What is your diagnosis? Hepatosplenomegaly in a dog

摘要

A nine-year-old, entire male Bernese Mountain Dog presented with a three week history of episodic inappetance and lethargy. The referring veterinarian had commenced prednisolone therapy (20 mg SID) after initial haematological evaluation two weeks earlier had shown a regenerative anaemia (PCV 0.26 L/L), leukocytosis, and thrombocytopenia. Prednisolone administration was ceased by the owners three days before presentation, as they did not feel there had been much improvement. Physical examination wasunremarkable, except for palpable hepatosplenomegaly. Pertinent haematologic and clinical chemistry abnormalities at this time included anaemia (haematocrit 0.27 L/L; reference interval 0.37-0.55 L/L), reticulocytosis (288 x lO'/L; reference interval < 95 x 10~9/L), mature neutrophilia (30.4 x 10~9/L; reference interval 3.0-11.5 x 10~9/L), monocytosis (2.9 x l0~9/L; reference interval 0.1-1.3 x 10~9/L), hypoproteinaemia (37 g/L; reference interval 54-78 g/L) due to hypoalbuminaemia (21 g/L; reference interval 24-38 g/L) and hypoglobulinaemia (16 g/L; reference interval 24-42 g/L), and hypocholesterolaemia (2.3 mmol/L; reference interval 3.9-7.8 g/L). Mild spherocytosis was noted on blood film examination. Platelet clumps were present, invalidating theautomated platelet count, with the platelet estimate on the blood film deemed to be within normal limits. Urinalysis and thoracic radiographs were unremarkable. Both the liver and spleen were hyperechoic and subjectively enlarged on abdominal ultrasoundexamination. There was also a small amount of free abdominal fluid. Ultrasound-guided fine needle aspirates were collected from the liver (Figure 1) and spleen (Figure 2).