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The patient is placed in dorsal recumbency, the abdomen is shaved, and acoustic coupling gel is applied for best visualization. Although image quality will be diminished, ample application of 70% isopropyl alcohol to haired skin can be utilized in an emergency situation. The spleen is located caudal to the stomach on the patient’s left side and can provide an acoustic window for the left kidney (see also Figures 6.18, 16.3, 16.4, 16.5). The spleen is identified by its hyperechoic (bright white) capsule and blood supply splitting its capsule, unlike the liver. Spleen position and size vary between patients and with the degree of gastric filling. The entire length of the spleen is generally not visualized in one acoustic window and so its entirety must be traced cranially to the head of the spleen and caudally to its tail.

The position of the spleen may vary between patients. The head or cranial aspect of the spleen is generally located on the left side caudal to the last rib. In large dogs, it may be located under the ribcage and therefore, repositioning into right lateral recumbency with a left intercostal approach may be necessary. The spleen is then traced caudally toward its hilus where the splenic vein is imaged and seen branching in a “Y” configuration, referred to by some sonographers as the “whale tail” shaped like the tail fluke (Figure 9.1; see also Figures 39.8 and 39.9). Splenic arteries are usually not visualized (Hecht 2008). Evaluation of the spleen continues as the sonographer follows the spleen distally along the left side of the abdomen to examine the caudal aspect of the spleen to its tail so that the entire organ has been examined. Remember that the spleen is anchored at the head by its short gastric vessels along the greater curvature of the stomach but has a relatively mobile tail. In some patients, the tail of the spleen may be located medial and to the right side of the patient instead of the left. Several sweeps along the length and width of the spleen may be necessary for a thorough interrogation, especially in animals with splenomegaly.

Pearl: Identify the spleen by its hyperechoic (bright white) capsule and blood supply splitting its capsule, unlike the liver.