Ultrasound on Tuesday...

[Marty]

I called my Vet today and he said the radiologist's report included several iffy spots on the liver, but he said that not spots have to mean cancer. He said the operation to remove the spleen is major surgery, and did I really want to put her through that at 12 years. Basically, it's not too bad for her age.

She eats well, and no vomitting, which are symptoms of liver problems. So maybe we'll just wait and let her live her life out, rather than subject her to surgery. Maybe get another ultrasound done later.

[Traci]

It would be hard to say based only on x-rays but "spots" or blotchy areas in or around the area should be further investigated. If it were neoplasia, it could be a sign that it is metasticizing, or spreading to other organs. I'd be concerned with the spleen as well, because if it is compromised, it could rupture, and hemorrhage and this isn't something you'd want to happen.

What were bloodwork results like?

While vomiting is a common sign of liver disease, (whether disease or neoplasia), there are other symptoms and both problems are almost quite rapid in progression. Weight loss is commonly seen, sometimes without additional symptoms, but the more common symptoms usually are soon apparent (within weeks or a few months, including jaundice, irregular temperature, anorexia, increased vomiting, rapid weight loss and painful abdomen).

I understand your decisions, but you might want to opt for the ultrasound now so that you know what to expect. If you choose not to persue surgery, at least get an ultrasound done for monitorization and maybe a "clearer" picture. Also ask about supportive treatment, such as antiinflammatories to help shrink any potential tumor....even if it isn't removed, growing tumors can cause alot of problems and pain and discomfort.

I truly hope it isn't a malignancy, Marty, but please consider at least finding out more, talk to your vet or a second opinion if necessary.

[Marty]

She kist had the ultrasound on Tuesday, Taci!

[Traci]

Sorry, my bad, I had xrays on my mind. Don't yell at me.

In any event, another UA at some point soon might be useful for monitoring.

[Marty]

How do I start...went to find Winnie for her meds this morn...she is usually on the doggie bed or in the crate. I finally found her in a corner of the bedroom closet. Then she refused to eat breakfast..this from a dog who has never voluntarily missed a meal. The other 2 dogs didn't want to eat either. Refused a treat. Went out to poop and was straining.

Thoroughly alarmed, I took her to the Vet. Her abdomen seemed sensitive, and he thought maybe her eyes looked a bit yellow. So she is staying for some tests. Not looking good, people...prayers for my Winsome Dixie needed...

[Traci]

If she is jaundiced and her blood serum is icteric, please, consider emergency surgery to remove the spleen (which could be at risk for rupture/hemorrhage)....while in surgery, your vet look at the liver and determine if there is lipidosis or a tumor to remove, etc.

I know you are hesitant about surgery, but I'm not sure bloodwork or another ultrasound is going to be very helpful this time, given her recent symptoms (especially if she's jaundiced and serum is icteric), she could be predisposed to an anemic crisis.

[Marty]

What's icteric?

He is doing the bloodwork in-house today instead of sending it out. I am sure he wil do surgery if that is what is needed...he was very concerned this morning.

I will be back when I hear from him. Thanks for quick reply!

[Traci]

Icteric is yellowing and lipids in the serum (like fat deposits), usually indicative of liver degeneration or anemia. Your vet will probably want to check her CBC, PCV, blood clotting factors and bilirubin especially, combined with her total blood profile (the chemical enzymes).

[Marty]

I just heard back...her pancreatic enzymes were very high at 3900, so he feels it is pancreatitis. Liver and kidneys were normal, but rbc and hemoglobin low. She will be treated and monitored overnight. I asked about the spleen, and he said he hasn't totally ruled that out yet and will watch for problems.

Now, isn't pancreatitis caused by eating something fatty? I haven't given her anything but a spoonful of cottage cheese along with her Rx food for kidney problems...

[Traci]

Inappropriate or fatty foods are one cause, but those cases can be either acute or chronic in nature. I suspect Winnie's case is acute. Meaning, there is something else going on, whether that is renal problems, duct obstruction or other obstruction, infectious (toxoplasmosis), or mass lesion somewhere, remains to be determined. Your vet said earlier he saw a spot on or near the liver, I'd keep that in mind, and ask him what other diagnostics he intends to persue (the low RBC may be concerning). The chemical enzymes for pancreatitis are not always a conclusive indicator for pancreatitis, and a TLI may need to be done (needs to be sent to an outside lab for confirmation). This could be a pancreatic episode, but could also be secondary to some other primary condition going on (i.e., liver/gallbladder/spleen/etc)

I assume he's got her on IV's and withholding food...but what else is he persuing?