- 14 year old MN DSH presented with clinical jaundice and inappetance,
- Bloods: mildly increased liver enzymes, and moderately increased tbil, HCT normal, globulin high normal, fPLI positive
- Responded to supportive treatment which included maropitant, analgesia, antibiotics, steroids
- Now severely anaemic (HCT 15, regenerative), clinically improved, faeces normal colour, ALP mildly increased, Tbil normal
- A few subtle liver nodules, pancreas and CBD look ok
- 14 year old MN DSH presented with clinical jaundice and inappetance,
- Bloods: mildly increased liver enzymes, and moderately increased tbil, HCT normal, globulin high normal, fPLI positive
- Responded to supportive treatment which included maropitant, analgesia, antibiotics, steroids
- Now severely anaemic (HCT 15, regenerative), clinically improved, faeces normal colour, ALP mildly increased, Tbil normal
- A few subtle liver nodules, pancreas and CBD look ok
- LN by pylorus/duodenum, jejunal and ICCJ LNs mildly enlarged with surrounding inflammation
- Intestines have altered layering ratio
- I aspirated liver (slides seemed quite fatty) and jejunal LN
- Do you think this was a hepatic jaundice…lymphoma? Have the steroids altered the picture? I am worried that FNAs will not be diagnostic
- Why now such severe regenerative anaemia…secondary haemolysis?
Comments
video 1 nice normal d-pap and
video 1 nice normal d-pap and cbd so nothing post hepatic.
video 2 nodular liver im concerned for steroids suppressing the presentation here. Cats typically dont do liver nodules well unless really old and wiht the jaundice either its hemolytic or parehcymal liver disease . ideally cbc path review, bone marrow aspirate , blood transfusion and se ewhat the fna liver says but if suppressed lsa by the steroids may get a nebuilous lymphoid result.
LN aspirate came back as
LN aspirate came back as inflammatory, liver not diagnostic. Cat is clinically much improved on steroids and HCT noe 26. No conclusive answers but at least he is doing well for now. Thanks for your help.