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Severe thrombocytopenia, cranial abdominal effusion, and tachycardia…is there a cardiac mass?

Sonopath Forum

Sonopath Forum

Severe thrombocytopenia, cranial abdominal effusion, and tachycardia…is there a cardiac mass?

  • 9 year old mn Shepherd X with vomiting, weight loss, and lethargy
  • CBC shows severe thrombocytopenia (<20,000 platelets) and a mild anemia (HCT=37%)
  • Liver panel showed mildly elevated liver enzymes
  • Abdominal radiographs showed possible splenic mass
  • Abdominal ultrasound shows a double layered gall bladder, dilated hepatic veins, free fluid between the liver lobes, and splenomegaly (no mass)
  • Chest radiographs do not show a thoracic mass

    • 9 year old mn Shepherd X with vomiting, weight loss, and lethargy
    • CBC shows severe thrombocytopenia (<20,000 platelets) and a mild anemia (HCT=37%)
    • Liver panel showed mildly elevated liver enzymes
    • Abdominal radiographs showed possible splenic mass
    • Abdominal ultrasound shows a double layered gall bladder, dilated hepatic veins, free fluid between the liver lobes, and splenomegaly (no mass)
    • Chest radiographs do not show a thoracic mass
    • A brief echo done after the abdominal scan shows tachycardia and decreased cardiac contractility. 
    • Am I seeing pericardial effusion on the left cranial views?  Is there a cardiac mass present?
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Comments

EL
October 24, 2013 at 2:54 pm -

melissa there is a trace
melissa there is a trace amount of effusion and poor contractility and an irregular rhythm. This would cause hv dilation in the liver. try this view of the right auricle from the normals dvd.

I would get an ecg to start , potentially treat, and recheck the scan in a few days with more views to see if the effusion is growing. But given the thrombocytopenia myocarditis is possible. How is the infectious status maybe a doxy clindamycin trial?

Electrocute
October 24, 2013 at 5:10 pm -

Thanks Eric.  The 4DXT was

Thanks Eric.  The 4DXT was all negative.

-M

EL
October 24, 2013 at 2:54 pm -

melissa there is a trace
melissa there is a trace amount of effusion and poor contractility and an irregular rhythm. This would cause hv dilation in the liver. try this view of the right auricle from the normals dvd.

I would get an ecg to start , potentially treat, and recheck the scan in a few days with more views to see if the effusion is growing. But given the thrombocytopenia myocarditis is possible. How is the infectious status maybe a doxy clindamycin trial?

Electrocute
October 24, 2013 at 5:10 pm -

Thanks Eric.  The 4DXT was

Thanks Eric.  The 4DXT was all negative.

-M

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