10 yo F/S Lab mix 29#
Seen for acute vomiting and anorexia a few days ago.
Mild neutrophilia (13.1 > 11.6), moderate hepatic cytolysis (ALT 662 > 125).
GI signs resolved completely with cerenia. Ultrasound for elevated liver values.
One large (4cm by 3cm) oval hypoechoic mass effect in or near the dorsal mid liver, dorsal to the stomach. The mass has a thick hypoechoic contour with the same echogenicity as the liver parenchyma. The center of the mass has anechoic fluid. The mass appears well encapsulated and surrounded by reactive hyperechoic fat, no blood flow.
Diff: hepatic abscess vs cystic tumor vs pancreatic abscess?
Rest of abdomen NSF, no big LN, no free fluid, pancreas 1.3cm.
Thank you!
Julie
Comments
Thats an abscess and cant
Thats an abscess and cant rule out abscessing carcinoma but unlikely… looks like an inflamed gb mucocele but not in the right position so always show a normal GB in these cases so the report shows that this isnt an inflamed mucocele as on a report you can’t tell where you are positionally in the liver.
You can drain culture and cyto here and inject with body dose baytril into the abscess after sampling or send to surgery but most of these i have been able to resolve with a probe a needle and injection and baytril clindamycin systemically assuming the culture fits.
Thank you so much! I have
Thank you so much! I have pictures of the GB, which was normal, no sludge, normal wall. I don’t think I could safely reach that deep to drain it. We put him on Baytril/Amoxi/Metro with ultrasound rechecks. Owners declined surgery and were on vacation here, but we’ll try to get an update in a few weeks with their regular vet.
1-month Update!
Patient has
1-month Update!
Patient has been doing great on AB. He had a recheck ultrasound in PA (he was vacationing in VA when I scanned him) by a radiologist. The cyst or abscess (seems to be mesenteric) is much smaller (under 2cm) now. They are continuing the AB and will recheck in 4-6 weeks.