I can use some help with this case . Zoey is a 7 years old lab X that presented for ascites
U/S : no macroscopic neoplasia, liver was subjectivelly small but did not looked cyrrhotic to me ( My understanding is that U/S can underestimate early cirrhotic appearance) . No hepatic congestion, no distended CBC. No pericardial effusion. No PLN. Albumin is low 16.9 before Prednisone trial then 19/L ( not low enough to explain ascites) Thoracic X-rays were normal
We’ve tried Prednisone at 2 mg/ kg daily and Spirinolactone as a treatment for PLE with no improvment after 2 weeks
Bile acids are both in high 80/88. I suspect cyrhosis with secondary Portal hypertension but not convinced . Did FNA of the liver, results are pending .
Does this look like liver cyrrhosis to you ? Does my PW help to confirm, rule out Portal Hypertension ?
Thank you !