- 13 year old FN Cairn Terrier with large volume ascites, weight loss and decreased appetite
- ALP severely elevated >4000, ALT moderately elevated, resting BA increased 90, albumin low normal.
- Nodular liver on scan with irregular contours and thickened GB wall with sediment
- The liver did not appear srunken as I would expect with cirrhosis but overall enlarged with tapered tips of lobes
- Do you think this is most likely chronic hepatitis and fibrosis/cirrhosis rather than neoplasia eg diffuse nodular HCC?
- 13 year old FN Cairn Terrier with large volume ascites, weight loss and decreased appetite
- ALP severely elevated >4000, ALT moderately elevated, resting BA increased 90, albumin low normal.
- Nodular liver on scan with irregular contours and thickened GB wall with sediment
- The liver did not appear srunken as I would expect with cirrhosis but overall enlarged with tapered tips of lobes
- Do you think this is most likely chronic hepatitis and fibrosis/cirrhosis rather than neoplasia eg diffuse nodular HCC?
- Portal hypertension causing ascites?
Comments
Two important differential
Two important differential diagnoses would be chronic-active hepatitis and neoplasia, both of which will cause portal hypertension and subsequent ascites. FNA cytology may give a diagnosis but most likely would need Tru-Cut/wedge biopsy.
This is where I love to use
This is where I love to use elastography to differentiate betwenthe two possibilities. The GB wall seems to lean more towards a chronic condition. Cholangitis has to be on the list as well. The very uniform diffuse pattern within the liver in my limited opinion makes me lean much more towards chronic active hepatitis. Still need biopsies to be 100%.
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