Hi,
Patches is a 14 year old F/S Foxterrier which has “chronic”liver enzymes elevations for more then 16 months now. Liver enzymes ALKP and ALT are 1.5 to 2 X normal and this dog is on SAMe for the last year.She is doing good except one ‘seizure “like episode witnessed by owner.
My questions:
-Would you FNA/Biopsy the nodule/ rest of liver. This looks like one of the “reactive hepatopathy” described by EL in a previous post
Hi,
Patches is a 14 year old F/S Foxterrier which has “chronic”liver enzymes elevations for more then 16 months now. Liver enzymes ALKP and ALT are 1.5 to 2 X normal and this dog is on SAMe for the last year.She is doing good except one ‘seizure “like episode witnessed by owner.
My questions:
-Would you FNA/Biopsy the nodule/ rest of liver. This looks like one of the “reactive hepatopathy” described by EL in a previous post
-What do you say about the GB? Those hyperechoigenicities in the wall are related to mucosa/thick mucus? The majority of them are not shadowing so less likelly uroliths/sand. CBD was normal.
Thank you,
Calin
Comments
lost the rest of images.
lost the rest of images.
lost the rest of images.
lost the rest of images.
this picture has the nodule.
this picture has the nodule. There are more then one
Thank you
this picture has the nodule.
this picture has the nodule. There are more then one
Thank you
This is likely a chronic
This is likely a chronic inflammatoy hepatopathy and any chronic condition that “lumps up” the liver like this merits a needle if empirical measures are not working. I push a needle on this as well preferably a bx because of the coarse architecture and that nodule to diff nod hyperplasia from chronic remodeling vs something more like an emerging lymphoma. FNA will help lean you to a direction but this is coarse enough to warrent core bx and maybe bile acids. The Gb is a bit echogenic and some minor debros but gioes along with chronic inflam hepatopathy.
So BA, coag panel, core bx of general parenchyma and the nodule if pssobile, lower 3rd intercostal approach and see what comes up. May need copper staining too but likely secondary if present in a 14 yr old rottie.
If its a money case and the pet is stable and BA are NOT up in a rottie at 14 with this liver??? big picture I wouldnt get too crazy on the diagnostics. Maybe a cursory fna to see what cell predominance comes up to play with our antigen surveilance theory:)
This is likely a chronic
This is likely a chronic inflammatoy hepatopathy and any chronic condition that “lumps up” the liver like this merits a needle if empirical measures are not working. I push a needle on this as well preferably a bx because of the coarse architecture and that nodule to diff nod hyperplasia from chronic remodeling vs something more like an emerging lymphoma. FNA will help lean you to a direction but this is coarse enough to warrent core bx and maybe bile acids. The Gb is a bit echogenic and some minor debros but gioes along with chronic inflam hepatopathy.
So BA, coag panel, core bx of general parenchyma and the nodule if pssobile, lower 3rd intercostal approach and see what comes up. May need copper staining too but likely secondary if present in a 14 yr old rottie.
If its a money case and the pet is stable and BA are NOT up in a rottie at 14 with this liver??? big picture I wouldnt get too crazy on the diagnostics. Maybe a cursory fna to see what cell predominance comes up to play with our antigen surveilance theory:)
Thank you Eric. Will start
Thank you Eric. Will start with a FNA. Bile acids were up but mild increase (37).Caudal pole of left adr was 0.83 cm. Don’t know haw big that is…? for a foxterrier.LDDex and ACTH both still negative for Cushings..
Thank you Eric. Will start
Thank you Eric. Will start with a FNA. Bile acids were up but mild increase (37).Caudal pole of left adr was 0.83 cm. Don’t know haw big that is…? for a foxterrier.LDDex and ACTH both still negative for Cushings..
Im sorry fox terrier not
Im sorry fox terrier not rottie. yes 0.8 is a bit big but often normal anomaly older dogs adenoma or hyperplasia but to watch
Im sorry fox terrier not
Im sorry fox terrier not rottie. yes 0.8 is a bit big but often normal anomaly older dogs adenoma or hyperplasia but to watch
will do US rechecks every 6
will do US rechecks every 6 months
Thank you
will do US rechecks every 6
will do US rechecks every 6 months
Thank you