-Duke, 1 year 2 mo old, was neutered 4/1, developed firm inguinal swelling over next 2 days.
-Firmess improved w/ hyperbaric O2, but then continued and is bigger in size, but less painful to patient. Some ventral edema settling in limb, w/ distal toes still warm to touch.
-Today, the swelling has what feels like a thrombosed vein running along the surface from cadual to cranial (visible on last video clip as hypoechoic tube top of screen).
-The swelling is now more over the proximal medial thigh; was more inguinal on 4/7.
-Duke, 1 year 2 mo old, was neutered 4/1, developed firm inguinal swelling over next 2 days.
-Firmess improved w/ hyperbaric O2, but then continued and is bigger in size, but less painful to patient. Some ventral edema settling in limb, w/ distal toes still warm to touch.
-Today, the swelling has what feels like a thrombosed vein running along the surface from cadual to cranial (visible on last video clip as hypoechoic tube top of screen).
-The swelling is now more over the proximal medial thigh; was more inguinal on 4/7.
-Most recent CBC showed inflammatory leukogram, not febrile.
-I am not seeing any pockets of fluid and our working diagnosis is an inguinal hematoma from faulty ligatures (unsure neuter technique), but I am alarmed with how long it is taking this to improve and wondering if we need to be considering having a surgeon explore the area.
-The first jpeg is today (significant increase in size) vs the next 2 images were from the presentation a week ago. The two video clips were today showing no doppler flow in the swelling itself. Tips on what I should be aiming for with imaging appreciated.
Comments
What breed of dog and is
What breed of dog and is there any history of prior bleeds or possible exposure to rodenticides?
1 year 2 month old Golden.
1 year 2 month old Golden. No clotting problems after venipuncture and CBC/Chem were unremarkable. Got some resolution of the case, thankfully – please see my reply to Eric. Thanks for your input.
von willebrands or other
von willebrands or other congenital coagulopathy?
Not sure I appreciate thrombosis on this view you would need to cone down the CF sector field and try power doppler as it looks to me that the hematoma is compressing the vessel. Pulse quality ok?
Turned out to be a somewhat
Turned out to be a somewhat dramatic end, so hopefully this will stick in my brain for some time. Thanks for the imaging tips. Could you explain when you reach for power doppler vs. color doppler (lower flow areas is what I understand)?
Duke came back in after the area ruptured (poor owners) – large amount of bloody fluid and continued to ooze liquid for several hours. ER vet tied a roled towel from inguinal to dorsum and that seemed to help settle everything down after several hours. The area that felt like a thrombosed vein was likely cellulitis within the skin. Cells were not that ugly microscopically but looked inflammatory. Did two more HBOT sessions and seems to be doing well now. Wew!
Color flow gives direction of
Color flow gives direction of flow but is less sensitive than power doppler. If I dont care about direction and just want to know if there is flow and subjectively how much I use the power doppler thats more sensitive to slow flow than color.
weird case for sure thanks for the post.