Hi,
This is a 10 years old Min PIn M/N that was diagnosed in January with pancreatitis and responded poorly to treatment
Now he presented in shock, tachipneic, vomiting, bloody diarheea, dehydrated 7-8 %.
Mild to moderatelly high Liver enzymes and mild anemia on bloodwork
AUS revealed this starry sky liver that I suspect it is either hepatitis/ lepto or neoplasia ( MCT/ Lymphoma). Somebody suggested that hepato-cutaneous syndrome mught have the same appearance. Ultimatelly a FNA might tell the story; he is not stable enough.
Hi,
This is a 10 years old Min PIn M/N that was diagnosed in January with pancreatitis and responded poorly to treatment
Now he presented in shock, tachipneic, vomiting, bloody diarheea, dehydrated 7-8 %.
Mild to moderatelly high Liver enzymes and mild anemia on bloodwork
AUS revealed this starry sky liver that I suspect it is either hepatitis/ lepto or neoplasia ( MCT/ Lymphoma). Somebody suggested that hepato-cutaneous syndrome mught have the same appearance. Ultimatelly a FNA might tell the story; he is not stable enough.
What would be my differentials for this liver appearance?
Thank you,
Calin
Comments
Attached are examples more
Attached are examples more consistent with hepcutaneous with lacey coalescing hypoechoic nodules. Here are some form the SonoPath basic search as well using “hepatopcutaneous” as the search word:
http://sonopath.com/members/case-studies/search?text=hepatocutaneous&species=All
Your images show diffuse to multifocal hyperechoic changes more consistent with mineralization. Ive also see heptic abscesses to this and hepatic carcinaoma. Surely needs a needle Bx, best if not then go wiht fna and culture. Mineralization pattern like this often occurs with chronic cholangiohepatitis … or the aftermath of it but if ALT and similar are blasting high with a white count I’d be concerned with abscessation. If stable LEs then likely the aftermath of prior insult but regardless i would get samples.
Thank you EL.
Coags were
Thank you EL.
Coags were normal but unfortunatelly dog deteriorated with very low BP, not responding to fluids, dopa, vasopressors and owner elected to euthanize. This dog also had changes consistent with pancreatitis, possible neoplasia of the RADR . I suspect he developed SIRS.