A 15-year-old FS Cocker Spaniel with a history of increased liver and pancreatic enzymes and chronic skin disease was presented for evaluation of weight loss and PU/PD. On physical examination, hepatomegaly, perianal mass, and several subcutaneous masses on the ventral thorax and lateral abdomen were evident. Urinalysis showed proteinuria as the only abnormality. Abnormalities on serum biochemistry were elevated ALT (142) and ALP activity (698).
Passive congestion liver pattern.
Hepatic cyst or abscess with deviated gallbladder.
A hepatic cyst or possible abscess was noted in the right cranial liver and measured 10.0 x 7.4 cm. The cyst deviated the gallbladder. The hepatic veins were dilated in this patient. The right heart should be evaluated for pericardial effusion or causes of right-sided heart failure. Otherwise, the liver was uniformly enlarged with areas of remodeling.
Echocardiogram is recommended followed by ultrasound-guided drainage and culture.
Ultrasound-guided FNA of the general hepatic parenchyma is also warranted given the
areas of remodeling.
Recheck ultrasound one month later –
The right pancreatic limb was hypoechoic and irregular with regional lymphadenopathy. This is a new development compared to the prior sonogram.
Hepatic mass not present on the previous scan, measuring 8.56 x 6.3 cm with potential ruptured cyst with regional inflammation. Heterogenous pancreas. Concurrent pancreatitis or possible pancreatic neoplasia. Exploratory surgery is necessary in this patient. This is an aggressive presentation and debatable whether resection is possible
Liver – chronic-active hepatitis, inflammatory hepatopathy, cirrhosis, neoplasia, abscessation, nodular regeneration
Gall bladder – cholecystitis, mucocele, neoplasia
Pancreas – chronic pancreatitis, neoplasia
