- 10 year old MN Alaskan Malamute
- History of intermittent vomting for 2 months, increasing in frequency to EOD or daily, losing weight
- Fasted for 24 hours prior to ultrasound exam
- Distended stomach that I could not follow from body to fundus or orientate myself well at all
- Full of fluid and material causing accoustic shadowing
- First 2 videos with dog in right lateral recumbency, second 2 in left lateral recumbency
- There is an area that I have arrowed which looks abnormal, can you comment on this?
- 10 year old MN Alaskan Malamute
- History of intermittent vomting for 2 months, increasing in frequency to EOD or daily, losing weight
- Fasted for 24 hours prior to ultrasound exam
- Distended stomach that I could not follow from body to fundus or orientate myself well at all
- Full of fluid and material causing accoustic shadowing
- First 2 videos with dog in right lateral recumbency, second 2 in left lateral recumbency
- There is an area that I have arrowed which looks abnormal, can you comment on this?
- Radiographs showed distended stomach with gravel sign/mineralised material in stomach
- My main concern is gastric neoplasia causing obstruction but could not clearly visualise pathology
- Any help much appreciated
Comments
If this patient was npo I
If this patient was npo I would be concerned for bloat and partial rotation. If you go to SDEP position 13 you should get the pylorus every time despite the luminal artifact present and increase your depth as well. Slide dorsally toward the spine and back ventrally… if the pylorus is replaced by small intestine then think GDV. Im not sure on that abnormal tissue as it may just be folded bowel maybe wiht vascular compromioze. Post some rads if you have them. With that history I have seen bloating dogs do this and then rotate and become profoundly clinical. Depends on when we are scanning them as to position of the pylorus. There may be mural pathology obscured by the artifact but likely will need explore to find out. Attached is what the normal pylorus should look like if in proper position from the SDEP 13 approach and all the luminal material will be out of view. If you arent familiar with SDEP here is the download
https://sonopath.com/products/downloadable
and the poster describing the positions and maneuvers
https://sonopath.com/products/poster
or consider one of our SDEP seminars … one end of month in Andover NJ 4 more spots left:)
https://sonopath.com/educationevents/2018-sonopath-sdep-veterinary-ultrasound-training-educationce-events