magic wand." It requires skill and excellent knowledge of anatomy and physiology. Like palpation, people who have an opportunity to examine large numbers of animals will be more proficient. Veterinarians are uniquely suited to provide this service.