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Right lateral (RL) recumbency is generally preferred over left lateral (LL) recumbency for AFAST because RL recumbency is standard positioning for electrocardiographic and echocardiographic evaluation (Figures 6.2 and 6.3; see also Figure 6.1). Moreover, the left kidney (a window into the retroperitoneal space) at the AFAST SR view and the gallbladder at the DH view (by directing the probe in the gravity‐dependent region or toward the tabletop) are readily imaged. RL recumbency over LL is preferred positioning for abdominocentesis because anatomically the spleen lies more on the left side of dogs and cats. LL recumbency may be used in cases in which injury prohibits RL positioning, or the right retroperitoneal space warrants imaging. In a more recent study evaluating RL versus LL recumbency, abdominal FAST time was shorter in LL recumbency and both kidneys were more reliably imaged (McMurray et al. 2016). However, this is probably due to training bias, as we could argue the same in RL recumbency (Lisciandro 2014a,b), and moreover, TFAST echo views are more easily acquired in RL recumbency. When combining AFAST and TFAST, RL recumbency is clearly advantageous. AFAST on a cat is shown in Chapter 39. See Chapters 17, 19, and 20 for echo views.

Figure 6.2. AFAST and its five views performed in right lateral recumbency in a dog. (A) AFAST unlabeled and (B) AFAST labeled. The order is always the same as follows: DH to SR to CC to HRU to HR5th bonus view. The final HR5th bonus view is not part of the abdominal fluid score. The AFAST images and their proportionality should look nearly the same regardless of positioning. DH, diaphragmatico‐hepatic view; DH1, DH 1 of 2 views; DH2, DH 2 of 2 views; SR, spleno‐renal view; CC, cysto‐colic view; HRU, hepato‐renal umbilical view; HR5th, hepato‐renal 5th bonus view; HRU1, 1 of 2 views; HRU2, 2 of 2 views. DIA, diaphragm; FF, free fluid; GB, gallbladder; LIV, liver; LK, left kidney; RK, right kidney; SI, small intestine. AFAST views are nearly identical no matter the positioning because the respective target organs are imaged with the same methodology.

Source: Reproduced with permission of Dr Gregory Lisciandro, Hill Country Veterinary Specialists and FASTVet.com, Spicewood. TX. Illustration by Hannah M. Cole, Adkins, TX.