Hyperechoic pathology

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Hyperechoic pathology

Lucy is a 12 year old Siamese cross that has a history of chronic intermittent vomiting. Mostly bile but food on occasion.

Her lab work run recently was totally normal except for a trace of blood in the urine – which was probably from the cysto. No history of loose stools

Ultrasound findings:

– Stomach and small bowel looked fine. Normal wall thicness with normal layering. Ilio-cecal-colic region was normal. 

– Normal size L kidney- but an irregular capsule probably indicating some sort of previous infarct

Lucy is a 12 year old Siamese cross that has a history of chronic intermittent vomiting. Mostly bile but food on occasion.

Her lab work run recently was totally normal except for a trace of blood in the urine – which was probably from the cysto. No history of loose stools

Ultrasound findings:

– Stomach and small bowel looked fine. Normal wall thicness with normal layering. Ilio-cecal-colic region was normal. 

– Normal size L kidney- but an irregular capsule probably indicating some sort of previous infarct

– Small R kidney with normal morphology. The kidney measured 2.70 cm

– Small amount of biliary sludge

The only area that I wanted an opion on was this area that is hyper-echoic. What does this represent and do you feel it is pathological. Is there some free fluid on one of the cine’s?

 

Thanks for any info you can give me.

I did request a FPancreatic lipase

 

 

 

Comments

Electrocute

Hi Randy,
Can you give

Hi Randy,

Can you give reference points as to where in the abdomen you are at in the above pictures? It looks like there is free fluid in the first cine loop.  The 2nd one looks like there are some reactive lymph nodes.

Electrocute

Hi Randy,
Can you give

Hi Randy,

Can you give reference points as to where in the abdomen you are at in the above pictures? It looks like there is free fluid in the first cine loop.  The 2nd one looks like there are some reactive lymph nodes.

randyhermandvm

R anterior quadrant. I think

R anterior quadrant. I think you can see the pylorus on one of the cine loops.

I was wondering if there were reactive LN. At first I thought I was looking at the R horn of the pancreas- but it is to far forward. The SPECfPL was normal at 2.5 

This cat had “kitty magic” sedation if that makes a difference.

randyhermandvm

R anterior quadrant. I think

R anterior quadrant. I think you can see the pylorus on one of the cine loops.

I was wondering if there were reactive LN. At first I thought I was looking at the R horn of the pancreas- but it is to far forward. The SPECfPL was normal at 2.5 

This cat had “kitty magic” sedation if that makes a difference.

EL

The hyperechoic area is an

The hyperechoic area is an extention of the falciform fat buttressing the liver as this cat is likely body score 4 or 5 of 5. The hypoechoic areas are epigastric LN.. rounded but enlarged so likely reactive.. this is somewhat common in gastritis/IBD cats but usually around the ICJ. My guess is that this cat has/had a bout of steatitis linked to inflamed epigastric ln.. this usually occurs in the mesenteric root but can occur here as well. The LN get hot>regional fatty inflammation>resolves totally or partially> bundled up saran wrap effect on the fat that stays hyperechoic and remodeled.

EL

The hyperechoic area is an

The hyperechoic area is an extention of the falciform fat buttressing the liver as this cat is likely body score 4 or 5 of 5. The hypoechoic areas are epigastric LN.. rounded but enlarged so likely reactive.. this is somewhat common in gastritis/IBD cats but usually around the ICJ. My guess is that this cat has/had a bout of steatitis linked to inflamed epigastric ln.. this usually occurs in the mesenteric root but can occur here as well. The LN get hot>regional fatty inflammation>resolves totally or partially> bundled up saran wrap effect on the fat that stays hyperechoic and remodeled.

Electrocute

So, is this something you

So, is this something you would treat?  Do you look for an underlying infectious cause or immune mediated?  Would you consider this an active problem or just residual change from an old process?

Electrocute

So, is this something you

So, is this something you would treat?  Do you look for an underlying infectious cause or immune mediated?  Would you consider this an active problem or just residual change from an old process?

EL

Could be either or whatever

Could be either or whatever causes IBD. I like zithromax pepcid, hydrolysed diet +/- pred as empirical here. Dont use pred if eventually going after Ln and GI Bx.

randyhermandvm

EL
Why would you use

EL

Why would you use zithromax?

 

EL

Could be either or whatever

Could be either or whatever causes IBD. I like zithromax pepcid, hydrolysed diet +/- pred as empirical here. Dont use pred if eventually going after Ln and GI Bx.

randyhermandvm

EL
Why would you use

EL

Why would you use zithromax?

 

randyhermandvm

Thanks EL
Always a learning

Thanks EL

Always a learning experience

randyhermandvm

Thanks EL
Always a learning

Thanks EL

Always a learning experience

EL

zithro covers bartonella and

zithro covers bartonella and rickettsials in  case they are players but most of all its sid in liquid. Easy tx for a cat.

EL

zithro covers bartonella and

zithro covers bartonella and rickettsials in  case they are players but most of all its sid in liquid. Easy tx for a cat.

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