Clinical Case Challenge

Case description:

“Sadie”, an 11-year-old female Pit Bull, presented to the Cardiology Service at Tufts Foster Hospital for Small Animals for further evaluation and treatment of a cardiac mass and signs of persistent right-sided congestive heart failure(RCHF). Sadie had previously been treated with standard doses of furosemide and pimobendan. Previous three-view thoracic radiographs at Tufts VETS showed possible small pulmonary nodules, and an abdominal ultrasound showed large volume ascites and nodules in both the spleen and liver.

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Clinical Case Challenge

Case description

Figure 1: A saggital T2 - weighted view of brain and upper spinal cord. The abnormal findings include generalized enlargement of the ventricular system and significant central intramedullary hyperintensity over C1 and C2.

Figure 1: A saggital T2 – weighted view of brain and upper spinal cord. The abnormal findings include generalized enlargement of the ventricular system and significant central intramedullary hyperintensity over C1 and C2.

A 1.5 year old neutered Labrador retriever, Rimadyl, presented to the Neurology Service at Tufts Foster Hospital for Small Animals for a two week history of neck pain. Rimadyl improved for about one week, however, clinical signs then progressed with an uncoordinated gait and dragging of all four legs. Continue reading

Clinical Case Challenge

Figure 2

Figure 2

History: A 6-year-old female spayed Lionhead rabbit presented to Tufts Foster Hospital for Small Animals with a one-day history of inappetance. She also had a recent history of urine scald. On physical examination the rabbit was noted to be overweight with increased subcutaneous and abdominal fat stores. The results of a complete blood count revealed a leukocytosis (26.2 x 103cells/µl; reference range, 5 – 12 x 103cells/µl) with a lymphocytosis (23.4 x 103cells/µl; reference range, 1.25 – 6 x 103cells/µl). Continue reading

Clinical Case Challenge

A 9-year-old intact male Labrador retriever presented to Tufts Foster Hospital for Small Animals for further evaluation of history of painful gait, chronic atopic dermatitis/pododermatitis (for years) and the recent discovery of of increased liver enzymes (ALT =422 U/L, ALP= 377 U/L, AST =73 U/L) with a normal albumin and bilirubin. The dog had failed to respond to consecutive 3 week courses of clindamycin and cefpodoxime. On physical examination the dog was normal except for extreme difficulty in getting up and walked gingerly. He would not permit full examination of the feet, but a moist dermatitis and areas of ulceration were appreciated (Fig 2 A).

Fig 2

Fig 2. Hepatocutaneous syndrome in a dog. A. Gross appearance of feet with hyperkeratosis and ulceration. B. Ultrasound of liver showing typical ‘honeycomb’ pattern consisting of variable-sized hypoechoic regions surrounded by hyperechoic borders. B. Skin biopsy (H&E) with 1: Marked parakeratotic hyperkeratosis; 2: Vacuolar change in the upper levels of the epidermis; 3. Hyperplastic epidermis with acanthosis. Images A and C courtesy of Dr Lluis Ferrer and B from Dr. Dominique Penninck.

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