Sonopath Forum

Hepatocutaneous Syndrome?

Saw about a 50 pound FS German Shepherd that was fairly lethargic, anemic, and had severe thrombocytopenia. For several years, the owners had a hard time keeping weight on her…generally ADR. Upon presentation, was walking around, quiet, alert, but not herself. Gradually declined over the course of 4 to 5 hours…then MM became pale…became agonal…had to humanely euthanize. I obtained some ultrasound images about an hour before euthanasia. Her ALT was only about 150 from what I recall. I am just wondering if this is what hepatocutaneous syndrome

Comments

DrMac

February 18, 2020 at 9:59 pm -

Hey Robb, IMO the swiss

Hey Robb, IMO the swiss cheese appearance of this liver can certainly look like HCS. If there were concurrent cutaneous lesions, it certainly could be. Generally with HCS, you see nonuniform increased parenchyma echogenicity with the irregular hypoechoic nodular changes that makes it look kinda moth eaten. The nodules, for the most part, look fairly well defined and diffuse. There is also some effusion between the liver lobes. I’m thinking more neoplasia here..with possible secondary bleeding in the abdomen or paraneoplastic anemia / ITP.

robbmurphie

February 19, 2020 at 5:09 pm -

thank you….another somewhat

thank you….another somewhat unusual case….minimal platelets….walking around in the morning…and becoming agonal and bleeding out in the afternoon….and not your typical hemoabdomen presentation. It was also kind of unusual to see a liver like this with a minimal elevation in ALT.