8 year old cat, lost 7 pounds over several months then presented for icterus
Initial ultrasound showed
hyperechoic liver
pancreatitis
biliary stasis but no obstruction with a small amount of localized free fluid right around the gall bladder
GI layering normal.
She was still eating but had severe icterus, clotting times off the chart, reduced platelets, and generalized petechieae. I chose not to do FNA at that time.
8 year old cat, lost 7 pounds over several months then presented for icterus
Initial ultrasound showed
hyperechoic liver
pancreatitis
biliary stasis but no obstruction with a small amount of localized free fluid right around the gall bladder
GI layering normal.
She was still eating but had severe icterus, clotting times off the chart, reduced platelets, and generalized petechieae. I chose not to do FNA at that time.
Clinically she has remained stable to maybe improved. PT normalized, PTT still off the scale. ALP and ALT greatly improved. Generalized petechiation and icterus. Eating, though not well. She is on IV fluids with potassium, flagyl, baytril, dexamethasone SP, vitamin B12, mirtazapine. sAME made her more nauseous.
She has more free fluid and her pancreatitis looks ultrasonographically worse. I can follow her bile duct to her esophagus but it still looks very dilated and tortuous.
Ideas for treatment? Time to FNA? I assume that I am likely missing the underlying cause.
Thanks,
Suzanne
Comments
Looks like a pretty good left
Looks like a pretty good left limb pancreatitis in th enear field on vodeo one and a lipidosis pattern and minor free fluid but underlying LSA cant be ruled out and can be obscured by the lipidosis as they can exist together. If coag can be reduced to 20% elevated then I would do a 25g fna of th eliver and maybe drop a peg tube.
If straight lipidosis usually time and feed them til they get better but need the fna to rule out lsa or similar.
Looks like a pretty good left
Looks like a pretty good left limb pancreatitis in th enear field on vodeo one and a lipidosis pattern and minor free fluid but underlying LSA cant be ruled out and can be obscured by the lipidosis as they can exist together. If coag can be reduced to 20% elevated then I would do a 25g fna of th eliver and maybe drop a peg tube.
If straight lipidosis usually time and feed them til they get better but need the fna to rule out lsa or similar.
Thanks. She developed
Thanks. She developed pulmonary edema and pleural effusion today and was euthanized.
Suzanne
Thanks. She developed
Thanks. She developed pulmonary edema and pleural effusion today and was euthanized.
Suzanne
If the effusion wasnt a
If the effusion wasnt a cardiac issue then lymphoma likely as this is how it moves to the chest.
Nice post
If the effusion wasnt a
If the effusion wasnt a cardiac issue then lymphoma likely as this is how it moves to the chest.
Nice post