Case study part 5

Given that my top differentials were leptospirosis and some type of cancer, I proceeded to do abdominal imaging. I started with an ultrasound of the abdomen.

On u/s, an extremely large, cavitated mass that appeared to be originating from the liver or spleen was found. The kidneys could not be visualized due to the enormous mass. The stomach was small and empty of food. No abnormalities were noted. The gallbladder was normal in size and appearance. The urinary bladder was moderately full. The intestines were displaced to the caudal abdomen due to the liver mass. The spleen was not well seen. No free fluid was noted in the abdomen.

Xrays of the abdomen confirmed an enormous abdominal mass. The kidneys could not be seen on either lateral or V/D. The intestines were displaced to the caudal abdomen. The entire cranial and mid-abdomen were filled with the mass. The head of the spleen was visible on V/D and appeared normal. The mass appeared to be originating from the liver.

I also collected a urine sample and blood sample to submit for lepto titers (BEFORE instituting antibiotic therapy).

What next?