A 7-year-old MN DSH was presented for decreased activity, inappetance, and icterus. On physical examination icterus, mild iris atrophy, and a 5-pound weight loss were evident. Abnormalities on CBC and blood chemistry were hemoconcentration, elevated ALT and elevated ALP activity, and marked hyperbilirubinemia. Coagulation panel was within normal range. Survey radiographs showed microcardia, hepatomegaly, and thickening of the stomach wall. The patient was treated with I.V. fluids, ampicillin, metronidazole, famotadine, Vitamin B complex, dextrose, coaxed/force feedings, and Cerenia.
A 7-year-old MN DSH was presented for decreased activity, inappetance, and icterus. On physical examination icterus, mild iris atrophy, and a 5-pound weight loss were evident. Abnormalities on CBC and blood chemistry were hemoconcentration, elevated ALT and elevated ALP activity, and marked hyperbilirubinemia. Coagulation panel was within normal range. Survey radiographs showed microcardia, hepatomegaly, and thickening of the stomach wall. The patient was treated with I.V. fluids, ampicillin, metronidazole, famotadine, Vitamin B complex, dextrose, coaxed/force feedings, and Cerenia. After 24-hours on fluids the patient was considerably brighter and affectionate.
Case Study
03_00184 Slanks B Hepatic lipidosis
Sonographic Differential Diagnosis
Primary differentials include lipidosis with underlying inflammatory hepatopathy and hepatic lymphoma.
Image Interpretation
The liver was swollen in contour, yet uniform and diffusely hyperechoic. Fine-needle aspirates were performed.
DX
Outcome
Empirical treatment for lipidosis was recommended. The treatment plan was continued and patient began eating on his own. Abnormalities on recheck blood work were mild hypokalemia and worsening hyperbilirubinemia despite fluid therapy. Ursodial, mirtazapine, and KCL were added to the treatment plan. The patient started to regress and was no longer eating on his own necessitating placement of a feeding tube. Prednisolone was added to current therapies.
Comments
The patient was lost to follow up.
Clinical Differential Diagnosis
Cholangitis, cholangiohepatitis, lipidosis, neoplasia, bile duct obstruction, liver toxicity, and fibrosis.
Sampling
US-guided FNA`s of the liver revealed hepatic lipidosis with intrahepatocellular cholestasis.
Video
Patient Information
Clinical Signs
- Anorexia
- Icterus
- Lethargy
- Weight loss
Exam Finding
- Icterus
Images
Blood Chemistry
- Alkaline Phosphatase (SAP), High
- ALT (SGPT), High
- Total Bilirubin, High
CBC
- Hematocrit, High
Clinical Signs
- Anorexia
- Icterus
- Lethargy
- Weight loss