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Repeat AFAST serially four hours post admission as standard of care (or sooner as clinical course dictates) and routinely repeat after resuscitation and rehydration (Lisciandro et al. 2009; Lisciandro 2011; Boysen and Lisciandro 2013). The four‐hour postadmission rule of thumb is supported in human medicine by the American College of Emergency Physicians (ACEP) guidelines (www.acep.org) as standard of care and has been shown to increase FAST sensitivity, improve patient management, and prevent the “crump factor” in people with hypotension (Blackbourne et al. 2004; Ollerton et al. 2006; Bilello et al. 2011). In the AFAST study, ~20% of dogs changed score on serial examination, most worsening with increasing abdominal fluid scores (Lisciandro et al. 2009).