Bosco is an 11 year old MN Weimeraner referred for abdominal ultrasound for weakness, some urinary incontinence, diarrhea and straining/stretching. The spleen had a mixed echogenic tumor >8 cm in the body. No effusion. The left kidney was very enlarged and tender during exam. Did not see a diltated ureter. No visible tumor involving the aorta and femoral pulses strong. The kidney had almost no normal architecture present, save a small rim of cortex.
Bosco is an 11 year old MN Weimeraner referred for abdominal ultrasound for weakness, some urinary incontinence, diarrhea and straining/stretching. The spleen had a mixed echogenic tumor >8 cm in the body. No effusion. The left kidney was very enlarged and tender during exam. Did not see a diltated ureter. No visible tumor involving the aorta and femoral pulses strong. The kidney had almost no normal architecture present, save a small rim of cortex. Was not given permission to aspirate, but wondering how high on my differential list you would put renal hemangiosarcoma or renal neoplastic process vs. a benign cystic kidney? Please note, “HD” should be “Left Kidney” in the video
Comments
Are you sure this mass is
Are you sure this mass is splenic? Can you follow the mass to the splenic hilus as its odd for a splenic mass to tie up a ureter and obstruct a kidney… they usually rupture before that happens whereas a left pheo from the adrenal would certainly do this and weimeraners are overrepresented in my pheo category..The echogenicity and pattern fits more pheo than spleen and can occupy the area of the splenic fossa devating the spleen dorsolaterally that you have to image is left paralumbar or intercostal. Power doppler on the mass will help as well.
Its an aggressive mass… if the dog is hypertensive im betting on pheo here but need more views of course maybe a good sweep along the left renal hilus and another connecting recoignizable spleen to the mass… or not and maybe some power or color doppler on the mass? Pheos usually light up on color.
A 25 g fna would help clarify as well.
Thanks, Eric. This was
Thanks, Eric. This was definitely a learning case for me. Thanks for your guidance.
Are you sure this mass is
Are you sure this mass is splenic? Can you follow the mass to the splenic hilus as its odd for a splenic mass to tie up a ureter and obstruct a kidney… they usually rupture before that happens whereas a left pheo from the adrenal would certainly do this and weimeraners are overrepresented in my pheo category..The echogenicity and pattern fits more pheo than spleen and can occupy the area of the splenic fossa devating the spleen dorsolaterally that you have to image is left paralumbar or intercostal. Power doppler on the mass will help as well.
Its an aggressive mass… if the dog is hypertensive im betting on pheo here but need more views of course maybe a good sweep along the left renal hilus and another connecting recoignizable spleen to the mass… or not and maybe some power or color doppler on the mass? Pheos usually light up on color.
A 25 g fna would help clarify as well.
Thanks, Eric. This was
Thanks, Eric. This was definitely a learning case for me. Thanks for your guidance.
You bet my pleasure.
You bet my pleasure.
You bet my pleasure.
You bet my pleasure.