Severe anemia in a dog with an intestinal mass


  • 8 year old MN Blue Heeler X who initially presented 5 weeks ago for lethargy and decreased appetite
  • Bloodwork initially showed a PCV of 26.8%.  It is now 15.2%.  Other labwork abnormalities include a reticulocytosis of 5.9%, leukoctyolsis of 21.52K/mcl (neutropphilia and monocytosis).  Chem prof done 6 weeks ago showed a decreased BUN=6mg/dl.  
  • The dog was placed on pred and doxycycline.
    • 8 year old MN Blue Heeler X who initially presented 5 weeks ago for lethargy and decreased appetite
    • Bloodwork initially showed a PCV of 26.8%.  It is now 15.2%.  Other labwork abnormalities include a reticulocytosis of 5.9%, leukoctyolsis of 21.52K/mcl (neutropphilia and monocytosis).  Chem prof done 6 weeks ago showed a decreased BUN=6mg/dl.  
    • The dog was placed on pred and doxycycline.
    • Abdominal rads read by a boarded radiologist showed hepatomegaly and possible sublumbar lymphadenopathy.  An abdominal US was recommended.
    • Abdominal US shows an asymmetical, circumferential small intestinal mass in the left midabdomen.  Part of the wall mass contains an psuedocyst or cavitation.  Hepatomegaly, hypovolemic spleen, and one reactive mesenteric lymph node were present.
    • My differential diagnoses list includes LSA, leimyosarcoma, carcinoma, and less likely benign leiomyoma or foreign body granuloma (no FB seen).  
    • I am wondering about the cystic portion of the mass-could this be hemorrhage from a foreing body? I just don’t see anything strongly shadowing.  There is no obstructive pattern and no history of vomiting or diarrhea.
    • Any other thoughts?

4 responses to “Severe anemia in a dog with an intestinal mass”

  1. Looks like an infiltrative

    Looks like an infiltrative intestinal mass and not like a foreign body obstruction or granuloma. Fluid could be blood or even chyle (if there is some lymphatic obstruction). An aspirate would give you more information.

  2. Thanks Remo.  I wanted to do

    Thanks Remo.  I wanted to do aspirtes, but because the dog had a PCV of 15% and no coag panel, I opted not to do it at the time of the initial exam.

  3. Looks like round cell tumor

    Looks like round cell tumor to me. These typically do not bleed. 25g in th ehypoechoic area should be diagnostic. Transfuse first ideally.

  4. Thanks  Eric.  The dog had

    Thanks  Eric.  The dog had dropped recently from 25% to 15% so that also made me hesitant to aspirate. Interestingly, he had already been placed on pred and Doxy with no response.  Not sure how big an immediate impact pred alone would have on that mass even if it is LSA.  See you tomorrow :).

     

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