Clinical Case Challenge

Labrador Collapses: What’s Your Diagnosis?

History: An eight-year-old, spayed female Labrador retriever presented for evaluation of acute onset of diarrhea and collapse. The owner reported that the dog was completely normal until 3 hours prior to presentation when the dog developed profuse bloody diarrhea.  There was no history of toxin exposure, and current medications included prednisone 1 mg/kg orally BID, famotidine 0.5mg/kg orally SID, and azathioprine 10mg/kg orally SID for immune-mediated hemolytic anemia diagnosed 4 weeks prior.

On initial physical examination the dog was recumbent with tacky, muddy mucus membranes and a capillary refill time of approximately 3 seconds.  The rectal temperature was 98.9° F, pulse 180 beats per minute, and respiratory rate 60 breaths per minute.  A large bore over the needle catheter was placed in the cephalic vein and the following minimum data base was obtained: PCV 34%, TP 5.4 g/dl, venous lactate 7.4 mmol/L. The dog had severe pain on abdominal palpation and there was a palpable abdominal fluid wave. An abdominocentesis was performed and the abdominal effusion was found to be a transudate. The remainder of the physical examination was non-remarkable. An emergency abdominal ultrasound was performed.

  1. Describe the lesion outlined in the ultrasound image:
    Clinical Case Challenge September 2011
  2. List 5 differential diagnoses for a dog presenting with an acute abdomen and abdominal effusion.

What’s your diagnosis? For the answers, please click here.