This 7 year old MN Labrador Retriever has a history of hypoalbuminemia, low BUN, Lepto ELISA positive and UTI.
Current CBC/Chem: HCT 38%, bile acids 85, post prandial 100, Albumin 2.2, BUN 7. U/A: bilirubin +1, blood +3, RBC 30-50/hpf
This 7 year old MN Labrador Retriever has a history of hypoalbuminemia, low BUN, Lepto ELISA positive and UTI.
Current CBC/Chem: HCT 38%, bile acids 85, post prandial 100, Albumin 2.2, BUN 7. U/A: bilirubin +1, blood +3, RBC 30-50/hpf
CT of the abdomen –
The portal vein presents a normal order of intrahepatic branching. However, the individual branches reveal an undulating course. Multiple small tortious vessels emerge from the left gastric and splenic veins and course dorsally in the region medial the left kidney where they end in the region of the left renal vein. All liver-lobes are small and present with multinodular parenchymal architecture and surface.
With the pertaining history the most likely underlying cause is infectious hepatitis such
as leptospirosis or viral hepatitis with bacterial superinfection. Other possible reasons
would be chronic toxin exposure or copper storage disease – likely with superinfection
too. Primary biliary cirrhosis is a lower potential.
Ultrasound guided Tru cut liver biopsy or surgical biopsies are warranted for further definition. Ultrasound guided Tru-cut biopsies of the liver may be performed with
reasonably low potential for complications under the following conditions: platelet
count > 50*103/μl, <25% prolongation of PT/PTT – less of deviation from normal
values acceptable in presence of peritoneal effusion. The intensity of the post
procedural patient monitoring needs to be tailored to the degree of deviation from
normal reference ranges. The options of causative treatment depend on the underlying disease but are considered limited. Dietetic management should be considered to alleviate the clinical signs. The long term prognosis is guarded to poor.
