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HISTORY & EXAM FINDINGS 14yr old K9
Patient seen in ER 9/30/19 for Diarrhea and painful abd. Diarrhea started last week. Yesterday Patient started breathing heavy and seemed very painful in the abd area. Owner has noticed patient drinking alot.
Rads showed possible soft tissue splenic mass
FINDINGS
ABDOMINAL SONOGRAM October 1, 2019: 89 static images and cine loops are provided for review
FINDINGS:
There are multifocal hypoechoic nodules and masses throughout the liver and spleen. There is a large hyperechoic mass within the liver measuring up to 5.3 cm diameter. There are multifocal hypoechoic nodules throughout the spleen measuring up to 2 cm diameter. The provided images of the small intestinal segments show normal thickness, echogenicity, and wall layering. The left kidney shows normal corticomedullary distinction and measures approximately 4.3 cm length with multifocal small anechoic cortical cysts. The left adrenal gland shows normal echotexture and measures approximately 3.7 mm thick. The right kidney shows normal corticomedullary distinction and measures approximately 4.4 cm length. There are multifocal small cortical cysts. The right adrenal gland shows normal echotexture and measures approximately 5.3 mm thick.
CONCLUSIONS
1. Large hepatic mass most consistent with neoplasia (ie. carcinoma, round cell, others). The additional multifocal hepatic and splenic nodules are highly suspicious for metastatic disease from the larger hepatic mass.
2. Mild bilateral chronic degenerative changes to the kidneys with cortical cyst.
RECOMMENDATIONS
For further evaluation of this patient, consider thoracic radiography to rule out pulmonary metastatic disease and pending any coagulation abnormalities ultrasound-guided fine-needle aspiration of the hepatic mass and splenic nodules.
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