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AFAST was never meant to be a “flash exam” of the abdomen. The “flash” mentality is a quick ultrasound sweep answering a single binary question of whether fluid is present or absent, a positive or negative test. It is often used as a desultory sweep for a midabdominal mass, but without standardization of views and knowledge of anatomy at specific acoustic windows as in AFAST. Without direction, it becomes easy for the sonographer to get lost. Easily detected soft tissue conditions are often missed by abdominal radiography (Table 7.9) and the reader is referred to Chapters 8–12. The objective is through repetition and standardization to be able to tell normal from abnormal (differentiate expected from unexpected) and capture conditions that would otherwise be missed without any imaging or with radiography. As you read through Table 7.9, think about the conditions listed and how often they are missed on plain radiography. Interestingly, incidental findings during FAST exams have been reported in people (Sgourakis et al. 2012).

Figure 7.15. Measurements at the AFAST CC view for estimating urinary bladder volume. In (A) the best largest oval in the longitudinal plane is used for length (L, cm) and height (H, cm) measured as 5.01 cm and 3.22 cm, respectively. In (B) the best largest oval in the transverse plane is used for width (W, cm) measured as 4.49 cm. With these measurements the equation would be 5.01 × 3.22 × 4.49 cm × 0.625 = 45.3 mL. The volume can be compared to that aspirated when patients are catheterized immediately thereafter to gain confidence in its use (Lisciandro and Fosgate 2017).

Source: Reproduced with permission of Dr Gregory Lisciandro, Hill Country Veterinary Specialists and FASTVet.com, Spicewood, TX.

Table 7.9. AFAST and its target organ approach as a soft tissue screening test.

Source: Reproduced with permission of Dr Gregory Lisciandro, Hill Country Veterinary Specialists and FASTVet.com, Spicewood, TX.

View	Target organ	Findings
DH	Gallbladder	SludgeMucoceleCalculiMasses
	Liver	MassesObvious mottled echogenicity
	Caudal vena cava	Caudal caval size abnormalitiesCaval syndromeHepatic venous congestion
	Lung	Alveolar‐interstitial edema (B‐lines)ConsolidationMasses
	Heart	Pericardial effusionLeft atrial enlargement
	Thorax	Pleural effusionMasses
SR, HR, SR5th, HR5th	KidneyLiver	PyelectasiaHydronephrosisCortical cyst(s)Perinephric cyst(s)Polycystic diseaseMassesSee DH view
CC	Urinary bladder	SedimentCalculiBladder wall irregularitiesMasses
HRU, SRU	Spleen	MassesObvious mottled echogenicityMidabdominal masses

See respective POCUS abdomen‐related chapters for examples.