My pet has the following symptoms:
We are not sure what to do next after these reports...we were told the next steps would be a CT scan and a biopsy that could cost up to $4500. She is now not really eating anything and throwing up when she does eat. All of the information is overwhelming and the options are all expensive so we want to make the best decision possible. This is the report from the vet so far:
"young dog, anorexia, weight loss
low BUN, low Potassium, low Albumin, elevated ALT, AST, & ALKP and bilirubin, low cholesterol, urine SG is 1.004, Bile Acids 262 & 252 pre&post."
After this, we had an ultrasound done with these reports:
"The liver was small, hyperechoic and irregularly marginated. The gallbladder was within normal limits. The abdominal fat was diffusely hyperechoic, more severely so in the cranial abdomen. A small volume of anechoic abdominal effusion was detected.
Insufficient portal vasculature was visible to reliably assess for portosystemic shunting. The adrenal glands were slightly small.
The spleen, kidneys, urinary bladder, GI tract, pancreas and abdominal lymph nodes were within normal limits.
Conclusions:
Evaluation for portal vascular anomalies was not possible due to the patient's body conformation, the hyperechoic abdominal fat graft interposed GI gas. Intrahepatic and extrahepatic portosystemic shunting remain possible. CT would be necessary to further evaluate. A small liver would be compatible with a shunt, although the hyperechoic parenchyma and irregular contours are not characteristic of a simple portosystemic shunt, and chronic acquired liver parenchymal disease should also be ruled out.
Histopathology is recommended to further evaluate this possibility. Unfortunately, due to the small size of the liver and the patient's body conformation, ultrasound guided sampling would not be possible.
The hyperechoic abdominal fat and abdominal effusion may be due to the reported hypoalbuminemia, portal hypertension or combination of processes.
The slightly small adrenal glands may be a normal variant in this young patient, although Addison's disease is also possible.
Adrenal function testing may prove useful in further evaluating this possibility."