Beatrice is a 34 lb. FS mixed breed with reduced appetite and lethargy. Intermittent murmur heard throughout time owner has had her (musical). Organomegally. Had HW ds, was treated and retested negative. No residual PH evidence. Does have ventricle dilation with AI and still has adequate function. Dr. Lamy thinks main reason for dog feeling poorly is the abdomen and doesn’t think cardiac treatment indicated at this time (did complete echo review). Blood pressure results not provided yet to determine if AI from hypertension.
Beatrice is a 34 lb. FS mixed breed with reduced appetite and lethargy. Intermittent murmur heard throughout time owner has had her (musical). Organomegally. Had HW ds, was treated and retested negative. No residual PH evidence. Does have ventricle dilation with AI and still has adequate function. Dr. Lamy thinks main reason for dog feeling poorly is the abdomen and doesn’t think cardiac treatment indicated at this time (did complete echo review). Blood pressure results not provided yet to determine if AI from hypertension.
My question is if you ever see such liver changes and enlargement with Cushings? I think it seems unlikely, but both adrenals appear similar to the video supplied and do not appear to be invading surrounding tissues. Owner/rDVM deciding if want to proceed w/ coags and liver FNA.
Comments
Liver changes unlikley from
Liver changes unlikley from Cushing’s, also the presenting signs not typical for Cushing’s. With the nodular appearance of the liver think of nodular hyperplasia, chronic hepatitis, neoplasia. FNA may help but may require Tru-Cut/wedge biopsy.
i dont like the localized
i dont like the localized free fluid adjacent to that mass swelling on the right looks like a pedunculated hepatoma which can torse or tear off. I do see hepatomas overrepresented in cushings patients but have no data other than whats between my ears:) Given the local fluid and inflammation Im betting that’s the clinical issue. see attached image.
Also check the GB to ensure the inflammation isnt coming from a mucocele instead.
The left adrenal looks mighty
The left adrenal looks mighty big. Is it over 1.5cm and more likely a tumor. If so, I think FNA of the liver nodules would be important to rule out metastaic disease. I am a gen. practioner but do see some nasty looking livers that cytology comes back nodular degeneration. The lobes are typically heterogenous with hypoechoic nodules and caudal margins can be scalloped. Your image appears more constistent w/ met. dz but I dont think you can tell without further diagnostics. Wil you post your cytological or histopath results if you do one?