The patient presented for ADR and hiding which was worsening over time. Blood chemistry, CBC, and urinalysis were both unremarkable. The caudal lumbar area of the patient was uncomfortable upon palpation. Radiographs revealed fused tail vertebrae, enlarged heart, and a mass effect in the chest. A double cavity ultrasound was performed and findings confirmed fused kidneys (which had previously been diagnosed) and a pericardial diaphragmatic hernia was noted. Falciform fat was in the pericardial space. The heart did not appear to be dysfunctional owing to this congenital defect. Due to splenic enlargement FNA of the spleen was recommended.
A few weeks later the patient's clinical signs worsened again. Despite treatment with pain medication, cortisone and antibiotics the patient presented again with dull mentation and not wanting to walk. Upon examination no ataxia or nystagmus was noted but the patient was squinting; there was concern for CNS disease. A CT study was performed at Blairstown Animal Hospital.
An 11-year-old MN Yorkshire Terrier presented for a second opinion for a 4-week history of back pain; an L2 lesion is suspected. Previous treatments were Gabapentin and Tramadol, but the patient showed no improvement. The patient was still very painful, reluctant to move, and baring teeth when owner tried to pick him up. The area of L2 appeared normal on radiographs. CBC was WNL, blood chemistry found an Alk. Phos. of 187 and a PSA lipase of 528. Urinalysis showed 2+ protein. A left medial liver nodule, likely lipogranuloma or benign lesion with minor renal mineralization was seen on ultrasound. The sonographic findings were not contributing to this patient's pain and there was no evidence of visceral disease that could be contributing to the clinical signs. A CT of the spine with contrast was strongly recommended given the patient's symptoms.
The patient was presented for intermittent lameness of the left hind for a duration of 1.5 years. Recently the right hind limb is painful, the patient seems more lethargic and does not get up much. Radiographs from previous vet showed mild inflammation of the fat pad of the left stifle. Currently on Rimadyl. Physical exam found no cranial drawer. CBC, blood chemistry, and T4 were all WNL.