This 12 year old FS Alaskan Malamute dog has a history of progressively elevating liver enzymes. Not clinical.
Chem: May 19, 2016 ALP 292, ALT 381; June 18, 2016 ALP 415, ALT 512, AST 79
This 12 year old FS Alaskan Malamute dog has a history of progressively elevating liver enzymes. Not clinical.
Chem: May 19, 2016 ALP 292, ALT 381; June 18, 2016 ALP 415, ALT 512, AST 79
CT of the abdomen – The liver is relatively small with retracted lobar margins, undulating contours and multifocal nodular changes deviating the liver parecnhyma.
The portal lymph nodes present mild generalized enlargement with maintained short-to-long-axis ration of < 0.5 and regular contrast enhancement pattern. The left kidney presents an incidental uncomplicated cortical cyst of 1.5 cm.
The most likely underlying causes include 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 potential too.
The findings are not typical for a neoplasia.
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.
Acute and convalescent phase leptospirosis antibody testing is recommended.
The leftsided renal cyst is an incidental finding.
