An 11-year-old SF Cocker Spaniel was presented for evaluation of lethargy and sloughing and ulceration of the pads of the feet. Abnormalities CBC and serum biochemistry were mild anemia, elevated ALT activity and cholesterol, and severely elevated ALP activity.
Diffuse hepatic nodular changes. Strongly suggestive for hepatocutaneous syndrome. FNA may allow for a definitive diagnosis. Core biopsy would be best. Biopsies of the crusting skin lesions are also warranted at that time. Bile acid profile is also warranted.
The liver in this patient presented diffuse micronodular and macronodular changes. Coalescing nodules were noted throughout the liver. This is strongly suggestive for hepatocutaneous syndrome. Core liver biopsy and crusting skin lesion biopsy or foot pad biopsy or nasal planum biopsy would be recommended at the same time. The gallbladder was unremarkable.
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Hepatocutaneous syndrome, neoplasia, chronic hepatopathy, Cushing’s disease
Feet – allergic dermatopathy, immune-mediated skin disease
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