International Veterinary Ultrasound Society

Case of the Month - November 2003

Click on an image for a larger view and scroll down to the bottom for the final answer.

Signalment:
14 year old, Male, Castrated, Cocker Spaniel

History:
Previously diagnosed with Addison's Disease and started on predisone. Seizures were controled with phenobarbital.

Presented with mildly elevated liver enzymes and hypoalbuminemia, elevated bile acids, increased lethargy.

Ultrasound Image:
Two images are provided of the Liver

Initial differentials?

Diagnosis:

Well, Spots went to surgery for the cholecystectomy and partial splenectomy (see cases August, September and October!) and the liver was smaller than normal, very firm and irregular in contour (see below). Histology revealed widespread, severe bridging fibrosis consistent with cirrhosis.
Cirrhosis has a classic appearance of very small size, irregular contour, nodular regeneration ("lumpy-bumpy") with ascites. However a retrospective study found this combination of findings in less that 20% of all the dog's with moderate to severe bridging fibrosis in the liver. Sonographers need to keep cirrhosis on the list of differentials in spite of a normal liver appearance. The portal hypertension and hypoalbuminemia caused the pancreatic edema and, possibly, the seizures. The other finders were unrelated, although we do not know the cause of cystic mucinous hyperplasia ("mucocele" (sic)) in gall bladders of dogs.

2009	2006	2005
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2004	2003
January 2004 February 2004 July 2004 August 2004 September 2004 October 2004 November 2004 December 2004	January 2003 February 2003 March 2003 April 2003 May 2003 June 2003 July 2003 August 2003 September 2003 October 2003 November 2003 December 2003

News

Meeting:
See you in Jackson Hole, WY for the 2012 Annual Meeting, October 9-13, 2012.
Meeting information and early registration are available now!

Certificate:
Drs. Bossung, Lindquist and Miller have successfully completed the IVUSS Ultrasound Certificate Program, which includes didactic training, case submission, practical exam and a written final examination.

Congratulations Amy, Eric and Chris!

IVUSS Election Results:
President: Eric Lindquist
President Elect: Doug Casey
Past President: Gretchen Rowe
Member-at-large: Fern Delaney

Members:
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