Zia is 6YO spayed female greyhound. She presented at the emergency clinic for acute bloody diarrhea and vomiting. She was hemoconcentrated with mild liver enzyme elevation and hypokalemia. No history of toxin, chemical, medication or foreign body ingestion. PCV 66, ALT 1136, ALP 139, Cpl negative. There was a small pocket of free fluid lateral to the spleen. Could HGE appear like this? Should I do a needle aspirate of the stomach wall?
Zia is 6YO spayed female greyhound. She presented at the emergency clinic for acute bloody diarrhea and vomiting. She was hemoconcentrated with mild liver enzyme elevation and hypokalemia. No history of toxin, chemical, medication or foreign body ingestion. PCV 66, ALT 1136, ALP 139, Cpl negative. There was a small pocket of free fluid lateral to the spleen. Could HGE appear like this? Should I do a needle aspirate of the stomach wall?
Comments
Stomach wall is thick and
Stomach wall is thick and hyperechoic. HGE does affect the stomach and the current thinking is that is acute hemorrhagic diarrhea only. ALT of 1136 is also very high, which may indicate acute hepatitis (bacteria, leptospira, toxins). What does the intestine and liver look like on ultrasound?
The liver appears coarse
The liver appears coarse throughout. The margins are somewhat scalloped. There is no distinct focal mass. The gallbladder has some mobile sludge in it. The small intestines except for the first 2-4cm of the duodenum is normal appearing.
I dont like the loss of
I dont like the loss of linear detail on this stomach. Are LN up in the region? gastric carcinoma does this , lsa less likely, agressive gastritis possible. Scope worthy or full thickness gastric and shopping spree of bx given the liver changes…hx wise is it truly acute?? or acute on chronic with weight loss… the latter scenario brings up neoplasia as higher potential.. If its a $ case and no sampling possible then I would give benfit of doubt and tx parasites and helocobacter and rescan every week or so… I have seen really bad gastritis do this and a helicobacter protocol resolve it all in a couple of weekeds even with neoplastic criteria met.
Great , I am seeing them
Great , I am seeing them again tomorrow! Thanks for the support.