Hematemesis

Sonopath Forum

– 22 month old FS Border Collie x presented for hematemesis and black, tarry stool with some fresh blood

– no history of FB ingestion but has been known to eat things that she shouldn’t

– survey rads unremarkable and initially started on famotidine and sulcrate

– giardia positive on fecal testing

– u/s showed fluid-filled stomach with increased rate of stomach contractions

– 22 month old FS Border Collie x presented for hematemesis and black, tarry stool with some fresh blood

– no history of FB ingestion but has been known to eat things that she shouldn’t

– survey rads unremarkable and initially started on famotidine and sulcrate

– giardia positive on fecal testing

– u/s showed fluid-filled stomach with increased rate of stomach contractions

– left lateral deep wall of the stomach shows a hypoechoic mass-like lesion that looks like to be coming from the wall with no colour Doppler flow; at times there almost looks like a hyperechoic linear object is in the region (FB?) but it might just be hyperechoic gas

– there is a trace effusion seen in the abdomen that is too little to tap

I am not sure what this is but am worried about possibly a migrating FB and severe gastritis/ulceration, gastric ulceration and hematoma, abscess, tumour, ?

Because the pet is vomiting blood, it has been referred as surgery may be warranted which way not be straight-forward. The pet was sensitive in this region when scanned.

Any thoughts?

 

Comments

EL

I had a case like this

I had a case like this yesterday but in an older dog. The mass is in the fundus which is where leiomyosarcomas grow but also epithelial tumors occasionally carcinomas but its a young dog for all that. I dont like effusion especially echogenic. The linear structure can be grass or similar but I have seen these be fb and grass and artifact…. tough to tell which but if persistent then likely real. This dog is staring at exploratory but if you can get further into the GES formt he fundus be sure the esophagus is not involved because is was in my case… a second lesion that rendered sx resection useless. This lesion appears resectablke given the position by a perf is possible wiht that effusion. I will try to post mine later as I tried to fna with all the techniques I could and wouldnt exfoliate and thats what Leios do. I offered core bx on mine but they didnt like my “cowboy hat” so going to scope and smoke the credit card at a referral facility:)

EL

I had a case like this

I had a case like this yesterday but in an older dog. The mass is in the fundus which is where leiomyosarcomas grow but also epithelial tumors occasionally carcinomas but its a young dog for all that. I dont like effusion especially echogenic. The linear structure can be grass or similar but I have seen these be fb and grass and artifact…. tough to tell which but if persistent then likely real. This dog is staring at exploratory but if you can get further into the GES formt he fundus be sure the esophagus is not involved because is was in my case… a second lesion that rendered sx resection useless. This lesion appears resectablke given the position by a perf is possible wiht that effusion. I will try to post mine later as I tried to fna with all the techniques I could and wouldnt exfoliate and thats what Leios do. I offered core bx on mine but they didnt like my “cowboy hat” so going to scope and smoke the credit card at a referral facility:)

Pankatz

Thanks Eric – this one is

Thanks Eric – this one is also at a referral centre now and had a CT scan last night and we are waiting on results – will keep you updated! The abdominal effusion worried me as well so no fooling around here.

JP

Pankatz

Thanks Eric – this one is

Thanks Eric – this one is also at a referral centre now and had a CT scan last night and we are waiting on results – will keep you updated! The abdominal effusion worried me as well so no fooling around here.

JP

Pankatz

An update on this case – CT

An update on this case – CT showed some granular material in the pylorus, but nothing else other than a slightly enlarged pancreas (the pancreas was sllightly hypoechoic on u/s).

The pet is now doing well. I am not sure why CT was chosen over scoping nor if CT would even show what I saw on ultrasound. Anyway, as long is the pet is doing well, that is good at this stage. Maybe this was just a very severe gastritis?

 

Pankatz

An update on this case – CT

An update on this case – CT showed some granular material in the pylorus, but nothing else other than a slightly enlarged pancreas (the pancreas was sllightly hypoechoic on u/s).

The pet is now doing well. I am not sure why CT was chosen over scoping nor if CT would even show what I saw on ultrasound. Anyway, as long is the pet is doing well, that is good at this stage. Maybe this was just a very severe gastritis?

 

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