Dog liver ultrasound: connective tissue & non-homogenous. What now?

I see a still ultrasound picture in your photo, and while there are some hypoechoic areas that could make the liver look like Swiss cheese it is very difficult to interpret a single still ultrasound image. It’s possible that these are cysts, part of a tumor, blood vessels or enlarged bile ducts. Often a liver biopsy is necessary to determine what is ultimately causing liver abnormalities. I would recommend talking to your vet for clarification on what they think this could be and what the next steps might be.

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I would be suspicious of a few things to cause these elevations, including: liver disease, or cholestatic disease (involving the gallbladder). Neoplasia also can't be ruled out here. I would highly recommend the next step here to be an abdominal ultrasound and a bile acid test to check the liver function. The ultrasound is valuable here b/c we can get a good look at the gallbladder and check for a mucocoele. I do hope that Bear's condition is able to be managed well moving forward. Best wishes and take care.

Hello, and thanks for your question on Petco Pet Education Center, formerly Petcoach. I would classify those liver elevations as mild to moderately elevated. Liver values can be quite fluctuant - those elevations are somewhat nonspecific and simply indicate that there is higher liver cell turnover than what would typically be normal. This can be due to anything inflammatory, infectious, cancerous, or otherwise disturbing to the liver. A blood test alone cannot usually say exactly why the liver values are elevated - to have more information, a liver function test such as bile acids could be run, or the liver could be evaluated via ultrasound to make sure it still has normal architectural appearance. If these results are 8 months old, then the best next step would simply be to repeat a liver panel of bloodwork, and see if those values have remained elevated. It's very possible they may have normalized by now; if they haven't, your vet can discuss the best next step with Bear's other history and exam findings. If the values are still elevated but you choose not to pursue further diagnostic testing, there are liver protective medications that your vet may recommend to help protect the liver from oxidative damage. Hope this helps!

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Elevated liver enzymes and abnormal liver appearance on ultrasound scan does not necessary mean liver tumour or liver failure. Older dogs often have abnormal liver appearance, which is not related to any serious underlying problem. Liver enzymes level is a measure of 'damage' to liver cells but it is not directly related to prognosis. Again, older dogs often have mild elevation of liver enzymes I would think that the specialist will perform full abdominal scan and possibly take liver samples through a needle - this is commonly performed procedure in dogs with signs of liver disease. Based on the findings of the aspirate, the doctor will recommend further testing or prescribe treatment for Mars.

Hello, I am sorry to hear about Ginger. Based on the recheck liver values I would be concerned that Ginger has a problem in her biliary system, such as a GB mucocele or potentially a biliary duct obstruction. I would recommend rechecking the ultrasound to look for either of these developments. One thing that is interesting is that the other values are improving. Did your vet have any concerns about the blood sample when he ran/submitted the bloodwork. If there is a large amount of hemolysis (or breakdown of red blood cells) secondary to a traumatic blood draw or mishandling of the blood tube, this can lead to a false elevation of bilirubin. Although this value seems quite high to be due solely to sample error, I wonder if it may be contributing somewhat. If Ginger has a repeat ultrasound it might also be wise to recheck her total bilirubin level. Hope this helps, good luck!

It is difficult to state exactly what would be the next step if I do not have the actual blood work but if the liver values are elevated I would agree with your veterinarian that an ultrasound is not a bad idea for Tiny. With the ultrasound they will be able to see if it is generalized enlargement and damage or if there are lesion that would be a good thing to biopsy. I would recommend having an internal specialist perform the ultrasound (and biopsy if they feel it is needed). I would not change Tiny's diet yet until they find out what is going on with Tiny's liver. Thank you for using Petco Pet Education Center, formerly Petcoach.