Hi everyone,
8 yo SF DSH was presented for lethargy, vomiting (yellow bile), inappetence and weight loss. Apparently unremarkable stools.
PE: mild jaundice
CBC/Biochem: elevation of ALT (500) and total bilirrubin (1,8).
UA: +2 bilirrubin, +2 blood, density > 1.050
Abd. US (what I see): The liver parenchyma is mildly echogenic. The gall bladder is mildly dilated with suspended debris, the wall is slightly thickened. CBD and duodenal papilla seem unremarkable. Medullary rim present in both kidneys. Stomach submucosa thickened.
Hi everyone,
8 yo SF DSH was presented for lethargy, vomiting (yellow bile), inappetence and weight loss. Apparently unremarkable stools.
PE: mild jaundice
CBC/Biochem: elevation of ALT (500) and total bilirrubin (1,8).
UA: +2 bilirrubin, +2 blood, density > 1.050
Abd. US (what I see): The liver parenchyma is mildly echogenic. The gall bladder is mildly dilated with suspended debris, the wall is slightly thickened. CBD and duodenal papilla seem unremarkable. Medullary rim present in both kidneys. Stomach submucosa thickened.
Comments
Nice case, could use some
Nice case, could use some more depth to get an overview but there is a hairball or dense ingesta in the stomach. The liver is coarse and minor increased portal markings suggestive of inflam hepatopathy. The Gb has some debris but not overly distended and the cbd seems normal and no lobar biliary duct dilation so i think you can rule out post hepatic obstruction. Needs a needle to confirm cholhep and maybe transition to LSA given the bili rise. The parenchyma is isoechooic to falciform so if lipidosis not likely a primary player here. The answer is in the parenchyma and the needle. If exposed to toxoplasma consider that too. Welcome to sonopath forum!!
Nice case, could use some
Nice case, could use some more depth to get an overview but there is a hairball or dense ingesta in the stomach. The liver is coarse and minor increased portal markings suggestive of inflam hepatopathy. The Gb has some debris but not overly distended and the cbd seems normal and no lobar biliary duct dilation so i think you can rule out post hepatic obstruction. Needs a needle to confirm cholhep and maybe transition to LSA given the bili rise. The parenchyma is isoechooic to falciform so if lipidosis not likely a primary player here. The answer is in the parenchyma and the needle. If exposed to toxoplasma consider that too. Welcome to sonopath forum!!
Any anemia on thematology as
Any anemia on thematology as could be dealing with pre-hepatic icterus.
Also with normal ALP feline hepatic lipidosis unlikley – but can be easily diagnosed on FNA cytology. Possible also consider FIP.
Any anemia on thematology as
Any anemia on thematology as could be dealing with pre-hepatic icterus.
Also with normal ALP feline hepatic lipidosis unlikley – but can be easily diagnosed on FNA cytology. Possible also consider FIP.
Curiously the FNA came back
Curiously the FNA came back as hepatic lipidosis. It is still unclear what was the primary insult, but the cat is doing fine with the e-tube so I guess this should resolve rather quickly.
Thanks for the help!
Curiously the FNA came back
Curiously the FNA came back as hepatic lipidosis. It is still unclear what was the primary insult, but the cat is doing fine with the e-tube so I guess this should resolve rather quickly.
Thanks for the help!
Just shows cannot be dogmatic
Just shows cannot be dogmatic about anything and cannot beat doing FNA cytology
Just shows cannot be dogmatic
Just shows cannot be dogmatic about anything and cannot beat doing FNA cytology
Cool thx for the follow
Cool thx for the follow up
Cool thx for the follow
Cool thx for the follow up