A 7-year-old MN American Cocker Spaniel with history of surgery on an abscess ventral to the right ear, was presented for urinating in the house and hematuria. On physical examination, the surgical site was scabbed but had pus coming out of the center. The only abnormality on urinalysis was an inappropriate specific gravity. CBC was within normal limits but elevated urea nitrogen, elevated BUN/creatinine ratio, elevated potassium and elevated amylase were present on serum biochemistry.
A 7-year-old MN American Cocker Spaniel with history of surgery on an abscess ventral to the right ear, was presented for urinating in the house and hematuria. On physical examination, the surgical site was scabbed but had pus coming out of the center. The only abnormality on urinalysis was an inappropriate specific gravity. CBC was within normal limits but elevated urea nitrogen, elevated BUN/creatinine ratio, elevated potassium and elevated amylase were present on serum biochemistry.
Case Study
03_00185 Percy B Metastatic carcinoma, liver *BK*
Sonographic Differential Diagnosis
Multiple liver masses, potential hepatomas. More likely low grade hepatocellular carcinoma or other neoplasia.
Image Interpretation
The liver presented multiple hyperechoic and mixed hypoechoic masses throughout the right and left lobes. They were deriving from the caudate process. The larger mass deriving from the caudate process was somewhat pedunculated and at risk for potential torsion. The gallbladder presented some minor debris that was otherwise uneventful with minor wall thickening.
DX
Outcome
The patient presented a month after the exam for urinating and diarrhea accidents throughout the house. Prostate at the time was palpated and enlarged. Urinalysis revealed 3+ proteinuria, pyuria, 1+ hematuria, and bacterial rods.
Comments
The carcinoma lesions were likely deriving from the liver itself since no other primary tumor was found.
Clinical Differential Diagnosis
Renal disease – chronic kidney disease. pyelonephritis.
Sampling
25 gauge fine-needle aspirates were performed on two of the masses and submitted for cytology review. These masses are very fragile in nature. Cytology revealed metastatic carcinoma.
Video
Patient Information
Clinical Signs
- Hematuria
- Inappropriate Urination
Images
Blood Chemistry
- Amylase, High
- BUN high
- BUN/Creatinine Ratio, High
- Potassium, High
Clinical Signs
- Hematuria
- Inappropriate Urination
Urinalysi
- Specific Gravity Abnormal