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These subsets of veterinary patients often have no ultrasonographically visible free fluid until after they are resuscitated and rehydrated. In the dehydrated patient with a bowel perforation, the omentum is often adhered to the defect, with the resorption (recruitment) of any available free water from the abdominal cavity. Thus, the serious lesion (same for a “small‐volume bleed” from a mass) is not producing substantial free fluid until after rehydration and resuscitation. We use the mantra “Rehydrate, resuscitate, reevaluate with a minimum of at least one additional serial AFAST and AFS” within the next 2–4 hours. In humans with possible bowel injury, serial ultrasound examinations are recommended out to 12‐24 hours post‐admission (Mohammadi and Ghasemi‐Rad 2012) (Figure 7.9).

Pearl: Serial AFAST exams increase sensitivity in detecting peritonitis and “small‐volume bleed” suspects and should be performed four hours post admission, and again after resuscitation and rehydration. If the patient has not declared itself overtly surgical but remains a candidate, AFAST and AFS should be used serially for at least 12–24 hours and longer if patient status is questionable.