An 11-year-old FS Cane Corso dog was presented post ovariohysterectomy for evaluation of anorexia and an incision site painful seroma that was dripping serosanguinous fluid. Fluid cytology showed the presence of neutrophils.
An 11-year-old FS Cane Corso dog was presented post ovariohysterectomy for evaluation of anorexia and an incision site painful seroma that was dripping serosanguinous fluid. Fluid cytology showed the presence of neutrophils.
Uterine stump granuloma was noted and measured 3.0 x 5.0 cm with possible adhesions to the dorsal bladder wall. The area of the left ovarian fossa revealed granulomatous type, mixed echogenic tissue owing to healing. This appears subjectively excessive. A separate granuloma was noted cranial ventral to the urinary bladder and measured 4.36 x 3.86 cm with mixed, hypoechoic, fluid filled regions as well as hyperechoic, reactive surrounding tissue.
The liver appeared normal in size with no overt evidence of hypovascularity. The gallbladder presented thin walls with normal, primarily anechoic content. The cystic and common bile ducts were normal. No pathological hepatic lymphadenopathy was evident. No overt structural evidence of inflammatory, infiltrative or regenerative pathology was noted.
A vascular anomaly was noted in this patient in the cranial abdomen. It appeared to be an arterial caval fistula with a cul de sac. This appeared to be an aorta to vena cava fistula with dilation of the vena cava or other vascular anomaly with a cul de sac type flow. This is a congenital anomaly and a completely different issue with regards to the reproductive pathology and granulomas, which are likely reaction based.
This may be suture reaction. Surgical intervention with debridement of all three regions would be recommended at the level of the uterine stump cranial ventral to the urinary bladder and in the region of the left ovarian fossa.
Vascular anomaly in the cranial abdomen, appears to be an arterial caval fistula with a cul de sac.
Bile acid profile is recommended prior to surgical intervention with immediate removal of the granulomatous tissue at the uterine stump cranial ventral to the urinary bladder in the region of the ovarian pedicle.
Examination of the vascular anomaly could be considered, but would be best defined by CT and contrast, yet this is a congenital anomaly that needs to be further defined as to whether it is a functional issue or an anomaly that would not necessarily detract from quality of life or metabolic function. The vascular anomaly appeared to have bidirectional flow. This was just cranial to the right kidney and appeared to be deriving from the vena cava. It is likely an anomaly related to the right renal vein. The sonographic pattern and dilation of the vena cava would suggest probable canine segmented caudal vena cava aplasia. This may be associated with portosystemic shunting and eventual thrombosis. CT evaluation would be recommended. This is a congenital lesion and there is no correlation to the caudal abdominal reproductive pathology. Further imaging of the portal hilus can also be considered from a sonographic perspective under sedation and on an empty stomach. However, antithrombolytic therapy may be necessary in this patient long term in this patient as this pooling of blood that occurs with this anomaly tends to form thrombosis especially when prothrombotic states may occur such as sepsis, eventual Cushing’s disease, neoplasia or other causes of thromboembolic events. There was no evidence of thrombosis at this time.
Incision site seroma, granuloma, abscess
Stump pyometria
Peritonitis
