Can I get your opinion on these liver images please?
– 5 yr MN Labrador hx lethargy, off form, pu/pd, appetite normal, weight stable
– Bloods: poorly regen v. mild anaemia, midly elevated ALT, mod elevated ALP, GLDH/tBIL/resting BA/cholesterol/T4/TSH normal
– Urine sg 1.011, culture negative
Can I get your opinion on these liver images please?
– 5 yr MN Labrador hx lethargy, off form, pu/pd, appetite normal, weight stable
– Bloods: poorly regen v. mild anaemia, midly elevated ALT, mod elevated ALP, GLDH/tBIL/resting BA/cholesterol/T4/TSH normal
– Urine sg 1.011, culture negative
– I am worried about hypoechoic liver with increased portal markings, mildly heterogenous echotexture, would you agree? Should I FNA liver and spleen or biopsy liver?
– Spleen is a normal size with mildly heterogenous echotexture.
-I think the adrenal glands are a normal shape but right AG bigger than left, should I rule out cushings first with low urine SG? or is it more likely that primary liver disease be causing the pu/pd?
Any help is much appreciated. Thank you.
Comments
History not really indicative
History not really indicative of Cushing’s disease but SG and adrenal glands may point towards it. Would be more concerned about primary liver and splenic disease and would FNA both first to rule out infiltrative diseases such as lymphoma and mast cell tumor. If those are negative then go for an ACTH stim or LDDS test.
Thank you, sounds like a good
Thank you, sounds like a good plan.