C09972810 / invoice 10000

02/03/2026 Diagnosis:splenic liposarcoma, aggressive features (mitotic count 36), splenectomy 4/9/25. Completed 5x doxorubicin treatments 22/12/25

Disease status: concern for progressive disease (hepatic or medial iliac LN)
Restaging/monitoring plan: thoracic radiographs and AUS today
Other medical history/co-morbidities:
- RHL lameness/neurological deficits post-splenectomy – improvement with rest/time ddx IVDD (CT review no compression lesions)
- Possible medial iliac lymphadenopathy reactive  at time of chemotherapy
- Grade II L systolic murmur ddx open no appreciable vavular regurgitation or structural abnormalities on echo. Fractional shortening WNLs. Ddx physiological?
- ALT < ALP elevation noted at oncology initial ddx steroid hepatopathy - aspirates consistent with vacuolar hepatopathy/EMH
- probable hyperadrenocorticism - not causing clinical signs currently - montior
- mild regenerative anaemia (HCT 0.34, retic ) noted 27/1/26 - reassess today

History since last visit: Lucy has been well at home, EDDU normally. There are no new concerns. She has a chronic cough, noted prior to diagnosis that is persistent.
Current medications: none
Current diet: sardines, rice, chicken, vegetables.

Physical Examination findings: 
Demeanour: BAR
Body condition score 
MM, CRT secs, HR 108, RR 28, Temp 38.3 Wt: 11.5kg
Oral: Moderate-marked dental disease and halitosis
Eyes: nuclear sclerosis OU, no major concerns
Ears: no concerns noted
Nose: no abnormalities detected
Integument: Soft subcutaneous mobile mass 23mm L lateral thorax caudal to axilla. 5mm pink raised mass L inguinal fold. Static SQ mass L lat thorax 26mm (prev identified as lipoma)
Lymph nodes:Peripheral LNs WNLs
Cardiovascular: grade II L systolic murmur, static, pulses strong and synchronous, no arrhythmia
Respiratory: normal bronchovesicular sounds bilaterally, normal rate and effort
Abdomen: tense (anxious) no major concerns, no fluid or masses palpable
Rectal: NE
Musculoskeletal: ambulatory x 4, normal gait, full MSK exam not performed
Neurological: no abnormalities noted, full neurological exam not performed

Laboratory results: 
FBE sent to Aurora, results pending

Procedure:
Sedation: Medetomidine (3mcg/kg - given no structural cardiac abnormalities), butorphanol (0.2mg/kg) IV; later reversed with antisedan IM (equal volume).

Thoracic radiographs: 3-view thoracic radiographs no evidence pulmonary nodules. L lateral view mild bronchointerstitial pattern caudodorsal 

Abdominal Ultrasound (by Jess Morey): 
- The liver appeared homogenous, it was somewhat enlarged and had some subtle hypoechoic lesions throughout the body (these have previously been sampled as benign changes). These remain stable. There was a moderate amount of gall bladder sludge, no evidence of biliary duct obstruction.  
- The spleen was absent (previous splenectomy). 
- The left and right kidneys were within normal with normal corticomedullary definition. The left adrenal gland remained prominent, measuring 0.6 and 0.58 cm at cranial and caudal poles. 
-From the left side, in the retroperitoneal region (caudal to kidney, cranial to MILN) there was a mixed hyperchoic/hypoechoic mass, doppler flow negative. This measured 2.34-2.7 x 3.65 x 3.97 cm. 
- All other structures were viewed (urinary bladder, gastrointestinal structures) and no abnormalities were detected.  There was no other internal lymphadenopathy and no free fluid. 

Fine needle aspirates collected of above mass, in house cytology noted adequate cellular yield, slides sent externally for analysis.

Assessment:
- splenic liposarcoma - concern for progressive disease, metastatic lesion in abdominal LN
- previous static anaemia w/ moderate reticulocytosis and presence of nRBCs possibly related to cavitated LN vs bleeding elsewhere - await FBE today




At home medications: trazodone 60mg (6mg/kg) = 3x 20mg capsules PO evening prior (before bed) and 1-2 hours prior to vet visits.

Plan: 


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