Case Study #1

2 year old stray male, DSH presented with lethargy, inappetence, weight loss and urinary incontinence. Increased renal values on bloodwork.

Based on the sonographic findings and clinical history, the presumptive diagnosis was feline infectious peritonitis (FIP). Other differential diagnoses included: lymphoma, inflammatory bowel disease, pyelonephritis and chronic renal disease.

Thickened Jejunum

Thickened intestinal wall layering was observed; the muscularis propria layer in particular was disproportionate. This finding is often consistent with infiltrative neoplasia like lymphoma, inflammatory bowel disease and Feline Infectious Peritonitis (FIP)

Prominent Lymph Nodes

Several prominent and enlarged lymph nodes were seen within the mesentery. Differentiation of reactive LNs from malignant/metastatic LNs by ultrasound appearance alone can be challenging. Ultrasound-guided FNA of suspicious nodes is recommended, and often required for definitive diagnosis.

Abnormal Kidneys

Bilateral abnormal kidneys with poor corticomedullary distinction and several echogenic (bright) shadowing foci, consistent with uroliths, were observed.

Case Study #2

12 year old male, intact Spaniel hunting dog. Presented with a 2 month history of hematuria and difficulty urinating, without resolution following antibiotic therapy. Benign prostatic hyperplasia was suspected.

Prior to surgical castration, an abdominal ultrasound was performed and an irregular, sessile vascularized mass was found to extend into the bladder lumen.

Prostatomegaly

A diffusely enlarged, homogeneous and hyperechoic prostate gland was observed; a finding consistent with benign prostatic hyperplasia (BPH), as often seen with intact male dogs greater than 4 years of age.

Bladder Mass

Focal wall thickening and abnormal wall layering, with a large, irregular, sessile vascularized mass extending into the bladder lumen was observed. The most likely neoplasm is transitional cell carcinoma (TCC), but ultrasound guided catheter biopsy of the mass and aspiration of regional lymph nodes is recommended to further characterize.

Hydronephrosis & Hydroureter

Dilation of the renal collecting system and ureter is observed secondary to obstruction caused by the mass where the ureters implant into the bladder, at the level of the trigone.

Case #3

9 year old, male neutered, Golden Doodle presenting with vomiting and diarrhea x 6 weeks, lethargy, inappetence. Treated for pancreatitis following a positive Spec cPL.

An ultrasound was performed and demonstrated mild pancreatic changes, incidental liver nodules and significant changes within the kidneys. Consultation with internal medicine is suggested for guidance regarding additional diagnostics and management of this patient.

Abnormal Kidneys

Bilateral kidneys showed smooth contour, multiple focal irregularly shaped hyperechoic regions within the cortex and mild fluid distension in the renal pelvis. The changes are highly suggestive of pyelonephritis, a degenerative process or a thromboembolic disease.

Liver Nodules

An incidental finding of 2 hyperechoic nodules in the liver, consistent with benign nodular regeneration.

Pancreas

The pancreas is slightly hypoechoic and coarse, but the degree of change is not marked. No significant hyperechoic fat adjacent to the pancreas is seen, nor free fluid or reactive lymph nodes. These findings indicate mild pancreatitis or a normal pancreas with age-related changes.