- Signalment: 10 yo FS corgi
- Hx: long hx of lupoid dermatitis controlled with prednisone. Severe flare ups if off prednisone
- Reason for scan: Owner reports increased PU/PD. Labwork shows ALP>1000, UPC 1.5. rDVM wanting to rule out other causes of proteinuria, and increase in clinical symptoms (dog has been on pred and exhibiting these side effects for a long time, but now they are more marked.)
- Signalment: 10 yo FS corgi
- Hx: long hx of lupoid dermatitis controlled with prednisone. Severe flare ups if off prednisone
- Reason for scan: Owner reports increased PU/PD. Labwork shows ALP>1000, UPC 1.5. rDVM wanting to rule out other causes of proteinuria, and increase in clinical symptoms (dog has been on pred and exhibiting these side effects for a long time, but now they are more marked.)
- Other findings on scan: hyperechoic subtle nodule measuring 0.7 cm in splenic parenchyma (no distortion of capsule), prominent muscularis in stomach in some planes (but no loss of layering or thickening overall), aging changes in kidneys, flattened adrenals (pred), and a very tiny amount of free fluid that I suspect is physiologic in the absence of hypoalbuminemia.
- Questions to this forum:
- How do you guys interpret a duodenum that has a mucosa that looks like this? It’s the “mucosal fogging” type presentation but more irregular. I don’t want to overinterpret.
- When the muscularis of the stomach appears prominent in an asymptomatic dog…worth paying attention to?
- I have recommended monitoring the splenic lesion. I also recommended checking calcium levels. Would it be wrong to FNA this spleen? (I’ve had so many unexpected cancers recently I’m worried I’m getting a little needle happy.).
Thanks all!
Comments
I see this mucosal echogenic
I see this mucosal echogenic change often wonder if its a post prandial scenairo but doubt if clinical. Mucosal fogging and striations are more vertical and approach or reach the submucosal layer while these change in your image are superficial mucosal.
See the difference in this mucosal fogging case from the archive
https://sonopath.com/members/case-studies/cases/lymphangectasia-presentation-likely-protein-losing-enteropathy-ple-4-year
The focal isoechoic splenic swelling is worth watching and if losing wt i would 25g fna.
The one that I had that
The one that I had that looked like that Rottweiler ended up being lymphoma on liver FNA. Thanks for the reply, Eric
If the intestinal were true
If the intestinal were true mucosal fogging/speckling from lymphangectasia/severe IBD, would expect hypoalbuminemia.