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Is this splenic torsion?

Sonopath Forum

Sonopath Forum

Is this splenic torsion?

Berm is a 2 year-old French Bulldog with a leucocytosis (WBC around 30,000). The dog seems to be fine. He can walk and eat normally. My associate scan him and found

Berm is a 2 year-old French Bulldog with a leucocytosis (WBC around 30,000). The dog seems to be fine. He can walk and eat normally. My associate scan him and found

what looked like splenic torsion, he thinks it’s more likely splenitis since the dog seems to be okay which I agree. In my opinion, splenic torsion should be presented with more serious clinical signs (I’ve never met one myself though). So, your opinion is needed here to help us clarigy things. Thanks.

P.S. the client feeds him with raw chicken, do you think this is related with this lesion?

 

Comments

dcasey
October 30, 2013 at 2:49 pm -

It may be splenitis, I would

It may be splenitis, I would FNA spleen since it is so abnormal.

Put the color flow Doppler on the splenic vein, look for blood flow , r/o thrombosis of splenic vein, 

Torsion will have no color flow

Aspirate the left lateral liver, capsule appears to be bulging, liver parenchyma appears course with areas of hypoechogenicity. Rule out systemic disease

Even though your Frenchie seems fine, the ultrasound findings and severe leukosis concerns me, I would cover with antibiotic cocktail like Baytril/Clavamox or equivalent multiquadrant therapy

Good Luck, keep us posted

Doug

 

dcasey
October 30, 2013 at 2:49 pm -

It may be splenitis, I would

It may be splenitis, I would FNA spleen since it is so abnormal.

Put the color flow Doppler on the splenic vein, look for blood flow , r/o thrombosis of splenic vein, 

Torsion will have no color flow

Aspirate the left lateral liver, capsule appears to be bulging, liver parenchyma appears course with areas of hypoechogenicity. Rule out systemic disease

Even though your Frenchie seems fine, the ultrasound findings and severe leukosis concerns me, I would cover with antibiotic cocktail like Baytril/Clavamox or equivalent multiquadrant therapy

Good Luck, keep us posted

Doug

 

Peter
October 30, 2013 at 4:51 pm -

I agree with Doug. Splenitis

I agree with Doug. Splenitis possible but I would prefer torsion since it looks necrotic to me. These patients typically have initial clinical signs followed by a short time period where they do quite well and then come up with anemia, leukocytosis and do worse. The hyperechoic fat around the spleen makes me worry. If it was my case I would take it out and send to histopath. But a few days trial with antibiotics under clinical supervision can of course be tried as well…

 

Peter
October 30, 2013 at 4:51 pm -

I agree with Doug. Splenitis

I agree with Doug. Splenitis possible but I would prefer torsion since it looks necrotic to me. These patients typically have initial clinical signs followed by a short time period where they do quite well and then come up with anemia, leukocytosis and do worse. The hyperechoic fat around the spleen makes me worry. If it was my case I would take it out and send to histopath. But a few days trial with antibiotics under clinical supervision can of course be tried as well…

 

Peter
October 30, 2013 at 6:32 pm -

looking again at the

looking again at the pictures, I would remove it…

Peter
October 30, 2013 at 6:32 pm -

looking again at the

looking again at the pictures, I would remove it…

rlobetti
October 30, 2013 at 8:27 pm -

The spleen has the typical
The spleen has the typical reticular pattern described with torsion, so I would go for torsion rather than splenitis. Leukocytosis secondary to necrotic reaction within spleen. Do not be fooled by the apparent normal appearance of the patient. Do you have the red cell count and platelet count, as often these are low.
Agree with Doug – use colour flow doppler.
Splenectomy would be way to go for this patient.

rlobetti
October 30, 2013 at 8:27 pm -

The spleen has the typical
The spleen has the typical reticular pattern described with torsion, so I would go for torsion rather than splenitis. Leukocytosis secondary to necrotic reaction within spleen. Do not be fooled by the apparent normal appearance of the patient. Do you have the red cell count and platelet count, as often these are low.
Agree with Doug – use colour flow doppler.
Splenectomy would be way to go for this patient.

Anonymous
October 31, 2013 at 11:31 am -

Dear all,
 
I asked RDVM

Dear all,

 

I asked RDVM about the details of the case, hereby are the blood results:

On 28/10/2013

– WBC = 39500 cells/uL

– Neutrophils = 25,155 cells/uL

– Lymphocytes = 2,765 cells/uL

– Monocytes = 1,580 cells/uL 

– Hct = 21%

– SNAP cPL: normal

– SNAP 4DX: negative all

– ALT = 76

– ALP = 147

  • The main chief complain was vomiting.

On 30/10/2013:

– Total protein = 8 g/DL

– HCt = 24%

– Urinalysis: Protein 3+, Bilirubin 3+, Hemoglobin 4+, Urine specific gravity = 1.020

 

Thanks.

Anonymous
October 31, 2013 at 11:31 am -

Dear all,
 
I asked RDVM

Dear all,

 

I asked RDVM about the details of the case, hereby are the blood results:

On 28/10/2013

– WBC = 39500 cells/uL

– Neutrophils = 25,155 cells/uL

– Lymphocytes = 2,765 cells/uL

– Monocytes = 1,580 cells/uL 

– Hct = 21%

– SNAP cPL: normal

– SNAP 4DX: negative all

– ALT = 76

– ALP = 147

  • The main chief complain was vomiting.

On 30/10/2013:

– Total protein = 8 g/DL

– HCt = 24%

– Urinalysis: Protein 3+, Bilirubin 3+, Hemoglobin 4+, Urine specific gravity = 1.020

 

Thanks.

Peter
October 31, 2013 at 1:18 pm -

I would go for splenectomy,

I would go for splenectomy, cbc is typical for torsion

Peter
October 31, 2013 at 1:18 pm -

I would go for splenectomy,

I would go for splenectomy, cbc is typical for torsion

Anonymous
October 31, 2013 at 1:52 pm -

Thanks for all comment, I’ll

Thanks for all comment, I’ll inform RDVM right away!

Anonymous
October 31, 2013 at 1:52 pm -

Thanks for all comment, I’ll

Thanks for all comment, I’ll inform RDVM right away!

EL
November 2, 2013 at 6:56 pm -

splenectomy for sure has all
splenectomy for sure has all criteria for torsion

EL
November 2, 2013 at 6:56 pm -

splenectomy for sure has all
splenectomy for sure has all criteria for torsion

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