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The POCUS examination of the spleen is a valuable diagnostic tool for guiding clinical care and, with adequate care and awareness, can be effectively performed by a nonradiologist veterinarian. The POCUS spleen examination is not meant to replace a complete detailed abdominal ultrasound study by a veterinarian with advanced training (the veterinary radiologist or internist) but rather serves as a screening test for obvious abnormalities. Ultrasonographic findings involving the spleen may be subjective and nonspecific, including splenic size and generalized changes in echogenicity. Additionally, the frequent close anatomical contact of the spleen and liver can make it difficult to differentiate the origin of a mass, particularly for a less experienced sonographer.

As stated in Chapter 8, a concurrent AFAST examination should be performed with any of the POCUS abdominal organ examinations to rule out intraabdominal, retroperitoneal, pleural and pericardial effusions, and in the case of the POCUS spleen examination, to rule out splenic hemorrhage. The AFAST not only detects free peritoneal fluid but also semiquantitates its volume using its abdominal fluid scoring system and assigning an abdominal fluid score (see Chapter 6). The abdominal fluid score helps predict the degree of anticipated anemia in cases of hemoabdomen (Lisciandro 2011; Lisciandro et al. 2009). Global FAST is an even better approach to survey for pleural and pericardial effusion, cardiac and pulmonary abnormalities, and patient volume status. Moreover, Global FAST is used as a screening test to rapidly discriminate between localized versus disseminated disease, comorbidities, and complications, which may be especially helpful in hemoabdomen cases.