Ultrasound imaging displayed on a portable device during a veterinary examination. Photo courtesy Antech Since the first stethoscope was placed against a patient’s chest in the early 19th century, diagnostic tools have been used to access the hidden internal world of the body.1 Today, veterinarians rely on ultrasound to support their clinical decision-making, from emergency triage to reproductive management, cardiac evaluation, and guided biopsies. Over the past 40 years, ultrasound has evolved from an experimental tool into an everyday part of veterinary diagnostics, balancing high-tech innovation with practical accessibility. The increased use of ultrasound in general practice enables faster patient triage and more rapid decisions on treatment or further diagnostics, ultimately improving patient care. Improving patient care As ultrasound technology has advanced, machines have become more compact and accessible, making this imaging modality a staple offering in many veterinary clinics. In one survey of Canadian veterinarians, 88 percent of respondents reported they used ultrasound2 and in a 2019 survey of veterinarians from the southeastern United States, 53 percent of respondents reported having an ultrasound unit in their practice, with 45 percent performing ultrasound more than five times a week.3 The unique strengths of ultrasound include: Providing images in real time, adding benefit to a wide range of clinical conditions. No need for general anesthesia, meaning it is a valuable tool for sick patients, neonates, or trauma cases. No radiation exposure makes it suitable for repeated exams, at no risk to personnel. Other advances have included: High-frequency linear probes, which enhance imaging of superficial structures like lymph nodes or tendons Digital storage allows easier review and comparison of images, and even remote consultation with specialists—improving confidence in diagnostic accuracy.5 POCUS and portability While ultrasound is useful for general surveys of internal organs and viscera, point-of-care ultrasound (POCUS) is increasingly popular. These efficient, focused examinations result in less patient stress and more streamlined diagnostics. The portability of modern systems allows clinicians to perform bedside examinations without moving unstable patients, enabling rapid detection of conditions such as free abdominal fluid after trauma, pericardial effusion, or urinary obstruction.6 The results of POCUS techniques, such as AFAST (abdominal focused assessment with sonography for trauma, triage, and tracking) and TFAST (the thoracic version of the same), can guide next steps in treatment and increase confidence in the diagnosis, especially before choosing to perform potentially high-risk surgery or medical treatment. Due to its limited but specific nature, POCUS can be used by practitioners who are less experienced or have received less extensive training. It can help clinicians communicate with clients, and the images can provide reassurance about the recommended therapeutic pathway, risks, and potential outcomes. Likewise, digital images gathered from POCUS can be shared with veterinary colleagues or referral centers. This can help clinicians determine when specialist referrals are needed or when the patient’s condition can be managed in general practice, reducing unnecessary referrals and building the practice team’s confidence to handle more complex cases. Like all diagnostic imaging modalities, ultrasound has advantages and limitations (Table 1) and will deliver the most valuable results when used appropriately (Table 2). Ultrasound is best integrated into a multi-modal diagnostic approach.4,5 Table 1: By acknowledging both strengths and limitations, veterinarians can choose ultrasound for appropriate cases while complementing it with other imaging techniques, such as CT and MRI as needed. Strengths: Limitations: Real-time, non-invasive imaging of soft tissue and blood flow. Wide applications: reproductive, abdominal, cardiac, musculoskeletal, and emergency care. Minimally invasive procedural guidance (biopsy, aspiration). Portable, cost-effective, and increasingly user-friendly. Operator-dependent: skill dramatically affects diagnostic accuracy. Acoustic interference: gas, bone, or obesity can limit usefulness. Depth-resolution trade-offs require multiple transducers. Cannot replace CT or MRI for complex neurologic or orthopedic cases.5,6 Table 2 Imaging modality Common uses Advantages Limitations Typical species/applications Radiography Abdominal and thoracic pathology, dental imaging Widely available, fast, relatively inexpensive Limited soft tissue contrast Ionizing radiation Small and large animals, exotic pets Ultrasonography Abdominal organs, pregnancy diagnosis, cardiac evaluation (echocardiography), assessment for effusion, mediastinal and some pulmonary pathology No radiation, real-time imaging, good soft tissue detail Operator-dependent Limited by gas/bone Small and large animals, abdominal organs, and viscera Computed tomography (CT) Complex fractures, nasal disease, pulmonary and abdominal pathology Excellent bone detail, cross-sectional imaging, fast acquisition Radiation exposure Higher cost Requires anesthesia Small and large animals, oncology staging Magnetic resonance imaging (MRI) Brain/spinal cord disease, soft tissue injuries, intervertebral disc disease Superior soft tissue contrast, no ionizing radiation Expensive Longer scan times Requires anesthesia Neurologic cases in small animals, specialty referral Nuclear scintigraphy Bone pathology, occult lameness, thyroid disease Functional imaging; detects early bone changes Limited availability Radiation handling requirements Feline hyperthyroidism Fluoroscopy Dynamic swallowing studies, airway collapse, and interventional procedures Real-time motion imaging Radiation exposure Specialized equipment Small animals, interventional diagnostics, and surgery Ultrasound images demonstrating tissue assessment using advanced imaging techniques. Photo courtesy Antech Into the future: AI and 3D imaging The next phase of veterinary ultrasound is being shaped by AI, wireless devices, and 3D imaging. AI-assisted interpretation has tremendous potential to reduce variability in image acquisition and diagnosis, particularly in general practice, where clinicians may need rapid turnaround times or find themselves without anyone to help guide and reassure them. When interpretation models are trained by board-certified veterinary imaging specialists to detect specific findings, the risk of missed pathologies is reduced. In this way, AI can be used responsibly to enhance veterinarians’ confidence in their diagnoses. Additionally, many AI-assisted services also offer the option to seek input and guidance from experts as needed. More wireless and handheld probes are entering the ultrasound market, expanding their use in mobile settings. This provides efficiencies for carrying out sophisticated imaging without delay and avoiding the need to transport patients to another facility. 3D and 4D imaging are also in development, and volumetric evaluation of fetal development and musculoskeletal dynamics is also on the horizon. These innovations aim to provide additional operator support, increase accessibility, and expand diagnostic accuracy for ultrasound.6 The challenge for practitioners is to integrate new technology thoughtfully while maintaining high standards of training and interpretation. Ensuring AI and advanced features complement, rather than replace, clinical judgment will be key. An ultrasound exam at the Academy of Veterinary Imaging, part of Sound Powered by Antech, using GE HealthCare’s Versana Balance Ultrasound. Photo courtesy GE Healthcare Photo courtesy GE Healthcare Key takeaways Ultrasound use in veterinary medicine illustrates a broader lesson: technology alone does not define progress. True impact comes when innovation meets clinical insight, training, and thoughtful integration. In the past 40 years, ultrasound has shifted from experimental to essential, yet its limitations remind us that skill, judgment, and context are critical. With more expertise and support becoming available through imaging consultation services and AI-assisted interpretation tools, there is a real opportunity for all veterinary professionals to build the skills and confidence needed to make ultrasound an indispensable part of their diagnostic toolkit. Facts and Statistics Equine practitioners use ultrasound monitoring in over 90 percent of breeding programs for early pregnancy detection and reproductive cases.5 Doppler imaging has improved cardiac diagnostic accuracy by up to 35 percent in dogs with valvular disease, according to recent studies.6 These numbers illustrate ultrasound’s penetration across species and specialties and highlight its real-world impact on outcomes. Lisa Ziemer, VMD, DACVR, obtained her bachelor’s degree with honors from Bryn Mawr College and received her Doctor of Veterinary Medicine degree from the University of Pennsylvania in 1998. She then completed a one-year fellowship at the University of Pennsylvania, conducting research on noninvasive imaging of hypoxia. Dr. Ziemer completed a residency in radiology, becoming board-certified in 2003, and then spent one year as a postdoctoral fellow in oncology at the University of Pennsylvania. After spending several years in private radiology practice, Ziemer joined Antech and now leads the Antech Imaging Services team as chief radiologist. References King AM. Development, advances and applications of diagnostic ultrasound in animals. Vet J. 2006 May;171(3): Over the Past 25 Years.408-20. Pelchat J, Chalhoub S, Boysen SR. The use of veterinary point-of-care ultrasound by veterinarians: A nationwide Canadian survey. Can Vet J. 2020 Dec;61(12):1278-1282 DeFrancesco T, Royal K. A survey of point-of-care ultrasound use in veterinary general practice. Education in the Health Professions 2019 Jan; 1(2):50 Pinilla M. Veterinary Business Journal. Image is everything: new developments in diagnostic imaging. 2025;264(March):8-11. Yitbarek D, Dagnaw GG. Application of Advanced Imaging Modalities in Veterinary Medicine: A Review. Vet Med (Auckl). 2022 May 31;13:117-130 Meomartino L,Greco A, Di Giancamillo M, Brunetti A, Gnudi G. Imaging techniques in Veterinary Medicine. Part I: Radiography and Ultrasonography, European Journal of Radiology Open, Volume 8, 2021 Hayashi R, El-Husseiny HM, Tanaka R. Editorial: Outstanding advances in veterinary diagnostic ultrasonography: novel milestones in disease detection, prediction, and treatment. Front Vet Sci. 2025 Sep 16;12 Samir H, Swelum AA, Kandiel MMM. Editorial: Exploring roles of diagnostic ultrasonography in veterinary medicine. Front Vet Sci. 2022 Nov 18;9 Latif M, MS Arshad, M Usman, M Mobashar, Z Wali, H Ashraf, T Ahmad and MAS Mughal, 2024. Advancement in diagnostic imaging techniques in veterinary medicine. Continental Vet J, 4(1): 120-127 Oliveira IM, da Silva WPR, Ribeiro RR, Lopes MM, Costa PRDS, Borges NC. Ultrasound elastography in dogs: Physical principles and application in intestinal evaluation. Vet World. 2024 Dec;17(12):2985-2991
