– 8 yr old MN Bull dog in a wheel chair due hind paralysis (diagnosis unknown)
– presented with acute vomiting and pale mm; did not appear painful in the abdomen
– trace abdominal effusion seen between the liver and spleen
– the spleen is enlarged and “meaty”looking (normal for breed vs abnormal); no colour flow at the splenic hilus (repeatable); hyperechoic surrounding fat
– the paranchyma does not show the typical hypoechoic lacey appearance described for splenic torsion but I am wondering if this could be an acute presentation?
– 8 yr old MN Bull dog in a wheel chair due hind paralysis (diagnosis unknown)
– presented with acute vomiting and pale mm; did not appear painful in the abdomen
– trace abdominal effusion seen between the liver and spleen
– the spleen is enlarged and “meaty”looking (normal for breed vs abnormal); no colour flow at the splenic hilus (repeatable); hyperechoic surrounding fat
– the paranchyma does not show the typical hypoechoic lacey appearance described for splenic torsion but I am wondering if this could be an acute presentation?
– also there appears to be a “perivenous hyperechoic triangle” at the level of the portal hilus decscribed in d’Anjou’s textbook
– no murphy sign during scanning but the dog is partially paralyzed and in diapers?
(echo normal, bloodwork and clotting profile pending)
Comments
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very splenic torsion looking
very splenic torsion looking but splenic torsions can also have LSA or other in them. If nothing esle looks LSA -sih LN liver gi.and chest is clean on rads .. then sx asap
Chest rads were clear and
Chest rads were clear and rest of abdominal scan was normal – looks like we should head to surgery
Thanks EL!
With the pale MM most likely
With the pale MM most likely dealing with anemia secondary to splenic torsion – all pointing towards laparotomy. As Eric states there may be underlying disease so get a sample for histopath.
Pet is competely normal
Pet is competely normal today? Mild anemia noted and neutrophilia. Perhap we should start with FNA’s?
Good idea and repeat the
Good idea and repeat the ultrasound in a few days time, sooner if there is any deterioration.
Hmmm if nothing else says
Hmmm if nothing else says round cell neoplasia in the abdomen I wouldn’t keep that spleen in there… pop a probe on it and see what it says and post a still if you can. Once a bad spleen alwasy a bad spleen… they are like anal glands and GBs in this regard:)
We are watching closely – I
We are watching closely – I did read that splenic torsions don’t always have the classic starry night look to them or this may develop with time so if I get a change to rescan, I’ll post for sure. I don’t like the anemia and effusion in this patient either : (
anemia and effusion needs a
anemia and effusion needs a scalpel unless multicentric badness… splenic torsions vary based on the type and level of vascular compromise… they dont all look the same.