– 6 year old MN Weiremeraner presented on the weekend for non-productive retching, straining urinate and blood in the urine
– U/A showed RBC’s and WBC’s, no crystals ; culture was not performed; rDVM started Baytril
– abdominal rads unremarkable (I have recommended chest rads)
– bloodwork showed only a mild neutrophilia, liver enzymes normal, BUN slightly low
– pet now anorexic and has a fever 41C; no more dysuria seen but still retching
– 6 year old MN Weiremeraner presented on the weekend for non-productive retching, straining urinate and blood in the urine
– U/A showed RBC’s and WBC’s, no crystals ; culture was not performed; rDVM started Baytril
– abdominal rads unremarkable (I have recommended chest rads)
– bloodwork showed only a mild neutrophilia, liver enzymes normal, BUN slightly low
– pet now anorexic and has a fever 41C; no more dysuria seen but still retching
– u/s ub small and intrapelvic but no lesions seen in the trigone/prox urethra – prostate could not be seen but I think if it were enlarged I would see part of it and it would have also looked big on x-ray; medial iliac LN’s not seen; kidneys normal
– GI, stomach, pylorus normal
– no stones seen in the distal urethra scanned through the prepuce
The liver looks diffusely hypoechoic to me with prominent portal markings. It is hypoechoic to the falciform fat, spleen and renal cortices. It does not appear to be enlarged. In light of normal liver enzymes, what is this significance if any? Differentials would be congestion, acute hepatitis, possible lymphoma but I think unlikely. The dog was under dexdomitor/butorphanol sedation – could this cause some passive liver congestion. The blood in the CVC showed some smoke and swirling during the exam which I have seen under dexdomitor sedation before.
Comments
Hi JP your focal point is at
Hi JP your focal point is at the bottom which artificially causes the liver to be hypoechoic. Im not seeing anything that bothers me here other than minor age related changes. If you didn’t already I would get a probe on the deep pelvic urethra and prostate to assess carcinoma with that history.
I wondered if this may have
I wondered if this may have been setting dependent. Nothing seen in the prostate or proximal urethra.
Yes focal point is my
Yes focal point is my sentinel adjustment… if my day is crazy the FP ends up in the wrong place as its the last adjustment I do in an exam…. so if my image is dark it triggers me to think focal point or the cat walked over my TGC:)
If you get a chance to rescan
If you get a chance to rescan it would be interesting to see what the liver looks like
with the focal point in the middle of the scan. Maybe you can post updated images.
Most likely won’t get a
Most likely won’t get a chance as this was a mobile client 1 hour away Randy : (