A 8 year old F/S Cocker Spaniel presented for a 5 day history of vomiting, diarrhea and inappetance. She had been seen 2 days earlier and treated empirically for non-specific gastroenteritis with Cerenia and bland diet. On presentation, she had a fever of 104.2 and was tense but not overtly painful on abdominal palpation. CBC showed mild anemia (HCT 32%) and thrombocytopenia (52,000). Chemistry profile revealed elevation of ALT (235 U/L), ALP (982 U/L), GGT (24 U/L) and total bilirubin (1.2 mg/dl). cPL was normal. Abdominal radiographs showed splenomegaly and loss of serosal detail in the cranial abdomen. She was admitted to the hospital for supportive care. During hospitalization, she became hypoglycemic (blood glucose 52 mg/dl) but she responded to administration of intravenous dextrose. A complete abdominal ultrasound was requested.
In this blog, we will discuss using focused ultrasound of the liver to evaluate for diffuse hepatic parenchymal changes. The goals of using focused ultrasound examination for evaluation of the liver include recognizing focal and multifocal mass lesions and evaluating diffuse parenchymal changes. Evaluation for hepatic venous congestion can also be accomplished with the focused exam. The focused exam can help guide clinical decisions by providing initial information that may not be evident without the use of ultrasound.
Director of Internal Medicine, OPD
|“Tucker” is a 12 year old M/N Collie that presented for a 3 day history of vomiting and inappetance. Physical examination revealed 5-7 % dehydration and icteric sclera and gums. A
bdominal palpation was unremarkable and he was not overtly painful on palpation. CBC showed mild anemia
(HCT 32%) and neutrophilia (neutrophils 24,000). Chemistry profile showed mark ed elevation of liver en zymes (ALP 4136 U/L, AL T 935 U/L, GGT 54 U/L) and elevation of tota l bilirubin (4.7
mg/dl). A complete diagnostic abdominal ultrasound was requested and the following images were obtained.
Diagnostic ultrasound is one of the most significant medical services you can provide to your patient base. Oncura Partners' diagnostic ultrasound services provide a unique and cost-effective solution for equipment, training, and interpretation of images. Oncura's integrated system is unique in the veterinary industry.
In A New World of Ultrasound Diagnostics in Veterinary Care, we discussed some realities around the challenges of integrating ultrasound into daily practice. Yes, ultrasound is one of the most powerful diagnostic tools you can use in a small animal practice, but it is also one of the most intimidating diagnostic tools for veterinarians to master, or even to become comfortable with for minimal use.
So, you want to integrate or routinely utilize ultrasound in your small animal practice? Ultrasound is one of the most important diagnostic tools that any hospital can integrate into their patient management workflows. Right now it is often relegated to a tertiary diagnostic tool—call in a mobile sonographer/specialist or refer out to another facility.
Good cancer care begins with good client communication. Communicating effectively with pet owners before and after a cancer diagnosis, however, can be challenging. Every owner handles a diagnosis in their own way, but there are common concerns that many clients have. Consider the following to help you prepare and review the messages you want to communicate when talking about cancer with your pet owners:
Pet owners are often hesitant to begin cancer treatment out of concern for their pet's quality of life. Your clients may have witnessed the effects of cancer on a relative or friend and may associate cancer treatment with pain and discomfort. In fact, clients can be reassured that extending quality of life is the fundamental reason for treating cancer in a beloved pet.
Many people associate chemotherapy with adverse side effects. This association can make owners hesitant to pursue chemotherapy for their pets. Fortunately, the risk of adverse effects is low and many adverse effects can be prevented with quality pre-emptive care. When side effects do occur, most are mild and self-limiting. Consider the following statistics:
Many clients struggle with the decision to treat their pets after a cancer diagnosis. Their decisions can be complicated by the need to travel to outside specialists. As a veterinarian, you may wish you could offer clients a solution that allows you to continue to take a lead role in their pets' treatments at your clinic. However, case management can be difficult in a regular clinic and you may have reservations about whether you can safely offer the best cancer care using chemotherapy drugs. Oncura Partners Online Cancer Management System offers solutions.