A 10-year-old SF Beagle cross was presented for evaluation of elevated liver enzyme activity and bilirubinemia. Additional history was the presence of poor appetite and weight loss.
A 10-year-old SF Beagle cross was presented for evaluation of elevated liver enzyme activity and bilirubinemia. Additional history was the presence of poor appetite and weight loss.
Case Study
03-00270 Lilly S ——-NEEDS DX, SL———
Sonographic Differential Diagnosis
Given the mild elevation in coagulation parameters only fine-needle aspirates were performed as opposed to core biopsy. However, significant chronic active hepatitis is suspected and may not be overtly reflected upon fine-needle aspiration. The portal vein velocity was subnormal at 14 cm/sec. Leptospirosis should be ruled out. Empirical treatment with ampicillin and doxycycline combination with continuation of nutraceuticals would be recommended. Vitamin K supplementation can be utilized with potential core biopsy.
Image Interpretation
The liver in this patient revealed increased portal markings, mild, subnormal size and moderate parenchymal heterogeneity. The gallbladder and common bile duct were normal. Minor periportal lymphadenopathy was noted at 2.08 x 1.0 cm. These lymph nodes were echogenic and consistent with chronic lymphadenitis.
Outcome
The patient is still very picky about food. The owner is considering aspirates at this time.
Clinical Differential Diagnosis
Liver – vacuolar hepatopathy, nodular hyperplasia, infectious hepatitis (viral/bacterial/fungal), toxins, neoplasia, drug-induced, chronic-active hepatitis, trauma Gallbladder – obstruction, cholecystitis, mucocele Pancreas – pancreatitis, neoplasia
Sampling
Liver FNA
Video
Patient Information
Gender :
Female, Spayed
Species :
Canine
Type of Imaging : Ultrasound
Clinical Signs
- Anorexia
- Weight loss
Images
Blood Chemistry
- Elevated Liver Enzymes
- Total Bilirubin, High
Clinical Signs
- Anorexia
- Weight loss