- 12 yr old mn Dachshund with decreased appetite one month and vomiting and anorexia for the past 10 days.
- Had a temp of 104 last week which responded to a short course of metronidazole.
- PE done Friday revealed an intra-abdominal mass
- Abdominal US done today shows reactive echogenic fat throughout the cranial and midabdomen, retained gastric ingesta despite 18 hr fast, and a midabdominal 5.5cm diameter cystic structure with intraluminal swirling faintly echogenic debris and echogenic foci.
- 12 yr old mn Dachshund with decreased appetite one month and vomiting and anorexia for the past 10 days.
- Had a temp of 104 last week which responded to a short course of metronidazole.
- PE done Friday revealed an intra-abdominal mass
- Abdominal US done today shows reactive echogenic fat throughout the cranial and midabdomen, retained gastric ingesta despite 18 hr fast, and a midabdominal 5.5cm diameter cystic structure with intraluminal swirling faintly echogenic debris and echogenic foci.
- FNA of the cystic structure yielded purulent material. In house cytology showed RBC’s, diplococci (extracellular), degenerative PMN’s, and reactive small lymphocytes. I was able to drain 17mls but could not completely drain the lesion as the needle kept clogging and I did not want to go higher than a 20g or do multiple sticks. Samples were submitted for culture and pathology.
- I have recommended surgical exploratory but the client has very limited funds. Wondering if medical management might work but think there may be a migrating FB (please see images..shadowing echogenic density in the far field at 5 O’Clock).
- Do you think there is a migrating FB here? Should medical management not be attempted?
Thanks everybody for your input!
Comments
If surgery is not possible
If surgery is not possible what options do you have.
I would use a large catheter (14-16 guage) if needed to try and drain this abscess.
Not surprising it was clogging up based on the the density of the material in the abscess.
I would drain as much as possible and get a culture.
If you can drain most of it you can instill Baytril- just like doing this with a prostatic cyst.
Of course there could be leakage into the abdomen which would obviously not be good.
There could be a migrating FB – but consider a gas producing bacteria.
This is world according to Garp 🙂
I agree with Garp:)
I agree with Garp:)
Thanks guys. Cytology and
Thanks guys. Cytology and Culture are pending. Will keep you posted.
What did the L kidney look
What did the L kidney look like?
Strange location for an abscess.
The kidneys were normal. The
The kidneys were normal. The abscess was located closer to the right side, medial to the right kidney but a bit caudal for pancreas. Near the ICC but I could not connect it. The dog is doing very well on amoxicillin and metronidazole- no vomiting, eating well, and acting normal. Cytology showed a mixed bacterial population and suppurative inflammation suspicious for GI perforation. No neoplastic cells seen. I have put in a request to the primary vet for culture results. I am worried that this lesion could still be smoldering and will cause recurrent bad disease for the dog. I am hoping to get the opportunity to rescan but am not sure if that will happen.