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Abnormal pylorus and focal stomach lesion in a senior dog with anemia

Sonopath Forum

Sonopath Forum

Abnormal pylorus and focal stomach lesion in a senior dog with anemia

Abnormal pylorus and focal stomach lesion on senior dog with anemia:

* 14 yo F/S Lhassa Apso with PUPD, distended abdomen, good appetite, HCT 20%, ALP 1700, ALT 480, high cPL.

* On ultrasound: chronic pancreatitis (right lobe is hypoechoic heterogeneous, bright fat around it, no nodule seen), large left adrenal (8mm cranial pole, 7.2mm cdl pole), hepatomegaly due to Cushing vs other.

* 3 images below of pylorus: thickened hypoechoic pylorus wall with focal loss of layers due to gastritis? tumor? artifact?

Abnormal pylorus and focal stomach lesion on senior dog with anemia:

* 14 yo F/S Lhassa Apso with PUPD, distended abdomen, good appetite, HCT 20%, ALP 1700, ALT 480, high cPL.

* On ultrasound: chronic pancreatitis (right lobe is hypoechoic heterogeneous, bright fat around it, no nodule seen), large left adrenal (8mm cranial pole, 7.2mm cdl pole), hepatomegaly due to Cushing vs other.

* 3 images below of pylorus: thickened hypoechoic pylorus wall with focal loss of layers due to gastritis? tumor? artifact?

* 1 image of stomach wall (fundus): focal loss of layers, thickened heterogeneous wall: ulcer? mass? or artifact?

* I suspect the anemia is due to chronic GI loss. The intestines looked perfect. No free fluid, no swollen LN.

Thank you so much for your input!

Julie Pearson

 

Comments

rlobetti
January 11, 2020 at 3:41 pm -

Appearance of the stomach

Appearance of the stomach very suspicious for neoplasia and most likley ulcerative. Can try FNA the wall but would recommend gastroscopy. Other signs are indicative of Cushing’s disease. 

EL
January 11, 2020 at 10:57 pm -

muscularis thickening and

muscularis thickening and thick submucosal layer that suggests chronicity. At the end of the second video in t he upper right there  is a little triangular hyperechoic focus. This may be  an ulcer.

sonopaws
January 12, 2020 at 1:20 pm -

Thank you both so much for

Thank you both so much for your input! Given the age of the patient, I am not sure the owner will pursue more diagnostics (low dose dex test and FNA stomach), but I offered to recheck the stomach in a month. I would expect more obvious lesions by then if it’s a tumor.

There were no swollen lymph nodes near the stomach (or anywhere else in the abdomen). Does that make neoplasia less likely and chronic ulcerative lesion more likely?

Thank you again!

Julie

rlobetti
January 13, 2020 at 12:26 pm -

Unfortunately not that clear

Unfortunately not that clear cut. 

sonopaws
January 13, 2020 at 2:27 pm -

Good to know! Thanks!

Good to know! Thanks!

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