An 11-year-old FS Mixed breed dog was presented for evaluation of a progressive loss of appetite. Vomiting and/or diarrhea were not present. Physical examination was within normal limits. Urinalysis revealed 3+ bilirubin and isosthenuria. CBC was within normal limits. Abnormalities on serum biochemistry were elevated globulins, elevated liver enzyme activity, and elevated bilirubin. T4 was low.
An 11-year-old FS Mixed breed dog was presented for evaluation of a progressive loss of appetite. Vomiting and/or diarrhea were not present. Physical examination was within normal limits. Urinalysis revealed 3+ bilirubin and isosthenuria. CBC was within normal limits. Abnormalities on serum biochemistry were elevated globulins, elevated liver enzyme activity, and elevated bilirubin. T4 was low.
Case Study
03_00200 Casey C Hepatitis
Sonographic Differential Diagnosis
Chronic active hepatitis with potential emerging neoplasia. Periportal lymphadenopathy. Portal hypertension with ascites.
Image Interpretation
A minor amount of anechoic ascites was noted in this patient. The liver had increased portal markings and irregular contour with some capsular retraction. The portal vein velocity was subnormal at 11 cm/sec. This is consistent with portal hypertension. A periportal lymph node was enlarged and microcystic at 4 x 2.6 cm. Ultrasound-guided biopsy would be warranted with potential lymph node biopsy.
DX
Outcome
The patient was started on amoxicillin, Baytril and Denamarin for chronic active hepatitis.
Comments
No video is available on this patient.
Clinical Differential Diagnosis
Liver – vacuolar hepatopathy, neoplasia, infectious (bacterial/viral), cirrhosis, toxic. Gall bladder – mucocele, cholangitis, partial obstruction.
Sampling
None.
Patient Information
Clinical Signs
- Anorexia
Images
Blood Chemistry
- Globulin, High
- Total Bilirubin, High
Clinical Signs
- Anorexia
Urinalysi
- Bilirubin Present
- Isosthenuria Present