- 11 year old mn Wheaton Terrier presented for acute onset lethargy and anorexia.
- Bloodwork shows a leukopenia with normal RBC count, Total Bilirubin=3.9, and slightly elevated ALT
- Abdominal US shows a 5.0cm segment of small intestine in the left midabdomen with adjacent reactive fat and a 1.5cm hypoechoic lesion in the gastric wall with echogenic borders. The liver and gallbladder both appeared normal. There is no evidence of any GI obstruction or extrahepatic biliary obstruction.
- 11 year old mn Wheaton Terrier presented for acute onset lethargy and anorexia.
- Bloodwork shows a leukopenia with normal RBC count, Total Bilirubin=3.9, and slightly elevated ALT
- Abdominal US shows a 5.0cm segment of small intestine in the left midabdomen with adjacent reactive fat and a 1.5cm hypoechoic lesion in the gastric wall with echogenic borders. The liver and gallbladder both appeared normal. There is no evidence of any GI obstruction or extrahepatic biliary obstruction.
- What are your thoughts on this gastric wall lesion? My differential list includes benign tumor, ulcer, neoplasia (LSA), and less likely artifact (kibble).
Comments
It looks epithelial… this
It looks epithelial… this happens a lot in older dogs and is usually hyperplasia or low grade epithelial tumor and you can differentiate from kibble using power doppler. LSA destroys the submucosal layer which is intact here as are the muscularis and seosal layers. These lesions are very amenable to scope since they are mucosal.
The bili being up means the liver deserves a needle if no anemia/hemolytic disease and no post hepatic obstruction. I would chase the liver here assuming the bili elevation isnt lab error.
My favorite altered parameters: elevated bili and low albumin… things are easy to define re case direction when these occur in the profile.
Thanks Eric!
Thanks Eric!