Description of Laparoscopic Ultrasound of the Liver in Healthy Dogs

Enrollment Status: Closed

Inclusion Criteria: Healthy dogs presenting for laparoscopic (minimally-invasive) spay, gastropexy (tacking of the stomach), or both.

Exclusion Criteria: Dogs will be excluded from the study if they are determined to be unfit for anesthesia or surgery based on physical examination and routine bloodwork; or if they have a history of known liver disease based on previous bloodwork or imaging.

Procedures: Each dog will undergo a complete physical exam and have screening bloodwork performed to ensure they are healthy prior to undergoing anesthesia and surgery. Dogs will be placed under general anesthesia, and a small (2 cm) incision will be made into the abdomen, through which all procedures will be performed. One to two additional small incisions (0.5-1cm) may also be needed to provide adequate access to perform the spay and/or gastropexy. A laparoscope (camera) and special ultrasound probe intended for laparoscopic use will be inserted through the incision to perform thorough imaging and evaluation of the entire liver. No surgical procedure will be performed on the liver. Following the acquisition of both laparoscopic images and ultrasound images, each dog will have their intended elective procedure (spay, gastropexy, or both) performed.

Cost: This study will cover a maximum of $800 towards the cost of diagnostics, anesthesia, surgical procedures, medications, and hospitalization. There will be no cost of the laparoscopic ultrasound procedure. All other costs surgery beyond $800 will be the responsibility of the client.

Study Contact: If you would like to be considered for the study, please call the UF Small Animal Hospital to schedule an appointment for your dog with the Small Animal Surgery Service at (352) 392-2235. For other questions regarding the study, please complete the Study Interest Form.

Principle Investigator: J Brad Case, DVM, MS, Diplomate ACVS-SA, ACVS Founding Fellow-Minimally Invasive Surgery

Background:

Liver cancer can occur in dogs, and pre-operative planning and staging is important in these patients to understand the full extent of their disease and look for spread of cancer elsewhere. In veterinary medicine, this is typically accomplished with imaging techniques such as computed tomography (CT), or standard abdominal ultrasonography.  However, these imaging studies often miss additional tumors or underestimate the severity of disease, and more extensive disease may be found at the time of open abdominal surgery, changing the treatment plan. This places emotional and financial burden on the owner, and puts the patient through a possibly unnecessary invasive, painful surgical procedure.

In people, laparoscopic ultrasound (LUS) has been used successfully for staging of liver cancer and is now considered the gold-standard. Laparoscopic ultrasound is a minimally-invasive imaging technique that involves placing an ultrasound probe through a small incision into the abdomen, and directly placing the probe on the liver to acquire images. This is advantageous due to the ability to better visualize the liver without other organs in the way and by directly seeing the liver with the laparoscope (camera) at the same time. Additionally, LUS can be used to guide minimally-invasive surgery of the liver.

The purpose of this study is to describe the use and feasibility of laparoscopic ultrasonography of the liver in healthy dogs. Our ultimate goal is to eventually apply this technique to dogs with liver cancer to advance the clinical management of these cases.