I am glad that you put this information together in a systematic protocol (Global FAST®). I found the material to be very well organized with an appropriate amount of repetition. Quizzes were good tests of the material presented and I can see where this (Global FAST®) will be an invaluable addition to our overall patient assessment and care.
Dr. Josh Horner
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Greg,
Group photos from all 4 sessions! Gobal FAST® keeps growing!
I have a doctor that used this diagnostic tool the evening after her Global FAST® training and sent me 2 cases- she is so excited about the impact this is having in her practice! I wanted you to know the impact this is having in the care of out patients:
- I took pictures this time. 9y MN DSH presented for renal failure and three days of IVF diuresis. This morning he was a became a little tachypneic during blood draw. I did a GFAST® and he has wet lungs and a little pleural effusion and an enlarged right ventricle. Fluid overload diagnosed ✅
This is the most empowering tool I’ve ever had. Love it!!! - I wanted to share the case I saw last night after our Global FAST® wet lab.My associate was seeing an 11y MN DSH that presented with a 2 day history of seizures. He had been to Blue Pearl yesterday- they did blood work that revealed mild azotemia. On presentation to us the pet had anisocoria so we were worried about an intracranial mass or possible thromboembolic events. My associate did radiographs that were read as normal except for pinpoint renal calculi in the right kidney.
My associate gave a 2 mg/kg dose of phenobarbital slow IV and the patient went into respiratory arrest. He responded to resuscitation and that’s when I was asked to consult.We did a Global FAST® scan and I found shred sign in left perihilar zone and >3 B-lines on right perihilar. The heart looked normal, so I suspect a non cardiogenic pulmonary edema from the seizures. The heart appeared normal. On AFAST® we could see that the right renal pelvis was extremely dilated compared to the left. We are now suspicious of either a ureter obstruction or pyelonephritis.These were pieces of the puzzle that we would not have had without Global FAST®. I don’t know that it changed the outcome of this poor kitty but it sure felt empowering to have this new information.
- The best part – I have two vet students at my hospital and I got to look like a complete BadA$$ showing them these ultrasound views. 😂
Anyway – I just wanted to share my excitement and thank you both for organizing and presenting the Global FAST® lab. I couldn’t be more excited about having this new skill in my toolbox. We are going to be able to improve our clinical skills tremendously. I am going to strongly encourage every vet in my practice to take this class.
Thank you for your commitment to sharing this incredible tool!
Suzanne Sculley, DVM
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Hello Dr. Lisciandro,
I just want to express my sincere gratitude towards your Global FAST® class…. I truly believe that I now have a great foundation to start performing these series of quick assessments (NOT FLASH) to help provide me with the answers that I have been needing for the majority of my cases that often leave puzzled and curious as to what was ACTUALLY going on with the patient because I had no clue, needing an expert and not having access to the knowledge I have known.
After, listening and participating, being encouraged by you and all your assistants providing guidance, I know that I have failed some of my patients, thinking, believing, having the idea that I knew enough and was practicing, the right way, of FAST. I am in awe as too how much I have gained from this experience (Global FAST® Course)… I hesitate to call this a class, it seems so much more important and essential to call this merely a class or continuing education… All of Global FAST® should be taught in every Vet School. I would highly encourage you to talk with St. George’s University in Grenada, West Indies, about being a visiting professor… They do that a lot especially for small animal med, there is also a large VECCS student organization that when I was running it, was having wet labs every other week/weekend in which I would have the visiting professor help provide guidance (the lab would generally be in that particular area of specialty, but VECCS focused.) I really learned a lot from SGU, we did so much, and having people like you come and provide your knowledge and experience in FAST, I think, would be right up their alley.
That’s besides the point, or maybe is the point. I know have an amazing skill set and knowledge base, that I feel you have made putting in practice so simple, easy, and understandable, that I am overjoyed. I mean, seriously, you taught me more in an hour to use my ultrasound, than ANY other person, even the company that was suppose to teach me this stuff when we bought the thing. THANK YOU!!!
I am so very grateful that you have given me the tools to find answers and to help my patients lead longer fruitful lives. And thank you for the encouragement to text, call, whatever, if I have a question or need guidance or any support with FAST.
This course is a MUST for ANY DVM.
PS – Only a DVM (she is referring to me, Greg, when I had severe COVID-19 pneumonia and imaged and followed my clinical course at home using our Global FAST® Approach) would tell their MD (my primary care physician), “No, seriously, I’ll do a Vet BLUE® lung examination on myself and send you/call you with results…I have my own ultrasound at home… No biggie” – that was the best story ever!
With love and great regards,
Cheers, Liz Hughs, DVM
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Hi Dr. Lisciandro,
Just got off a shift and wanted to send a quick note from my day. Not 24 hours after your training I was putting it (Global FAST®) to use. I had a lily cat that gained some weight, thanks to Global FAST® I felt comfortable he was not actually fluid overloaded.
I had a hemoabdomen go from a 2/4 fluid score to a 3/4. While the client still declined surgery today I felt confident in my recommendation knowing there was continued bleeding (otherwise may have attributed the PCV drop to hemodilution).
I had a tachypneic cat with B-lines but no heart changes and what looked like nodule or wedge sign (I might send you a video tomorrow for your interpretation). We ended up getting X-rays and the radiologist thinks it’s severe asthma. A week ago I would have started furosemide already.
I had a pneumonia patient that was doing worse. TFAST® showed pleural effusion (maybe new or just missed on yesterday’s x-rays). I’m not sure how much it’s contributing to patient signs but I got a sample and there are several multi nucleate cells. Awaiting pathology review but we may have just found the true underlying issue.
Another case was in for GI issues. Bilateral middle lung >3 B-lines. Patient was not showing clear respiratory signs yet so I definitely wouldn’t have happened to do X-rays, plus it was much cheaper for the client to catch it with the (ultrasound) probe.
The last one I remember was a saddle thrombus. I felt confident sharing that the cat was not currently in heart failure too as many are. It may not change the outcome but it still really helped in the prognosis and next step options for that case.
I still have a lot of practice ahead of me and am hoping for some slower days ahead for more intentional practice, but already I feel so much more confident in my ability to manage these complex cases.
I am so grateful for the (Global FAST®) training you provided and the techniques you have been pioneering…
Best wishes,
Isaac Secor, DVM
Isaac Secor, DVM
Global FAST® is our new core skill for veterinary medicine, used as an extension of the physical exam, as part of the physical exam, “everyday ultrasound on nearly every patient™” – Greg Lisciandro, DVM, DABVP, DACVECC 2014
