What’s your diagnosis #6?
Hello everyone! Welcome to week 6!
“Goldy” is a 10-year-old female spayed Golden Retriever dog. She is presented today for a one-month history of reduced appetite, gradual weight loss of 4 lbs, and occasional vomiting that is increasing in frequency.
The vomiting started about 1 month ago. Goldy used to eat stuffed toys as a puppy but has never destroyed any toys as an adult. She did not have vomiting before this past month. The owner describes the vomit as being mostly food with a little bit of yellowish fluid in it. The food is usually partially broken down but still recognizable as kibble. She has watched Goldy vomit and the dog retches and has abdominal contractions when vomiting. At first she only vomited once or twice a week after meals, but this past week she has vomited four times and yesterday there was a small amount of blood in the vomit. Her stools have been normal….
Some good responses so far. Just about everyone requested a CBC/chem/UA, which is always a great place to start when you have a senior patient, no matter what the presentation. I also had a few requests for radiographs and ultrasound. The results for the above are under the jump. Has any diagnosis shot to the top of your list? How can you confirm it? For this case, you are at a specialty practice with endoscopy, a board-certified surgeon, and a nearby imaging facility with MRI and CT.
You perform the upper GI endoscopy on “Goldy.” This is her pyloric region of her stomach.
The mass is ulcerated, thickened and causing narrowing of her pylorus, which has resulted in her vomiting, hematemesis, weight loss and poor appetite. You collect several samples, but when you give Goldy’s owner the news, she elects to euthanize Goldy later that evening. Goldy dies peacefully in her owner’s presence.
The mass was most likely a gastric adenocarcinoma, the most common type of stomach cancer in dogs. Goldy, being a 10-year-old Golden Retriever, is unfortunately much more prone to cancer than, say, a 10-year-old Chihuahua or Shih Tzu. Cancer should have been high on your differential list because of her age and breed, especially given the fact that this has been slowly progressing for several weeks; problems like pancreatitis, dietary indiscretion, foreign body and toxins are much more likely to be acute in their presentation. That doesn’t rule them out entirely, but it does make them less likely. Poor Goldy. :(
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- esefue answered: foreign body?
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- ladyofthelight101 answered: gastritis, IBD or the like? do an endoscopy and biopsy the thickened area
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- sydalready answered: I’d run a CBC, chemistry and a UA to rule out pancreatits, renal failure or DKA
- eat-sleep-owls answered: I would want to run blood work (maybe PCV and CBC/Chem) and ultrasound
- whitetigerlilies answered: Hmmm. Perhaps pancreatitis?
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- crashburnrisefly answered: At my clinic we have an HM5 that runs a complete blood panel with diagrams and graphs. See if her WBC are elevated, maybe infection?
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