About a 100 pound FS lab mix. Presented for vomiting and diarrhea for 4 to 5 days or so, off and on lethargy during that timeframe as well. Stable, walking around, no discomfort, etc.
About a 100 pound FS lab mix. Presented for vomiting and diarrhea for 4 to 5 days or so, off and on lethargy during that timeframe as well. Stable, walking around, no discomfort, etc. on presentation. My primary findings were pale-pink MM and diarrhea. PCV was 30%…bloodwork otherwise wnl. Radiographs seem to show likely reduced abdominal detail….concering for some degree of hemoabdomen to me. However…she is a little overweight. I performed a brief ultrasound, and see what looks like nodules/cavitated regions on what looks like the tail portion of the spleen to me. I attempted an abdominal tap….but obtained no fluid/blood. My presumption is an intermittent abdominal bleed. Owner also noted hematochezia when they took her home that evening…and she is on chronic rimadyl….so primary differentials are GI bleed/ulcers and/or splenic intermittent bleed.
I am concerned with this region of the spleen. Based on the video, do you agree this could be an issue….the kind of splenic mass that could bleed? My other theory is the vomiting might have cause enough abdominal pressure to rupture this mass on her spleen. Thank you
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That caudal pole does look
That caudal pole does look concerning, I would imagine the veterinary specialists will likely rec. an FNA.
This looks like a splenic
This looks like a splenic infarct. Sharply demarcated uniform hypoechoic parenchyma within the splenic capsule. There is mild lateral capsule distortion so a nodular process is also possible. Coag panel and US guided FNA of the area with a 25 ga needle is suggsted for cytology.
thank you, I appreciate the
thank you, I appreciate the help, kind of an unusual case, the pet is currently doing very well now…I kind of threw everything at her….doxy, metronidazole, vit k, sucralfate, etc….
It may be a splenic infarct
It may be a splenic infarct run power doppler over the splenic vein and normal parenchyma as a baseline and then move it to the hypoechoic are to see if flow is lacking… and a 25g fna of course as well ideally cyto and culture in case its asbcessing.