Snowball is a7 year old M/N DSH wich is icteric with high ALT . PCV is 17 %. I think the icterus is pre-hepatic (liver has no lesions except moderatelly hypoechoic, GB, CBD normal) and suspect Mycoplasma Felis or Lymphoma. However found moderatelly enlarged splenic and portal LN’s and again mild hypoechoic left pancreatic limb consistent with pancreatitis.
Snowball is a7 year old M/N DSH wich is icteric with high ALT . PCV is 17 %. I think the icterus is pre-hepatic (liver has no lesions except moderatelly hypoechoic, GB, CBD normal) and suspect Mycoplasma Felis or Lymphoma. However found moderatelly enlarged splenic and portal LN’s and again mild hypoechoic left pancreatic limb consistent with pancreatitis.
My question is regarding the hypoechoic structure that was found on sagital view dorsal to spleen and left pancreas( left pancreas is on top of the structure -ventrally). It has the same structure like spleen and appear to conect. Can this be the head of thespleen? It is definatelly more hypoechoic comparing with the rest of the spleen and very painfull. I put doppler on it and has nice supply so no torsion. If the images are not clear I can send more tommorow.
Thank you
Comments
Etiologies would be neoplasia
Etiologies would be neoplasia (lymphoma, mast cell, sarcoma), granuloma, hematoma. Pain is most likley from distension of the capsule. Looking at the rest of the data the mass may be incidental, however, neoplasia can result in the icterus, anemia, and elevated ALT. Also Hemoplasmosis is unlikley to give enlarged abdominal lymph nodes. Consider doing a FNA of the mass.
Thank you.That’s what I
Thank you.That’s what I thought, that abdominal LN’s shouldn’t be enlarged with Hemobartonella. If able enough next step would be FNA’s of the Spleen(mass) and LN.
Etiologies would be neoplasia
Etiologies would be neoplasia (lymphoma, mast cell, sarcoma), granuloma, hematoma. Pain is most likley from distension of the capsule. Looking at the rest of the data the mass may be incidental, however, neoplasia can result in the icterus, anemia, and elevated ALT. Also Hemoplasmosis is unlikley to give enlarged abdominal lymph nodes. Consider doing a FNA of the mass.
Thank you.That’s what I
Thank you.That’s what I thought, that abdominal LN’s shouldn’t be enlarged with Hemobartonella. If able enough next step would be FNA’s of the Spleen(mass) and LN.
On the still that hypoechoic
On the still that hypoechoic lesion looks like pancreas or LN maybe comiing up off the right limb?? and would be odd in a cat, given the other image of the spleen is normal, that a focal lesion develops like that from the spleen. I would 25g fna that lesion and the liver if bili is up unless its a hemolytic case whcih the cbc path review may help with though spherocytes arent always present in cats in hemolytic cases. Regardless fna of the lesion is where I would start with. Have a video of it by chance ?? I dont like to make statements on stills alone as they can be interpreted too widely.
On the still that hypoechoic
On the still that hypoechoic lesion looks like pancreas or LN maybe comiing up off the right limb?? and would be odd in a cat, given the other image of the spleen is normal, that a focal lesion develops like that from the spleen. I would 25g fna that lesion and the liver if bili is up unless its a hemolytic case whcih the cbc path review may help with though spherocytes arent always present in cats in hemolytic cases. Regardless fna of the lesion is where I would start with. Have a video of it by chance ?? I dont like to make statements on stills alone as they can be interpreted too widely.
I’m attaching still for the
I’m attaching still for the left pancreas . It’s hypoechoic but to me it’s a different structure then the hypoechoic head of the spleen. I’ll attach also a clip for clarification
Thank you
I’m attaching still for the
I’m attaching still for the left pancreas . It’s hypoechoic but to me it’s a different structure then the hypoechoic head of the spleen. I’ll attach also a clip for clarification
Thank you
I’ve attached 2 clips one
I’ve attached 2 clips one showing the pancreas and the orther the hypoechoic structure that seems to be spleen ( conects with the rest of it).
CC
I’ve attached 2 clips one
I’ve attached 2 clips one showing the pancreas and the orther the hypoechoic structure that seems to be spleen ( conects with the rest of it).
CC
I’ve attached 2 clips in the
I’ve attached 2 clips in the “body ” of the initial post.
I’ve attached 2 clips in the
I’ve attached 2 clips in the “body ” of the initial post.
Excellent yep thats spleen
Excellent yep thats spleen caudal pole going cranially path of least resistance. LSA, MCT primary diffs or a really weaird splenitis/reactive but thats way to big so neoplasia +/- paraneoplastic hemolytic possible. I would screen fna spleen and liver if just in spleen then remove after transfusion. Fresh cbc and bone marrow fna wiht chest rads would complete the picture. great case
Excellent yep thats spleen
Excellent yep thats spleen caudal pole going cranially path of least resistance. LSA, MCT primary diffs or a really weaird splenitis/reactive but thats way to big so neoplasia +/- paraneoplastic hemolytic possible. I would screen fna spleen and liver if just in spleen then remove after transfusion. Fresh cbc and bone marrow fna wiht chest rads would complete the picture. great case
Thank you Eric.I can
Thank you Eric.I can update/post the rest of the dg’s if there is interess. So far this cat is responding to Doxycycline, Pred; more stable clinicall and PCV is increasing ( so far 16%).
CC
Thank you Eric.I can
Thank you Eric.I can update/post the rest of the dg’s if there is interess. So far this cat is responding to Doxycycline, Pred; more stable clinicall and PCV is increasing ( so far 16%).
CC
Most likely neoplasia with
Most likely neoplasia with secondary IMHA. Keep us updated as to progress.
Most likely neoplasia with
Most likely neoplasia with secondary IMHA. Keep us updated as to progress.
so far so good. PCV is
so far so good. PCV is climbing ( 22 % now), less icteric, more energetic….will keep you posted.
so far so good. PCV is
so far so good. PCV is climbing ( 22 % now), less icteric, more energetic….will keep you posted.
Good to hear it…may be a
Good to hear it…may be a suppressed lsa or mct though on the pred.
Good to hear it…may be a
Good to hear it…may be a suppressed lsa or mct though on the pred.