Case Study

RADS – Multiple Myeloma/Plasmocytoma in an 8 year old MN Chinese Crested dog

Recent history of acute and progressive anorexia, lethargy, pu/pd x 7 days. Now is having trouble ambulating on both hind legs (more RH partial weightbearing)

Physical Exam: CP slow on right hind, normal on left hind. Patella WNL, no suspicion of CCL. No spinal pain. The patient tries to stand up on hind legs and falls down into a sit. Partial weight bearing on right hind leg. Temp is 102.8. Lymph nodes are prominent submandibular/popliteal right/prescapular left.

Recent history of acute and progressive anorexia, lethargy, pu/pd x 7 days. Now is having trouble ambulating on both hind legs (more RH partial weightbearing)

CBC: Leukocytosis with marked lymphocytosis – Pathologist reviewed as suspicious for lymphoid neoplasia.

Chemistry: Elev GGT, low phosphorus.

Urine Analysis: Bilirubin 2+, rest WNL

DX

The radiographs are compatible with a multiple myeloma/plasmocytoma. Even if less likely lymphoma is a possible differential diagnosis. Lymphoma and multiple myeloma cannot be differentiated based upon radiographic findings in general.

Image Interpretation

Rads of left lateral and VD thorax and abdomen, and lateral lumbar spine – Osseous structures: There were small round punched out osteolytic lesions lacking sclerotic reaction within the dorsal spinous processes of L1, L2 and L3 as well as within the vertebral body of the first caudal vertebra.
Intraabdominal structures: There was moderate generalized hepato- snd splenomegaly and mild generalized bilateral renomelagy.
Intrathoracic structures: The course of the trachea was normal, there was no mediastinal widening. The main stem bronchi were within normal limits. The cardiac silhouette and caudal vena cave were small.

Outcome

For Further diagnostic workup ultrasound of the abdomen with fine needle aspirates of the spleen and liver is recommended. If that is inconclusive further measures such as urine survey for Bence-Jones proteins and bone marrow biopsy may be considered.
There was microcardia and underperfusion of the cadual vena cava as a function of hypovolemia.