C09997559 / invoice 10000

HISTORY: Repeat ultrasound to monitor adrenal enlargement and liver mass
Report to follow
WEIGHT: 14.50

HISTORY: Hi Gabby,

Thanks for scanning Barney dog.

I have a question about the liver cytology - do you think the sample is representative of the lesion? or normal tissue surrounding the lesion? 
Not sure how much pressure to place on this incidental finding. He is clinically well. Does have mild elevation liver enzymes however.

Do you think it is worth re-scanning and re-aspirating the liver mass either now or in another 3ish months? O reluctant for biopsy due to invasive nature in clinically well dog - I suggested this would be best done with Dr Brett if its the only way forward pending consult with him.

We are going to leave the likely hyperA until we feel better about a liver lesion plan.

thanks again,

Dr Amy

--
--
Margaret River Veterinary Hospital
(& Augusta Veterinary Clinic)
1/47 Station Road
Margaret River, WA, 6285
P: (08) 9757 2163
w: margaretrivervet.com.au

HISTORY: Reason: Please see vet email - thank you nk

GAC reply

Hi Amy. 

I consider this a good result for Barney with respect to the liver lesion cytology- at worst case a well-differentiated (and relatively benign) hepatic tumour in a location well away from potential trauma, and best case nodular hyperplasia!  The joy of ultrasound-guided sampling is the certainty that the sample collected has come from the identified lesion- this is certainly true for Barney.

A repeat ultrasound assessment in 2-3 months is well worth considering (reduced charges apply) for monitoring lesion behaviour (more useful than blood samples where we have potential for adrenal gland hypertrophy to also affect the results).

It would be interesting to see how well Barney's hair regrows at the ultrasound clip area.  Poor regrowth may add weight to the tentative hyperadrenocorticism diagnosis.  It might also be worth objectively quantifying 24-hour water intake to ensure that he is not polyuric-polydipsic.  I feel that unmanaged hyperadrenocortism would be a huge concern if considering major abdominal surgery!

So, maybe we'll see Barney back in the next few months!

Gabby :-D