11 yo MN Labradoodle 57#
U/s for asymptomatic mild elevated ALP before dental.
Normal abdomen except for a 5mm apparent tear in the spleen, with scant amount of free fluid and omentum patching the area.
How often does this happen? The dog is doing great, normal HCT, no hx of trauma. I rechecked the spleen at the end of the scan and there was no changes, not actively bleeding.
Recommended recheck HCT tomorrow and recheck spleen in a week.
What do you think?
Thank you for your input as always!
Julie
Comments
The area around the
The area around the hemorrhage appears to be hyperechoic and with the age and breed of dog would be concerned about emerging neoplasia.
Thank you Dr. Lobetti. I’ll
Thank you Dr. Lobetti. I’ll let you know how it looks on recheck.
Yes neoplasia with those
Yes neoplasia with those hetero changes and fluid next to it is concerning but I would investigate further and even laparotomy/splenectomy if nothing else in the abdomen is a concern and the rest of the spleen is nsf. I have seen histopathologically benign hetero changes and local free fluid at the splenic fold and i think its a congestion and hyperplastic thing especially in big spleen breeds (GSD or Greyhound for example) or those with reactive spleens that tend to fold a lot. I would encourage the owners that neoplasia may not be in play here so they go forward. Regardless the spleen needs to be removed.
Thank you so much for your
Thank you so much for your input. That was a weird one! I will recommend splenectomy and will let you know the histopath.
u bet looking forward to it.
u bet looking forward to it.
Update. The owners are not
Update. The owners are not excited about a splenectomy. Recheck ultrasound done a few days ago. The tear has healed. It’s making a small dent in the parenchyma, with bright mesentery patching it. No free fluid. The spleen is otherwise WNL. I recommended splenectomy again to prevent hemo-abdomen. Will let you know what they decide.
Update. Patient had a recheck
Update. Patient had a recheck u/s at a referral practice before surgery. The spleen had healed completely. No splenectomy! Happy news.
Great news thank you for the
Great news thank you for the follow-up