Today’s case is a 13 year old male neutered German Shepherd that has been losing weight for three months, and has had a 7 day history of vomiting, diarrhea, lethargy, inappetence, decreased drinking, and straining to defecate and urinate.
13 year old German Shepherd
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{ 3 comments… read them below or add one }
Is a picture:
On the left side and the twelve place has a 11 medium density shadow in the third round, a medium density in the lumbar spine circular shadows, 13 in the shadows, high density rib spleen move up, the left costal diaphragms fossae move up, gather together more than a small amount of gas.
Side a picture:
In the second, three, four, and finally the lumbar spine and lumbar intervertebral disc JianZhui have multiplied, before mobile spleen ossification, medium density round after liver shadow, the ventral have round and across the abdominal muscle line, shadow fluctuate inside the gas of aggregation, and have moved.
Based on above, can prove this case features a vertebral and abdominal space-occupying lesions, may be vertebral bone increase, the bowel lymphoma.
Advice: for CT or B ultrasonic diagnosis
Hi,
I was very eager to see the result in this case as I found it very difficult to determine which organ was likely to have the focal mineralisation observed based on radiographic signs. I was unable to definitively see the stomach on the lateral and VD views. In the lateral views there is a well defined soft tissue circular opacity in the region that the pylorus normally occupies but this appearance I thought was more typical in a R lateral recumbent animal due to fluid accumulation in the dependant pylorus whle in the L lateral recumbent view this appearance is not often seen due to gas accumulation within the pylorus? I was having trouble identifying the stomach in the VD views also. Is the stomach displaced to the L lateral region in the VD view? I was thinking giving a barium swallow to define the stomach margins in this case would be what I would have done to be certain where it is to allow me to better judge whether it has been displaced.
The other part I was unsure about is the comment on mild enlargement of the kidneys. When I measure them in the VD view I get approx 3.1-3.2 x length of L2. Does this make them within normal limits radiographically?
Thankyou
Yes it is tricky to determine which organ the mass originates from, and differentials would be cranial abdominal organs. The stomach does not contain gas so is not helpful as a landmark. A barium swallow is a good option if ultrasound or CT is not available. Most liver masses will displace the stomach focally, though they can be located dorsally, ventrally, or laterally. Normal kidney length is 2.5-3.5 x the length of L2 in dogs, so in this case is normal.
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