Radiology Packet 40

1. Radiology Packet 40 Miscellaneous Abdomen

2. 8-year old Cocker Spaniel • Hx: Presented for anorexia and depression of several days duration. The dog’s abdomen was tender to palpation and appeared bloated.

4. 8-year old Cocker Spaniel • RF • In both vies the cranial abdomen is under-exposed and there is a loss of abdominal detail. • The gastric axis is caudally displaced indicating hepatomegaly. • A 10cm soft-tissue opacity mass is present in the left, ventral abdomen. • The small intestines are displaced caudo-dorsally and to the right by the enlarged liver and splenic mass. • There is a loss of abdominal detail in the cranial to mid-abdomen. • RD • Hepatomegaly • Splenic mass • Free abdominal fluid • Next • Ultrasound

5. 3 year old FS DSH“Shivers” • RF • The kidneys are at the lower limits of normal size with the left kidney being slightly smaller than the right. • A faint focal area of mineral opacity is present superimposed with the renal pelvic area in the lateral view. • The urinary bladder is distended. • RD • Kidneys at the lower limits of normal. • R/O • Chronic renal disease • Normal in this patient • Next • Evaluate BUN and creatinine levels.

6. 14-year old MC Cocker Spaniel“Prince” • Hx: Presented with PU/Pd, an enlarging abdomen, and some anorexia and diarrhea during the past week.

9. 14-year old MC Cocker Spaniel“Prince” • RF • Liver margin is quite rounded and extends beyond the costal arch. • Irregular soft tissue mass in the right ventral abdomen, caudal to the liver. • Faint mineralization is present overlying both kidneys. • One pea-sized cystic calculus and many tiny calculi are in the urinary bladder. • The abdomen has an mild “pot-belly” appearance but overall serosal detail is good. • The cardiac silhouette is large. • There is an incidental finding of spondylosis of the lumbosacral junction. • RD • Hepatomegaly • Irregular soft tissue mass • Renal mineralization and cystic calculi • R/O • Hyperadrenocorticism • Next • Ultrasound

10. 10-year old M Yorkshire Terrier • Hx: Presented for straining to urinate.

12. 10-year old M Yorkshire Terrier • RF • Markedly enlarged urinary bladder. • Multiple urinary bladder calculi present. • Prostate gland is visible, not too large given the elderly and intact status of patient. • Focal solitary urethral stone noted just proximal to the os penis. • Large, rounded liver. • RD • Urethral obstruction leading to inability to urinate • Multiple larger cystic calculi • Hepatomegaly • “Pendulous” appearance of the abdomen • R/O • Hyperadrenocorticism • Next • Ultrasound • ACTH stimulation test

13. 6-year old cat“Twisted” • Hx: Presented for dyspnea. She is anemic.

15. 6-year old cat“Twisted” • RF • The thorax contains a moderate volume of pleural effusion which partially obscures the cardiac silhouette. • In the VD view there is an area of opacity noted in the right thorax, which appears to be continuous with the heart. • There is caudal displacement of the gastric axis indicating large size of the liver. • The kidneys are hard to visualize but appear slightly enlarged. • Serosal detail is diminished. • There are mineral opacity structure seen in the ventral caudal abdomen which are believed to be mineral material present within the GI structure. • RD • Pleural effusion • Hepatomegaly • Ascites • Next • Ultrasound

16. 10-year old MC DSH“Puddy” • Hx: Presented for depression, anorexia and lethargy of several days duration. The cranial abdomen is painful to palpation.

18. 10-year old MC DSH“Puddy” • RF • The liver is mildly enlarged. • The spleen is enlarged. • The small intestines are fluid filled but are within normal limits. • In the lateral view there is areas of soft tissue opacity in the mid-abdomen immediately ventral to the kidneys. • There is slightly decreased serosal detail. • RD • Hepatomegaly • Spleenomegaly • Possible mid-abdominal mass • Possible free abdominal fluid • Next • Ultrasound

19. 13-year old MN DLH“Casanova” • Hx: Listless. Weight loss.

21. 13-year old MN DLH“Casanova” • RF • The liver is mildly enlarged. • The left kidney is enlarged and misshapen. • The right kidney is large and misshapen. • The urinary bladder is moderately distended. • Increase in renal size has caused ventral displacement of the intestinal segments. • RD • Mild hepatomegaly • Bilateral renal enlargement with alteration of renal shape • R/O • Neoplasia • Hydronephrosis • Perinephric pseudocyst • Inflammatory disease • Toxicity • Infiltrative disease • Polycystic renal disease • Next • Ultrasound

22. 11-year old M Poodle • Hx: Presented with a 3 month history of PU/PD and polyphagia. Hematuria and dysuria have been noticed for the last 3 weeks. PE findings include an enlarged, tense abdomen and a thin haircoat.

24. 11-year old M Poodle • RF • The liver is enlarged and has rounded margins and has caused caudal displacement of the gastric axis. • The kidneys are difficult to visualize on the VD projection but the left kidney appears enlarged. • There are multiple, irregularly shaped mineral opacity structures seen within the bladder. • A mineral opacity structure is seen within the soft tissue in the perineal region. • The prostate is visible caudal to the prostate and is mildly enlarged. • There is gas in the pyloro-duodenal angle and the descending duodenum. • The abdomen appears large relative to the thorax. This may be due to fat deposition (Pickwickian syndrome). • There is a mild decrease in abdominal detail. • RD • Hepatomegaly • Cystic calculi • Urethral calculi • Prostatomegaly (mild) • Possible renomegaly • R/O • Endocrine disease (Cushing’s disease) • Prostatic disease • Next • Ultrasound

25. 3-year old M Springer Spaniel“Higgins” • Hx: The patient has been vomiting intermittently for 3 weeks. At presentation the patient is dehydrated and has elevated BUN and WBC count. He is depressed and tachypneic.

27. 3-year old M Springer Spaniel“Higgins” • RF • The liver is enlarged and has rounded margins and has caused caudal displacement of the gastric axis. • The spleen is enlarged with rounded margins. • The kidneys are of normal length but are wider than normal. • There is impression of thickening of the gastric wall and the rugal folds are prominent. • The intestinal segments are displaced caudally by the enlarged organs. • The cranial aspect of the urinary bladder is visible in the lateral view. • The abdominal detail is normal. • RD • Hepatomegaly • Splenomegaly • Renomegaly (bilateral) • Possible gastric wall thickening • R/O • Infiltrative disease (lymphosarcoma, disseminated mast cell disease. • Gastric wall thickening as a result of edema secondary to vomiting. • Next • Ultrasound and fine-needle aspiration.

28. 10-year old MN Old English Sheepdog“Rueben” • Hx: Abdominal distension. Heart murmur.

32. 10-year old MN Old English Sheepdog“Rueben” • RF • The cardiac silhouette and pulmonary vessels are at the lower limits of normal size. • There is a mild diffuse interstitial lung pattern that is consistent with the age of the patient. • There is marked loss of abdominal detail. • The stomach is displaced caudo-dorsally and to the left indicating that generalized hepatic enlargement is present. • The spleen is visible along the left lateral body wall and its’ axial border is nodular. • The small intestinal segments are displaced into the caudal abdomen. • The descending colon is irregularly marginated and gas-filled suggesting serosal inflammation. • There is an incidental finding of multiple sites of spondylosis throughout the thoracic and lumbar spine. • RD • Free abdominal fluid • Hepatic enlargement • Possible splenic nodules • Next • Ultrasound

33. 4-month old M Labrador Retriever“Midnight” • Hx: Hit by car. Films taken to rule out thoracic and abdominal trauma.

36. 4-month old M Labrador Retriever“Midnight” • RF • The cardiac silhouette and pulmonary vessels are small. • Evaluation of the VD view shows alveolar infiltrates in the right cranial and right middle lung lobes. • Air-bronchograms are visible in the accessory lobe in the lateral view. • The thymus is visible in the left cranial hemithorax. • Abdominal detail is poor in this patient. • The caudoventral margin of the stomach extends caudally due to a large amount of fluid and some gas causing the gastric distension. • Small intestinal segments are displaced caudally by the gastric distension. • Fracture of the ilium is visible and it is seen extending into the acetabulum. • Pelvic floor fractures and a mid-diaphyseal fracture of a femur is also seen. • RD • Small size of heart and pulmonary vessels • Pulmonary contusions • Gastric distension • Free abdominal fluid • Fracture of the ilium, acetabulum, pelvic floor and mid-dyphyseal femoral fracture • R/O • Hypovolemia causing decrease heart and pulmonary vessel size • Ileus resulting in gastric distension • Next • Abdominocentesis

37. 2-year old FS Siamese cat“Tao” • Hx: Presented for lethargy and weight loss.

39. 2-year old FS Siamese cat“Tao” • RF • Bilateral renal enlargement. • Decreased abdominal detail. • Mild liver enlargement. • Granular material in small intestine • RD • Renomegaly • Ascitis • Probably partial SI obstruction • Mild hepatomegaly • Next • Ultrasound • Abdominocentesis • Renal fine needle aspirate or biopsy