– 11 year FS Husky cross presented for routine blood testing prior to starting NSAID therapy
– no clinical signs of v/d or weight loss BCS 4/5
– low TP 30 (50-74), low alb 16 (27-44), U/A unremarkable SG 1.019, urine pro:crea 0.09 (N<=0.5)
– bloodwork otherwise normal; rDVM checked bloodwork 1 week later and low ALB persisting
– mild intestinal wall thickening on u/s (up to 0.59cm), prominent mucosa and I believe there are subtle mucosal striations present? no ascites
– 11 year FS Husky cross presented for routine blood testing prior to starting NSAID therapy
– no clinical signs of v/d or weight loss BCS 4/5
– low TP 30 (50-74), low alb 16 (27-44), U/A unremarkable SG 1.019, urine pro:crea 0.09 (N<=0.5)
– bloodwork otherwise normal; rDVM checked bloodwork 1 week later and low ALB persisting
– mild intestinal wall thickening on u/s (up to 0.59cm), prominent mucosa and I believe there are subtle mucosal striations present? no ascites
– both kidneys look abnormal with a very irregular capsule with indentations
So likely PLE r/o primary or secondary lymphangiectasia, IBD, lymphoma, internal parasites, but what is up with those kidneys? No protein loss according to lab testing, no azotemia. Are these old renal infarcts? Renal dsyplasia? (both kidneys looked similar but I only uploaded the left kidney)
Comments
Yep Im seeing mucosal
Yep Im seeing mucosal striations in both intestines. If you change your angles and increase your gain they will jump more. They kidneys are lumpy buit not a player with minimal proteinuria. Here are a bunch of similar PLE cases by searchign “mucosal striations” in the basic search:
http://sonopath.com/members/case-studies/search?text=mucosal+striation&species=All
Here is a quick tx for PLE. You dont have to use all of this of course just what is applicable
PLE Therapy
OBJECTIVE: keep albumin levels > 2 g/dl, Avoid thromboembolism and cavitary effusions, monitor concurrent PLN (Wheaton Terrier PLE/PLN) and liver disease:
Plasma 10 mL / kilogram IV over 4 hours
Or Human albumin 2 ml/kg/h over 10 hours. Total daily volume 20.l/kg/day
And Colloids/Hetastarch
10 to 20 mL per kilogram per hour and dogs
10 to 15 mL per kilogram per hour cats
(Can bolus first 1/3 of dose over 15 minutes)
& maintain on LRS maintenance otherwise.
Metronidazole (10-20 mg/kg po bid)
Famoditine 1 mg/kg Iv Im po dc Sid /bid
Sucralfate 0.5-1 g po tid dogs, 0.5 g bid cats in slurry Or Misoprostol 1-5 ug/kg po tid
Diet: Highly digestible high quality protein, low fiber, low fat diet (< 15% of dry matter). Hydrolyzed protein or novel protein. Purina HA or Royal Canine HP or similar.
Prednisone or prednisolone 2 mg/kg bid x 3-5 days then 2 mg/kg sid. Chlorambucil in refractive severe IBD/alimentary lymphoma cases (monitor cbc for rare bone marrow suppression) 4 mg/m2 Q 24-48 hours.
Cobalamine (B12) 250-1500 ug/dog weekly x 6 weeks.
Calcium supplementation if necessary.
Aspirin 0.5-1 mg/kg/day or Clopidrel (Plavix) 1-5 mg/kg/day.
Yep Im seeing mucosal
Yep Im seeing mucosal striations in both intestines. If you change your angles and increase your gain they will jump more. They kidneys are lumpy buit not a player with minimal proteinuria. Here are a bunch of similar PLE cases by searchign “mucosal striations” in the basic search:
http://sonopath.com/members/case-studies/search?text=mucosal+striation&species=All
Here is a quick tx for PLE. You dont have to use all of this of course just what is applicable
PLE Therapy
OBJECTIVE: keep albumin levels > 2 g/dl, Avoid thromboembolism and cavitary effusions, monitor concurrent PLN (Wheaton Terrier PLE/PLN) and liver disease:
Plasma 10 mL / kilogram IV over 4 hours
Or Human albumin 2 ml/kg/h over 10 hours. Total daily volume 20.l/kg/day
And Colloids/Hetastarch
10 to 20 mL per kilogram per hour and dogs
10 to 15 mL per kilogram per hour cats
(Can bolus first 1/3 of dose over 15 minutes)
& maintain on LRS maintenance otherwise.
Metronidazole (10-20 mg/kg po bid)
Famoditine 1 mg/kg Iv Im po dc Sid /bid
Sucralfate 0.5-1 g po tid dogs, 0.5 g bid cats in slurry Or Misoprostol 1-5 ug/kg po tid
Diet: Highly digestible high quality protein, low fiber, low fat diet (< 15% of dry matter). Hydrolyzed protein or novel protein. Purina HA or Royal Canine HP or similar.
Prednisone or prednisolone 2 mg/kg bid x 3-5 days then 2 mg/kg sid. Chlorambucil in refractive severe IBD/alimentary lymphoma cases (monitor cbc for rare bone marrow suppression) 4 mg/m2 Q 24-48 hours.
Cobalamine (B12) 250-1500 ug/dog weekly x 6 weeks.
Calcium supplementation if necessary.
Aspirin 0.5-1 mg/kg/day or Clopidrel (Plavix) 1-5 mg/kg/day.
Any idea why these kidneys
Any idea why these kidneys are so lumpy?
Any idea why these kidneys
Any idea why these kidneys are so lumpy?
They look like a combo of
They look like a combo of interstitial nephrosis and capsular retraction from fibrosis and infarcts. Chronic active disease but not a player here with minimal proteinuria.
They look like a combo of
They look like a combo of interstitial nephrosis and capsular retraction from fibrosis and infarcts. Chronic active disease but not a player here with minimal proteinuria.
Thanks EL
Thanks EL
Thanks EL
Thanks EL