Splenic torsion in a 7 year old FI Great Dane

Case Study

Splenic torsion in a 7 year old FI Great Dane

An intact 7-year-old female Great Dane dog presented for a history of vomiting and lethargy over a couple of days. At the previous assessment, anemia (32.5%), leukocytosis, and free fluid were present. On follow up assessment, the anemia had worsened (27.5%) and the leukocytosis was similar. ECG revealed VPCs. On cursory abdominal ultrasonography, free fluid and hyperechoic hepatic nodules were evident. The free fluid was found to represent a hemoabdomen.

An intact 7-year-old female Great Dane dog presented for a history of vomiting and lethargy over a couple of days. At the previous assessment, anemia (32.5%), leukocytosis, and free fluid were present. On follow up assessment, the anemia had worsened (27.5%) and the leukocytosis was similar. ECG revealed VPCs. On cursory abdominal ultrasonography, free fluid and hyperechoic hepatic nodules were evident. The free fluid was found to represent a hemoabdomen.

Sonographic Differential Diagnosis

These images are strongly suspicious of a splenic torsion with the potential for underlying, concurrent neoplasia. Immediate surgery is recommended.

Image Interpretation

The spleen is dramatically enlarged with generalized hypoechoic parenchyma and ill-defined, thickened hyperechoic vascular walls. The perisplenic tissue demonstrates hyperechoic omental changes that appeared to be attached to the spleen. Anechoic free fluid is present. Color flow assessment of the spleen revealed no visible blood flow.

DX

Splenic torsion

Outcome

The patient recovered uneventfully. ECG results were normal on follow-up.

Comments

Special Thanks to Drs. Cerf & Stancel at Ridgewood Veterinary Hospital, Ridgewood NJ, USA for their excellent management of this case. www.ridgewoodvet.com

Clinical Differential Diagnosis

Splenic disease – neoplasia, torsion, trauma. Liver disease – neoplasia (primary or metastatic), nodular regeneration, hematomas, granulomas. Hemorrhagic diathesis. Other intra-abdominal neoplasia.

Sampling

Surgical histopathology revealed severe splenic congestion with no evidence of neoplasia.

Patient Information

Patient Name : Angel S
Gender : Female, Intact
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 08_00059

Clinical Signs

  • Abdominal Distension
  • Abdominal Pain
  • Lethargy
  • Palpable Mass
  • Tense Abdomen
  • Vomiting

Exam Finding

  • Arrhythmia
  • Free fluid

Images

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CBC

  • RBC, Low
  • WBC, High

Clinical Signs

  • Abdominal Distension
  • Abdominal Pain
  • Lethargy
  • Palpable Mass
  • Tense Abdomen
  • Vomiting
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