12 year old FS lab, acute onset intractable vomiting

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12 year old FS lab, acute onset intractable vomiting

Hi all – I have some rads and no u/s (not affordable for the owner). Would like opinions on radiographs…

Hi all – I have some rads and no u/s (not affordable for the owner). Would like opinions on radiographs…

  • 12 year old FS lab
  • Only medical hx is past pelvic fx as pup due to HBC
  • 14 hr history of acute onset, severe and intractable vomiting and anorexia.
  • No medications, no history of toxin or getting into garbage, compost etc
  • Exam NSF except drooling, DJD hips and back, abdomen tense.
  • Blood work NSF except ALP 350 ish
  • Very quick freebie u/s on crappy machine: cystitis, no major tumors, no obvious pancreatitis
  • Rads are presented below:
  • Due to financial limitations, unable to do much more than what we did.
  • Tx: cerenia inj, home with reglan, amoxi, and pepcid.

I would like input on the rads. I am concerned about the radio-opacity of the area caudal to and surrounding the stomach and pylorus, especially in the area of the cranial duodenal flexure (or where I’d imagine that would be). Owner will be euthanizing tomorrow if no improvement and no indication of the cause of this nausea. 🙁

Comments

Anonymous
June 22, 2012 at 10:39 am -

Its too bad they are
Its too bad they are euthanizing because I dont see anything bad here. The liver is a bit small to the gastric axis is further cranial and the pyloric outflow creates that reverse 7 sign that you see sometimes with pancreatitis but I just think its a conformational thing owing to a smaller than normal liver. The VD shows that opacity that looks like a mass or something but the Lat in the same position has intestine there. This is an innocuous presentation i think. it fits with your nsf ultrasound scan.

Anonymous
June 22, 2012 at 10:39 am -

Its too bad they are
Its too bad they are euthanizing because I dont see anything bad here. The liver is a bit small to the gastric axis is further cranial and the pyloric outflow creates that reverse 7 sign that you see sometimes with pancreatitis but I just think its a conformational thing owing to a smaller than normal liver. The VD shows that opacity that looks like a mass or something but the Lat in the same position has intestine there. This is an innocuous presentation i think. it fits with your nsf ultrasound scan.

Anonymous
June 22, 2012 at 4:48 pm -

Thanks Eric. She has improved
Thanks Eric. She has improved slightly since Weds so they are willing to hold off. This dog also has significant untreated DJD (no pain meds) so the owner was feeling like her quality of life wasn’t good. Now with the tramadol on board, she is eating, not whining, etc. Incontinence is still an issue. I have added flagyl and am treating like pancreatitis.

Thanks for your explanation of looking at the lateral to compare the “mass effect” on the VD…You are right, I think it is just overlying intestine in that area.

Thanks again!
Liz

Anonymous
June 22, 2012 at 4:48 pm -

Thanks Eric. She has improved
Thanks Eric. She has improved slightly since Weds so they are willing to hold off. This dog also has significant untreated DJD (no pain meds) so the owner was feeling like her quality of life wasn’t good. Now with the tramadol on board, she is eating, not whining, etc. Incontinence is still an issue. I have added flagyl and am treating like pancreatitis.

Thanks for your explanation of looking at the lateral to compare the “mass effect” on the VD…You are right, I think it is just overlying intestine in that area.

Thanks again!
Liz

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