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Is this splenic torsion?

Berm is a 2 year-old French Bulldog with a leucocytosis (WBC around 30,000). The dog seems to be fine. He can walk and eat normally. My associate scan him and found

Berm is a 2 year-old French Bulldog with a leucocytosis (WBC around 30,000). The dog seems to be fine. He can walk and eat normally. My associate scan him and found

what looked like splenic torsion, he thinks it’s more likely splenitis since the dog seems to be okay which I agree. In my opinion, splenic torsion should be presented with more serious clinical signs (I’ve never met one myself though). So, your opinion is needed here to help us clarigy things. Thanks.

P.S. the client feeds him with raw chicken, do you think this is related with this lesion?

 

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16 responses to “Is this splenic torsion?”

  1. It may be splenitis, I would

    It may be splenitis, I would FNA spleen since it is so abnormal.

    Put the color flow Doppler on the splenic vein, look for blood flow , r/o thrombosis of splenic vein, 

    Torsion will have no color flow

    Aspirate the left lateral liver, capsule appears to be bulging, liver parenchyma appears course with areas of hypoechogenicity. Rule out systemic disease

    Even though your Frenchie seems fine, the ultrasound findings and severe leukosis concerns me, I would cover with antibiotic cocktail like Baytril/Clavamox or equivalent multiquadrant therapy

    Good Luck, keep us posted

    Doug

     

  2. It may be splenitis, I would

    It may be splenitis, I would FNA spleen since it is so abnormal.

    Put the color flow Doppler on the splenic vein, look for blood flow , r/o thrombosis of splenic vein, 

    Torsion will have no color flow

    Aspirate the left lateral liver, capsule appears to be bulging, liver parenchyma appears course with areas of hypoechogenicity. Rule out systemic disease

    Even though your Frenchie seems fine, the ultrasound findings and severe leukosis concerns me, I would cover with antibiotic cocktail like Baytril/Clavamox or equivalent multiquadrant therapy

    Good Luck, keep us posted

    Doug

     

  3. I agree with Doug. Splenitis

    I agree with Doug. Splenitis possible but I would prefer torsion since it looks necrotic to me. These patients typically have initial clinical signs followed by a short time period where they do quite well and then come up with anemia, leukocytosis and do worse. The hyperechoic fat around the spleen makes me worry. If it was my case I would take it out and send to histopath. But a few days trial with antibiotics under clinical supervision can of course be tried as well…

     

  4. I agree with Doug. Splenitis

    I agree with Doug. Splenitis possible but I would prefer torsion since it looks necrotic to me. These patients typically have initial clinical signs followed by a short time period where they do quite well and then come up with anemia, leukocytosis and do worse. The hyperechoic fat around the spleen makes me worry. If it was my case I would take it out and send to histopath. But a few days trial with antibiotics under clinical supervision can of course be tried as well…

     

  7. The spleen has the typical
    The spleen has the typical reticular pattern described with torsion, so I would go for torsion rather than splenitis. Leukocytosis secondary to necrotic reaction within spleen. Do not be fooled by the apparent normal appearance of the patient. Do you have the red cell count and platelet count, as often these are low.
    Agree with Doug – use colour flow doppler.
    Splenectomy would be way to go for this patient.

  8. The spleen has the typical
    The spleen has the typical reticular pattern described with torsion, so I would go for torsion rather than splenitis. Leukocytosis secondary to necrotic reaction within spleen. Do not be fooled by the apparent normal appearance of the patient. Do you have the red cell count and platelet count, as often these are low.
    Agree with Doug – use colour flow doppler.
    Splenectomy would be way to go for this patient.

  9. Dear all,
     
    I asked RDVM

    Dear all,

     

    I asked RDVM about the details of the case, hereby are the blood results:

    On 28/10/2013

    – WBC = 39500 cells/uL

    – Neutrophils = 25,155 cells/uL

    – Lymphocytes = 2,765 cells/uL

    – Monocytes = 1,580 cells/uL 

    – Hct = 21%

    – SNAP cPL: normal

    – SNAP 4DX: negative all

    – ALT = 76

    – ALP = 147

    • The main chief complain was vomiting.

    On 30/10/2013:

    – Total protein = 8 g/DL

    – HCt = 24%

    – Urinalysis: Protein 3+, Bilirubin 3+, Hemoglobin 4+, Urine specific gravity = 1.020

     

    Thanks.

  10. Dear all,
     
    I asked RDVM

    Dear all,

     

    I asked RDVM about the details of the case, hereby are the blood results:

    On 28/10/2013

    – WBC = 39500 cells/uL

    – Neutrophils = 25,155 cells/uL

    – Lymphocytes = 2,765 cells/uL

    – Monocytes = 1,580 cells/uL 

    – Hct = 21%

    – SNAP cPL: normal

    – SNAP 4DX: negative all

    – ALT = 76

    – ALP = 147

    • The main chief complain was vomiting.

    On 30/10/2013:

    – Total protein = 8 g/DL

    – HCt = 24%

    – Urinalysis: Protein 3+, Bilirubin 3+, Hemoglobin 4+, Urine specific gravity = 1.020

     

    Thanks.

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