Veterinary Abdominal Ultrasonography Report

Patient Information - Owner: Ms. Eleanor Vance - Patient's full name: "Buddy" - Species: Canine - Breed: Golden Retriever - Age: 8 years - Sex: Male (neutered) - Weight: 32 kg Date of Examination 01/11/2024 Reason for Ultrasound Buddy presented with a two-week history of intermittent vomiting, reduced appetite, and mild abdominal discomfort. Blood work revealed elevated liver enzymes and mild anaemia. Abdominal palpation was unremarkable. An abdominal ultrasound was requested to investigate the gastrointestinal tract, liver, and other abdominal organs for potential underlying pathology contributing to the clinical signs. 1. Liver - Liver is mildly enlarged with rounded margins; approximately 10.5 cm in length at its widest point. No significant size abnormalities relative to breed and body size noted. - Liver echogenicity is diffusely heterogeneous, appearing slightly hyperechoic compared to the spleen with a coarse echotexture. - Multiple hypoechoic, ill-defined nodules, ranging from 1-2 cm in diameter, are noted throughout both hepatic lobes, suggestive of diffuse hepatic changes. 2. Gallbladder and Biliary System - Gallbladder is mildly distended with a wall thickness of 1.5 mm, which is within normal limits. Luminal contents show mild biliary sludge but no choleliths. - Common bile duct is not dilated (2 mm diameter), and no obvious obstruction is identified. 3. Spleen - Spleen is within normal size limits for the patient's breed (14 cm length). Echogenicity is homogenous and fine. No focal lesions or diffuse abnormalities detected. 4. Pancreas - Pancreas appears mildly hyperechoic with slightly irregular margins, suggestive of mild inflammatory changes. The surrounding mesenteric fat is also mildly hyperechoic, consistent with localized inflammation. 5. Kidneys - Right kidney measures 6.5 cm x 3.8 cm, with good corticomedullary distinction. Renal pelvis is not dilated. No masses or cysts identified. - Left kidney measures 6.8 cm x 4.0 cm, with good corticomedullary distinction. Renal pelvis is not dilated. No masses or cysts identified. 6. Urinary Bladder - Bladder wall thickness is within normal limits (2 mm). Luminal contents are anechoic with a small amount of sediment. No uroliths or masses are present. 7. Gastrointestinal Tract - Stomach wall thickness is normal (4 mm) with appropriate layering. Contains a small amount of anechoic fluid and gas. - Small intestinal wall thickness is within normal limits (3 mm for jejunum) with preserved layering. Peristalsis is normal. No foreign bodies or obstructive lesions are noted. Large intestinal walls are unremarkable. 8. Adrenal Glands - Right adrenal gland measures 0.6 cm x 0.3 cm, normal shape and echogenicity. - Left adrenal gland measures 0.7 cm x 0.4 cm, normal shape and echogenicity. 9. Reproductive Organs - Prostate is moderately enlarged (4 cm diameter), diffusely hyperechoic, and slightly heterogenous, consistent with benign prostatic hyperplasia. 10. Abdominal Vessels - Abdominal aorta and caudal vena cava appear patent with normal flow characteristics. No abnormalities noted. 11. Other Findings - No peritoneal effusion detected. - No significant abdominal masses or lymphadenopathy are identified beyond the noted hepatic changes. - Incidental finding: Mild diffuse prostatic enlargement consistent with benign prostatic hyperplasia. Interpretation Abdominal ultrasonography reveals diffuse hepatic changes consistent with hepatopathy, characterized by heterogeneous echogenicity and multiple small hypoechoic nodules. While non-specific, these findings warrant further investigation to rule out inflammatory, metabolic, or neoplastic processes. Mild pancreatitis and benign prostatic hyperplasia were also identified as incidental findings, which may contribute to Buddy's discomfort but are unlikely to be the primary cause of his vomiting and elevated liver enzymes. The lack of overt gastrointestinal obstruction or significant foreign bodies is reassuring. Diagnosis Diffuse Hepatopathy; Mild Pancreatitis; Benign Prostatic Hyperplasia. Recommendations - Recommend liver biopsy or fine needle aspirate for definitive diagnosis of the hepatic changes. - Consider a course of dietary management and pain relief for mild pancreatitis. - Discuss options for managing benign prostatic hyperplasia, such as medical therapy with Finasteride. - Recheck blood work in 2-4 weeks to monitor liver enzyme levels. - Schedule a follow-up consultation to discuss biopsy results and treatment plan. Report Prepared By Dr. Sarah O'Connell, DVM Date of Report 01/11/2024