• ABDOMINAL/ECHOCARDIOGRAM ULTRASOUND OUTPATIENT REQUEST FORM

    Note: All interpretation results will be sent to referring vet directly. We will not be discussing any result with the pet owners for outpatient imaging
  • Submission Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Is this an urgent request?*
  • !

    If this is an emergency, please send the patient through Emergency & Critical Care. Call us now.

    Emergency & Critical Care

    ☎ +65 6996 1812

    Our team will advise and prepare for the patient's arrival and provide the appropriate support.

  • We do not accept unstable patients. Unstable cases must be stabilised and managed via our Emergency & Critical Care (ECC) department. The scan will be performed once the patient is clinically stable.

  • SCAN REQUEST

  • What ultrasound is this for?*
  • 0/200
  • 0/200
  • Additional requests
  • Date of last echocardiogram (Optional)
     - -
    2 digit day, 2 digit month, 4 digit year
  • Species/Breed*
  • Mandatory for all cats: gabapentin before the echocardiogram

    At Beecroft Animal Specialist & Emergency Hospital, we strive to ensure every visit is as calm and stress-free as possible for our patients.

    Our veterinary team will always attempt to perform examinations on fully conscious animals. However, accurate echocardiographic imaging requires patients to remain relaxed and still throughout the procedure.

    We strongly believe that gabapentin can help facilitate a more pleasant experience for our feline patients. Therefore, we kindly request that all cats scheduled for an outpatient echocardiogram receive gabapentin by mouth 2 hours before the appointment, at these doses:

    • Under 4 kg: 50 mg
    • 4 kg and above: 100 mg
  • How will the owner get the gabapentin?*

  • When the owner collects it, brief them:
    give gabapentin by mouth 2 hours before the appointment.

    • Under 4 kg: 50 mg
    • 4 kg and above: 100 mg
  • Echocardiogram: keeping your dog calm

    At Beecroft Animal Specialist & Emergency Hospital, we strive to ensure every visit is as calm and stress-free as possible for our patients.

    Our veterinary team will always attempt to perform examinations on fully conscious animals. However, accurate echocardiographic imaging requires patients to remain relaxed and still throughout the procedure. If you feel your patient may be too anxious to allow an unsedated examination, we recommend that the referring vet prescribes the following pre-visit medication, to be given 2 hours before the appointment:

    • Gabapentin 10 mg/kg PO
    • Trazodone 5 mg/kg PO

    Please note: this medication is prescribed and supplied by the referring vet. Beecroft does not prescribe or dispense it for outpatient scans.

  • PATIENT & REFERRING VET DETAILS

  • Clinic Name*
  •  -
  • Sex*
  • Neutered*

  • HISTORY AND CONSENT

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  • Have you submitted full history and relevant diagnostic?*
  • If the ultrasound reveals any abnormalities requiring further assessment or urgent patient care, do you consent for Beecroft Animal Specialist & Emergency Hospital to arrange an internal referral to the relevant specialist service or, if urgent, transfer the patient to the Emergency & Critical Care (ECC) service for further assessment and management?*
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