Anorexia

An 8-year-old male neutered Yorkshire terrier was presented for vomiting, anorexic, lethargy, dehydration, and azotemia. A 2 x 2cm dense mass was palpated in the left inguinal region. Non-reducible. R/O renal disease, pancreatitis. Current meds: Cerenia; Famotidine; Ampicillin; Baytril. CBC: pmns 22K; PCV 67%; TP 9.6; Bun 48; Creat 3; Phos 10 (values improving with fluids).

The patient was presented for painful abdomen, pyrexia, vomiting, and anorexia. After 12 hours on IVF and supportive care the patient's pyrexia resolved and there was no further vomiting. A painful abdomen persisted and mild icterus was evident in both the sclera and mucous membranes. The patient was treated with Cerenia, Unasyn, Metronidazole, Gabapentin, and Famotidine. Blood chemistry found AST 70, ALT 553, ALK. Phos. 8162, GGT 46, T. Bili. 7.2, K 3.4, Chol. 720, Trig. 609, amylase 2038, PSL 697. Urine specific gravity 1.011, proteinuria 2+, bilirubinuria 3+.

A 3-year-old, 60 lb, MN, Labrador Retriever mixed breed canine was presented with a history of possible dietary indiscretion while on a hike with his owner 48 hrs prior. The patient was ADR and had been intermittently vomiting for 24 hrs. Upon physical examination the patient exhibited pain in the caudal abdomen and an abnormal structure could be felt on palpation. Radiographs showed an irregular, semi-circular area in the caudal abdomen. The patient was hospitalized on I.V. fluids and supportive care pending ultrasound.

A 7-year-old FS Bullmastiff was presented for acute diarrhea and decreased appetite.

Sonographic summary: The initial ultrasound findings were: Part of the small intestine presents a 1:1 muscularis/mucosa ratio with decreased motility, mildly obscured wall layering and mild accumulation of chyme. Focal circumferential wall thickening of up to 7 mm with transmural loss of layering is seen in the ileocecal region and is associated with an incomplete obstructive pattern with segmental dilation of the intestine with chyme. The central abdominal mesentery presents a generalized increase in echogenicity with loss of the regular echoarchitecture emphasizing the lymph node and intestinal wall changes. Severe mesenteric lymphadenomegaly of up to 8 cm is noted. The lymph nodes are rounded with a pathologic increase of their short-to-long-axis ratio beyond 0.5. A significant mass effect on the intestine resulting in an incomplete obstructive pattern is noted. The margin to the intestinal wall is obscured. Scant anechoic peritoneal effusion is noted. Ultrasound guided fine needle aspirations were performed for further definition and confirmed a large cell lymphoma. The patient underwent chemotherapy and presented two months later due to extreme ADR since finishing the 2nd round of chemo (Adriamycin), anorexia with the exception of treats, and PU/PD. Subcutaneous lymphoma of a single mass had been detected via FNA 1 week prior, therafter multiple SQ masses developed.

The progression of pre-chemo, post chemo, and escape from remission sonographic images are sequenced below.

The patient was presented for evaluation due to severe vomiting. The vomiting stopped but the patient was now anorexic. The patient was quiet with a thin body condition. CBC found a low WBC of 3.7. Blood chemistry found albumin 3.7, total protein 7.0, ALKP 43, BUN 43, and cholesterol 79.

A 5-year-old male German shepherd was presented for evaluation of progressive pain, lethargy, anorexia, and hunched back following an episode of abdominal trauma - tried to jump over a large hole and hit his abdomen on the edge of the hole.

A 3-year-old intact male Labrador Retriever was presented for anorexia and weight loss. CBC was within normal limits, however blood chemistry showed hyperproteinemia, hypoalbuminemia, low albumin/globulin ratio, marked azotemia, hyperphosphatemia, mild hypocalcemia, hyperkalemia, and hyperamylasemia. T4 was within normal range. The urine had a cloudy appearance; 3+ proteinuria and 3+ hematuria were present on urinalysis.