8 yr FS mixed breed dog. No clinical symptoms, but liver values have been increasing – ALT 516. Saw this structure near the ICCJ and drained it. Liver appeared normal, but was hyperechoic. Spleen was enlarged, touching the cranial urinary bladder, but otherwise appeared normal. Fluid analysis and culture are pending, but looked like chyle. Lymphatics gone haywire and causing a hepatopathy? Pending the fluid analysis, planning to recheck liver enzymes in a week and then recheck ultrasound later this month – any other suggestions?
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Can get a chyle cyst/chylolymphatic cyst/retroperitoneal lymphatic cyst, which is a fairly rare cystic lesion containing chyle/lymph that develops from lymphatic vessels in the mesentery or retroperitoneum.
Need to confirm chylous fluid by running cholesterol and triglycerides on the fluid analysis as well as serum. True chyle cysts will have a much elevated fluid triglycerides than serum triglycerides. If triglycerides are not elevated and cholesterol is disproportionately high, then dealing with pseudochylous material rather than a true chyle cyst.
Thanks so much, Dr. Lobetti!