Good evening,
I wanted to get your thoughts on the vena cava and hepatic vein size, and if incidental peritoneal effusion is sometimes seen during exams. I haven’t run across this yet but spoken with another radiologist who mentioned they sometimes see a scant peritoneal effusion that isn’t repeatable on serial exams.
I scanned a 3 y.o MN greyhound today with a history of inappropriate urination. He had been worked up with labs, urinalysis, and a urine culture and was improving with behavioral intervention, but the owners wanted to rule out a medical reason.
Good evening,
I wanted to get your thoughts on the vena cava and hepatic vein size, and if incidental peritoneal effusion is sometimes seen during exams. I haven’t run across this yet but spoken with another radiologist who mentioned they sometimes see a scant peritoneal effusion that isn’t repeatable on serial exams.
I scanned a 3 y.o MN greyhound today with a history of inappropriate urination. He had been worked up with labs, urinalysis, and a urine culture and was improving with behavioral intervention, but the owners wanted to rule out a medical reason.
During the exam I found a normal appearing urinary bladder, kidneys, and prostate. However, I also found generalized splenomegaly and a scant amount of anechoic ascites near the splenic tail. I understand that greyhounds may have a larger spleen per breed variance but that infectious/rickettsial disease and other disorders should be ruled out.
The vena cava and hepatic veins appeared prominant to me. I did not perform a Doppler exam but plan to on a repeat scan. Could this be normal for the breed?
There is no history of heart disease or heart murmur. The patient is symptom free except for inappropriate urination.
The owner did not give permission for aspirates of the fluid or spleen, unfortunately.
Thanks!
Comments
Thats typical hypersplenism
Thats typical hypersplenism GSD and Greyhouinds are the poster breeds for this. I’m wondering if the foldeed spleen is pushing on the bladder apex causing overflow pressure when the UB is big ocntirbuting to thew clinical signs?? Im not sure on the hepatic vein dilation as I agree and Im assuming not sedated for the exam as dexdomitor will do this. The liver looks a bit coarse with increased portal markings for what its worth. Greyhounds love to form thromboses in my experience so just to chase a zebra ensure there isnt a clot forming in the CVC near the diaphragm for some reason.
Thanks for the prompt
Thanks for the prompt response! Super helpful. I’ll let you know if we find anything else.
With hypersplenism would
With hypersplenism would expect thrombocytopenia and occasional mild anemia.
Remo I know we use
Remo I know we use hypersplenism as a descriptive term sonographically regardless of CBC dyscrasias (GSD hypersplenism for example) but is the definition of “hypersplenism” from an internal medicine standpoint always come with thrombocytopenia and anemia?
Would splenomegaly not be the
Would splenomegaly not be the correct term for finding an enlarged spleen on US? Hypersplenism is a secondary process that can arise from splenomegaly of almost any cause Results in an increase in the spleen’s mechanical filtering and destruction of RBCs and often of WBCs and platelets. Compensatory bone marrow hyperplasia occurs in those cell lines that are reduced in the circulation.
Interesting… in the
Interesting… in the sonography circles it has become synonymous but I guess we have to change that and call it idiopathic splenomegaly or something similar if the thrombocytopenia and anemia isnt present.
When you FNA the spleen in your case iof true hypersplenism what do you get usually?? EMH?
EMH, some plasma cells.
EMH, some plasma cells.