A 3 year-old female Poodle mix was presented for evaluation of a 2 week history of poor appetite, lethargy, and PU/PD. Urinalysis showed SG of 1.024, 3+ protein and 1+ blood. Abnormalities on CBC and serum biochemistry were leukocytosis, mild anemia, elevated liver enzyme activity, low cholesterol, hypoproteinemia, and low BUN. Survey radiographs showed loss of abdominal detail.
The liver in this patient presented subnormal size and irregular nodular changes. This is consistent with end stage cirrhosis. Free fluid was noted owing to the ascites and likely portal hypertension. The gallbladder was double layered and echogenic. This is consistent with fibrosis.
The urinary bladder, trigone and pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. Small bladder calculi were noted and were non-obstructive measuring 0.95 cm. No evidence of inflammatory or neoplastic changes were noted. The ureters were not visible and therefore considered normal.
Liver – chronic-active hepatitis, cirrhosis, infiltrative neoplasia (lymphoma, mast cell)
Peritonitis
None
Hepatic cirrhosis pattern with ascites. This is likely owing to portal hypertension.
End stage liver disease.
Small bladder and renal calculi, non obstructive.
Core biopsy would be necessary in this patient given the elevated liver enzymes, sonographic structure and low BUN. End stage liver disease owing to chronic inflammation is likely. There was no evidence of neoplasia. Prognosis is poor long term.
