This 12 year old FS Maltese dog has a history of chronic vomiting and weight loss, mitral and tricuspid insufficiency and dental disease. Mild pain on abdominal palpation.
This 12 year old FS Maltese dog has a history of chronic vomiting and weight loss, mitral and tricuspid insufficiency and dental disease. Mild pain on abdominal palpation.
The liver was uniformly enlarged with minor, hypoechoic nodules. These may represent metastatic lesions or hyperplasia. The gallbladder presented a minor amount of debris and polyps. This is not likely a clinical issue. Regional free fluid was noted between the liver lobes. This is likely deriving from the gastric pathology. The gastric wall was significantly thickened with loss of mural detail. The gastric wall measured approximately 1-1.3 cm in thickness. Regional inflammatory pattern was noted around the stomach. This is indicative of transmural inflammation. Significant hypertrophied muscularis with some loss of detail of the submucosal layer was noted. Epigastric lymph node enlargement was also present. Other regional lymph nodes were also enlarged around the pyloric outflow.
Primary differentials are carcinoma, lymphoma or potential severe, complicated
gastritis.
Liver nodules, potentially metastatic disease. Gallbladder debris and polyps.
Sampling of the stomach is essential in this patient, ideally from surgical approach.
However, ultrasound-guided FNA of the gastric wall as well as the regional lymph
nodes and liver could also be considered from a cursory evaluation. Otherwise,
surgical biopsies of the lymph nodes, liver and gastric wall or endoscopy can be
considered as the mural changes appear to enter into the lumen and should be
accessible by endoscopy. Very guarded prognosis.
