Diagnostic ultrasonography is playing an increasingly important role in small animal practice. Its use has revolutionised our ability to investigate diseases in animals, complementing (but not replacing) radiography as an imaging tool. Advances in computer technology have led to the development of smaller machines, capable of doing greater things, at a lower cost. The price for introductory level machines is now at a level affordable to most veterinary practices in the UK.
There are many things to consider when choosing an ultrasound machine, but probably the two most important questions that you will need to answer before you start looking are 'What can it do for you?' and 'How much have you got to spend?' It can be very easy to get distracted by the latest machines available in the trade stands, but if the primary use for a machine will be pregnancy scans then all the expensive add-ons should not be a major consideration.
What Can It Do for You?
Ultrasonography allows visualisation of the internal organs of an animal, often without the need for any chemical restraint. It can allow comparison of a structure over time, can be used to guide a biopsy needle into a region of interest, and (using Doppler) can give functional and prognostic information in animals with cardiovascular disease. It has a high sensitivity for the detection of structural abnormalities within tissue, and findings may give a specific diagnosis in some instances.
However, a machine's value to a practice is dependent not only on the machine's capabilities, but also the skill and experience of the veterinarian performing the scan. It is probably true that these days (with most machines available in the marketplace) the limitation in diagnostic ultrasound rests in the skill and experience of the veterinarian and not the capabilities of the machine. Changes to an organ are not always specific for any particular disease, and ultrasound artefacts can be numerous and confusing. There is a steep learning curve with ultrasonography and opportunities for structured teaching for the practitioner are fairly limited in the UK. If no one in the practice has any experience operating an ultrasound machine, the practice should be prepared to invest in ongoing training once the machine is purchased. Having a high-tech machine does not make one a high-tech ultrasonographer.
How Much Have You Got To Spend?
When deciding on your budget you will need to consider what the realistic workload for the machine will be, whether you are aiming to create a new market for that machine or simply looking to replace or upgrade an existing machine. Buying a cheap 'entry-level' machine as a stepping stone into ultrasonography may make poor economic sense: the image quality in this level machine can be quite variable, and is usually far inferior to machines in a slightly higher price bracket. The end result may be disillusionment and frustration with what ultrasonography can give to your practice. A typical first opinion small animal practice looking to purchase a machine suitable for the range of cardiac and abdominal diseases that are typically seen will probably need to consider a budget somewhere between £8,000 and £20,000.
What Sort of Experience Does Your Practice Have?
If you are considering purchasing your first ultrasound machine, and no one in the practice has any real experience, then there probably is no need to purchase all the advanced features that may be available. The most important factor to consider in this instance is simply the quality of the B-mode image, and the only practical way that this can be assessed is by trying the machine on an animal. As experience grows, then machines can either be traded in for a more advanced model, or (in some instances) be upgraded by purchasing additional features. If you are upgrading a machine, or a member of your practice has some ultrasound experience, then these additional features may become a factor in the decision-making process. It should not be forgotten, however, that although there may be a great temptation to upgrade to Doppler or some other high-tech feature, the simplest and most cost-effective way of improving a machine may simply be by increasing the range of probes.
Whatever the experience of the members of your practice, there is always room for improvement. Practical scanning days are offered throughout the UK by several private CPD companies and remain one of the best ways of gaining practical tips using live animals as well as experiencing the range of machines that is currently available.
Does the Machine Need To Be Portable?
In the ultrasound world it is not always the case that smaller is better. Portability can add cost to a system, which may mean that you are purchasing a lower-specification machine for the price. Portability means convenience if the machine needs to be moved off-site, but this comes with the inconvenience of a small screen, a small keyboard, and often a single connecting port for a probe. If a machine's life is expected to be in the one practice, a larger machine may well be a better choice.
What About the Transducers?
Veterinary patients in a typical small animal practice come in all shapes and sizes, and there is yet to be a single ultrasound probe ideal for all. Probes are an expensive add-on to any machine, which inevitably leads to compromises on the type and number that are included in the sale. Many practices decide on one or two transducers, and if the machine will be used to scan hearts, then there is a further limitation on the range of probes to choose from. On the other side of the diaphragm, transducers that are better suited to abdominal scanning are often not ideal for cardiac work.
What About a Used Machine?
There have been remarkable advances in ultrasound machine and probe technology in recent years, with the knock-on effect being that a number of high-specification nearly new machines are entering the veterinary marketplace at considerable price savings. It is important to realise, however, that lower specification machines can also be sourced on the secondhand market and the price paid for what appears to be an amazing bargain may actually be poor image quality, limited probe selection and a machine unsuited to imaging veterinary patients. Sourcing a secondhand machine directly from an NHS hospital also includes that added problem of no after-sales back-up.
If looking into the secondhand market, it is so very important to know what you are looking for, to understand the demands of your practice and seek advice from more experienced colleagues. The cost of a comprehensive service contract and how long it would take for parts to be sourced would need to be part of the discussions when considering such a purchase.
What Sort of After-Sales Service Does the Seller Provide?
It is important to understand what sort of back-up is available for your ultrasound machine if the equipment malfunctions, before making your purchase. A new machine warranty will typically cover only manufacturer's defects, and if you damage your machine or probes you may be left with an expensive repair bill. A service contract will give greater peace of mind, and may be a more sensible option than extending the warranty. The annual cost of such a contract could be quite expensive (being related to the price of the machine), but this needs to be weighed against the cost of a call-out fee plus potentially very expensive parts. Having a service contract may also guarantee a quicker response by the service engineer when things go wrong, thereby limiting the inconvenience of re-booking ultrasound appointments with clients. If the fault cannot be rectified on site, many companies provide a replacement machine while yours is away; is there a fee for such a loan, and would it be a like-for-like replacement? Finally, new models are replacing old ones at a very rapid rate. Although your purchase may be new, is it an end-of-line model and how long will the company guarantee replacement parts?