Angel is a 16 year old ~15 pound mix that was presented earlier this week for vomiting and diarrhea of a few days duration. (She has had elevated renal values for several months but on this visit also showed elevation in alt (off scale, dont have after dilution values available to me at this time), alkp 2000, tbil normal, chol, amy, lipase elevated as well. She was brought in today for a recheck. the vomitinag and diarrhea are resolved but she is inappetant. The vet in charge of the case wanted an ultrasound to evaluate the liver, ect. cbc normal
I am attaching a clip of the cranial/left lateral aspec of the liver. There is a large hypogenic circular area and then adjacent to it is a lace like pattern. My rule outs are neoplasia like hemangio or an abscess. Her cbc was normal. Spleen normal and no other neoplasic abnormalities in abdomen. Her kidneys were abnormal, small and mineralized and her adrenals were enlarged
Was just looking for opinions on the mass. I assume if it was an abscess her wbc would be elevated(?).
Thanks
Sue Bulman
Comments
Are you sure that isn’t the
Are you sure that isn’t the gall bladdder and an inflamed mucocele? Assuming you see a definitive gall bladder in other views then parts of the lesion look like biliary carcinoma and other fluid filled parts may be abscess but cant tell if its a machine software issue or real echos in the fluid. If this is not the GB then I would drain culture and cytospin for neoplasia but biliary carcinomas dont exfoliate well. May be resectable depending on the surgeon but likely would want a CT for surgical planning.
Thanks. It definitely wasn’t
Thanks. It definitely wasn’t gallbladder. The owners elected euthanasia. I am a chicken doing fna of objects looking like this. If it happened to be hemangio would bleeding be a concern?
Thx
Solitary hemangio in the
Solitary hemangio in the liver like this is rare its usually metastatic from a splenic mass. Start with 25 gauge and draw back then if safe go in with a larger needle if its thick like an abscess. Right intercostal approach sdep 12 position would work well here.