- 9 year old Laborador Retriever presented for PU/PD and no other clinical signs
- PE shows a body condition score of 8/9-his body fat challenged the depth of my probe
- Chemistry profile shows a rising ALT (500 in May 2014 and 800 now), CBC is pending
- 9 year old Laborador Retriever presented for PU/PD and no other clinical signs
- PE shows a body condition score of 8/9-his body fat challenged the depth of my probe
- Chemistry profile shows a rising ALT (500 in May 2014 and 800 now), CBC is pending
- Abdominal US shows a poorly defined hypoechoic mass with echogenic foci (and nodule) in the left lateral liver with adjacent, echogenic tissue. The gallbladder and all other organs appeared normal. I did not see any other lesions in the right liver, however, his obesity made it difficult to image even paracostally.
- US guided FNA’s were done and cytology is pending.
- A in-house poorly stained slide showed RBC’s and lots of free hyaline material.
- My differential list includes neoplasia (although the dog is obese), abscess (but nonpainful and afebrile), granuloma, and less likely hematoma.
- Any other thoughts on differentials?
- If cytology is nondiagnositc, what to do next….core biopsy? exploratory surgery? CT?
- Thank you for your thoughts!
Comments
Looks like an abscess to me
Looks like an abscess to me but abscessing carcinomas can do this. You can drain it and do aerobic and anaerobic cultures but also FNA the mixed echogenic parenchyma at th eborders in multiple spits and ensure carcinoma isnt there. If abscess fluid once drained I do an injection of body weight baytril into the abscess. I have had great results with this but only liver panc and prostate. Never a kidney for this procedure.
Here are some various abscesses form the basic search:
http://sonopath.com/members/case-studies/search?text=liver+abscess&species=All
Looks like an abscess to me
Looks like an abscess to me but abscessing carcinomas can do this. You can drain it and do aerobic and anaerobic cultures but also FNA the mixed echogenic parenchyma at th eborders in multiple spits and ensure carcinoma isnt there. If abscess fluid once drained I do an injection of body weight baytril into the abscess. I have had great results with this but only liver panc and prostate. Never a kidney for this procedure.
Here are some various abscesses form the basic search:
http://sonopath.com/members/case-studies/search?text=liver+abscess&species=All
Thanks Eric. The links are
Thanks Eric. The links are very helpful. Have you ever used spinal needles to drain these? This dog is so obese, a 1 and 1/2 inch needle is not going to be long enough.
Thanks Eric. The links are
Thanks Eric. The links are very helpful. Have you ever used spinal needles to drain these? This dog is so obese, a 1 and 1/2 inch needle is not going to be long enough.
22g spinal needles wont draw
22g spinal needles wont draw purulent material well
22g spinal needles wont draw
22g spinal needles wont draw purulent material well
22g spinal needles wont draw
22g spinal needles wont draw purulent material well.
Try a 2 inch 14-16g iv catheter for these.
22g spinal needles wont draw
22g spinal needles wont draw purulent material well.
Try a 2 inch 14-16g iv catheter for these.
Ok, thanks!
Ok, thanks!
Ok, thanks!
Ok, thanks!