Case Study

03_00204 Sundance K Hepatic carcinoma

A 9-year-old FS Golden Retriever was presented for vomiting and anorexia. On physical examination pyrexia and tachycardia with ectopic beats were present. Abnormalities on CBC and blood chemistry were thrombocytopenia, monocytosis, moderately elevated ALT, elevated GGT, hyperbilirubinemia, mild hypernatremia, and marked hyperlipasemia. The patient was treated with I.V. fluids, Hetastarch, Baytril, and ampicillin. After 24 hours of therapy the patient`s temperature had normalized.

A 9-year-old FS Golden Retriever was presented for vomiting and anorexia. On physical examination pyrexia and tachycardia with ectopic beats were present. Abnormalities on CBC and blood chemistry were thrombocytopenia, monocytosis, moderately elevated ALT, elevated GGT, hyperbilirubinemia, mild hypernatremia, and marked hyperlipasemia. The patient was treated with I.V. fluids, Hetastarch, Baytril, and ampicillin. After 24 hours of therapy the patient`s temperature had normalized.

Sonographic Differential Diagnosis

Aggressive cholangiohepatitis pattern with portal hypertension.

Image Interpretation

The abdomen in this patient presented a mild amount of anechoic free fluid with severe hepatic changes, swollen contour, increased portal markings, and thickened gallbladder. This is highly suggestive of aggressive cholangiohepatitis with potential emerging lymphoma. Portal vein velocity was subnormal at 12-14 cm/sec. This is indicative of portal hypertension justifying the free fluid in the cranial abdomen.

DX

Hepatic carcinoma with evidence of intrahepatic cholestasis.

Outcome

After a normal coagulation panel and an injection of Vitamin K, ultrasound guided FNAs of the liver were performed. Leptospirosis titer results were negative. The patient was transferred to a 24 hour referral facility for continued supportive care, but was humanely euthanized shortly after the histopathology results confirmed hepatic carcinoma.