A 12-year-old FS Greyhound was presented for evaluation of intermittent hind-limb lameness and more recently cold limbs. Survey radiographs of the spine were unremarkable.
Case Study
Bilateral femoral thrombi in a 12 year old FS Greyhound
Sonographic Differential Diagnosis
Bilateral external Iliac and femoral thromboses. Renal cortical infarcts with potential glomerular nephritis. Assessment for proteinuria is recommended. Recommend assessment for hypercoagulable state in this patient. Plavix, plus or minus heparin therapy would be indicated. Interventional radiologist or surgeon may be the best option to address the thromboses. These appear to be relatively well-organized thromboses and therefore have likely been building up in situ for some time. Full coagulation panel with D-dimers, FDP and AT III levels would be recommended. If antithrombotic therapy is to be utilized, recheck sonogram is recommended in 7 to 10 days as patient is at risk for sudden death owing to pulmonary thromboembolic or myocardial thromboembolic events. Blood pressure measurements, assessment for proteinuria, and assessment for tick borne disease are all warranted.
Image Interpretation
Femoral arteries in this patient were nearly completely occluded by thrombosis bilaterally. The aorta itself was unremarkable until it reached the iliac bifurcation in which thrombi were completely occluding the external iliac arteries and the femoral arteries. Thromboses were confirmed on both long axis and short axis views and continued the length of the femoral arteries. Kidneys revealed multiple infarcts with a medullary rim sign, thickened irregular cortices. The renal cortical infarcts appeared to be of historic date. Right kidney measured 6.7 cm. Left kidney 7.04 cm.
DX
Bilateral external iliac artery and femoral artery thrombi
Outcome
None
Clinical Differential Diagnosis
Thrombo-embolic disease, spinal neoplasia, type II disc prolapse
Sampling
None
Video
Video Player
00:00
00:00
Video Player
00:00
00:00
Video Player
00:00
00:00
Patient Information
Patient Name :
KC Sandt/PA mobile
Gender :
Female, Spayed
Species :
Canine
Type of Imaging : Ultrasound
Status :
Complete
Code :
11_00057
Clinical Signs
- Lameness
Exam Finding
- Cool foot
Images
Clinical Signs
- Lameness