Case Study of the Month June 2013

Who Needs A CT When You Have Dx Efficiency By Ultrasound? Cardiomegaly in a cat, caudal mediastinal thickening, a probe, a soft hand, and a little geometric resourcefulness and we have a cheap CT maneuver and answers to why Snowy the cat is “ADR” at Whippany Veterinary Hospital. Dr. Louks, Smith & Staff go 2 for 2 (May + June) here at SonoPath.com with the June 2013 case of the month.

History

Imaging by Lindquist DMV, DABVP, Cert. IVUSS.

Sonogram (Thorax): Snowy

A 13-year-old hyperthyroid SF DSH was presented for “not doing right” and anorexia. Abnormalities on CBC and serum biochemistry were left shift leukocytosis and elevated ALT activity (698). The patient was treated symptomatically with Cerenia, Covenia, Enrofloxacin, and Buprenex.

Imaging by Lindquist DMV, DABVP, Cert. IVUSS.

Sonogram (Thorax): Snowy

A 13-year-old hyperthyroid SF DSH was presented for “not doing right” and anorexia. Abnormalities on CBC and serum biochemistry were left shift leukocytosis and elevated ALT activity (698). The patient was treated symptomatically with Cerenia, Covenia, Enrofloxacin, and Buprenex.

Comments

Special thanks to Dr. Jennifer Louks and Dr. Cheri Smith and staff at Whippany Animal Hospital, Whippany, NJ, USA (www.whippanyvethospital.com) for their excellent management of this case.

Clinical Differential Diagnosis

Uncontrolled hyperthyroidism
Liver – cholangio-hepatitis complex, neoplasia, toxins, infectious (viral/bacterial)
Cardiac hypertrophy secondary to hyperthyroidism
Neoplasia – thoracic cavity, abdomen

Image Interpretation

Lung mass with pleural effusion. Thoracic carcinoma suspected extending to the heart base and enveloping the thoracic duct/thoracic vena cava region. Secondary pulmonary hypertension and passive congestion in the liver.

Oncology consultation after pleurocentesis with immediate cytospin and slide preparation is recommended in order to preserve cell integrity. Poor prognosis. CT or exploratory thoracotomy was also offered.

Outcome

Owners declined further diagnostics. The owners elected humane euthanasia based on the poor prognosis and did not want to pursue chemotherapy.

Video

Patient Information

Age : 13 Years
Gender : Female, Spayed
Species : Feline
Status : Complete

Images

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