focal biliary tree choleliths
7 year 9 month old FS Chow with lethargy, vomiting and intermittently dribbling blood tinged urine. CBC WNL. Chem – ALT 773, ALP 389, GGT 31, T bili 0.5. Looks like choleliths in biliary tree, but focal region. No reported fever. Started Ursodiol, Denamarin, and antibiotics for cholangiohepatitis (Clavamox and metrondizadole). Urinary bladder looked unremarkable….
Reverse remodelling versus Mitral Stenosis
How would you diff b/w reverse remodelling and MV stenosis. Presented at recheck with mod severe pulmonary HT. Smll dog treated for chronic MVD stage C. US= LV under loading, FS > 50%, LAE remains significant. M e-vel is consistently 1.5m/s or higher but dec. time and press half time appear normal. E:A ratio around…
Chronic MVD with PHT
Chronic stage C MVD.TID Pimo and Lasix(high dose), ACEi and Spirono. Doing well. Recheck: Idexx GHP= CBC-NSF ,SDMA 15,BUN 14.1mmol/L, Creat 79umol/L. US: Cornell Indx LVd=1.46(prev2.1), LV septal flattening with diastolic dip,LAAO=2.47,Evel1.45m/s, TVregPG-68mmHg,HV distension-mod ascites.LV and LA underloading via diuretics and PHT (mild PHT past).PHT more pre vs post cap based on small LVsize? Consider…
Immune mediated anemia
6 yr MI Lab diagnosed with a regenerative anemia with spherocytes, negative slide agglutination, no hematuria, T bili WNL. Spleen very enlarged and irregular and I could not connect the more dorsal structure to any organs. Did FNA’s on both the spleen and suspected mass. Both came back as extramedullary hematopoeisis. Looked so irregular to…
splenic mass vs. infarction
10 yr FS Shep cross with lethargy, weakness and dec. appetite. Concern for the hypoechoic splenic head. Could see vessels on doppler, but think they were attenuated to those in the body. Patient was not painful during the exam. FNAs of the spleen, irregular liver (nodular) and the hypoechoic cranial abdominal lesion shown in the…
stomach polyps
9 year old FS Shepherd cross losing weight, intermittent vomiting, diarrhea that has been worsening now with blood. Do you think these structures in the stomach lumen could be polyps? So far, planning to recommend endoscopy.
Estrus with elevated WBC
8 month old FI Golden with no clinical symptoms. pcDVM did wellness blood work one week ago- WBC was 35,000 with all cell lines elevated. Two weeks ago, owners notes some vaginal bleeding (mild). One week ago (when blood work run), vaginal discharge became more clear (still mild) and behaviorally, the male neutered dog in…
Lung mass, choleliths
10 yr FS Boxer cross presented for coughing which seems to have resolved per owner. Please comment on attached thoracic radiographs. I was unable to find a discrete mass 1 week later, but have attached a video of all I could see of more consolidated lung adjacent to the heart. pcDVM actually captured the other…
renal dysplasia Corgi
7 month old FS Welsh Pembroke Corgi. Pre-anesthetic blood work BUN 63, SDMA 16, creat 1.5, SpG 1.015, manual UA did not show evidence of infection. Collected urine today for C&S. Asymptomatic. Grossly, would you have concerns for renal dysplasia?
acute abdomen
5 yr FI Lab acute lethargy, pale gums, strange breathing sounds. Chest rads WNL. Abdominal pain. BW- mild neutrophilia, UA SpG – 1.014 inactive sediment, C&S neg, Lepto Witness neg. Will eat now>18h. Owners declined abdominocentesis with fluid analysis. The attached videos are the only abnormality on ultrasound – hyperechoic mesentery around both kidneys, R>L…