Equivocal mild splenomegaly: should I worry?

[terestrife]

Elsa hurt herself because I made her eating area too high (this issue is resolved, and I have made their areas easier to get to.) Anyway, the vet said that she had a mildly enlarged spleen, he said he wasn't concerned, and it can be normal. But I am just posting here in case anyone experienced something similar.

You can see her results attached.

 

[silent meowlook]

Hi I am sorry, my phone won’t download. Can you quick say what is in the pdf? Or screen shot?

 

[terestrife]

Hi I am sorry, my phone won’t download. Can you quick say what is in the pdf? Or screen shot?

Requesting Doctor:
Patient Name: Elsa TERESA BORREGO (1251)
Species:
Gender: Breed:
Age:
Weight:
Feline 10Yr 6Mo
Female, Spayed Domestic shorthair 4.24 Kg
Radiology Services Report (9465848-15/Radiograph Consult -
Priority)
IDEXX Telemedicine Consultants
radiology | cardiology | specialty services
Completed 08/28/23 11:48 AM
Presenting Complaint: Lameness/Neuro
History: Current clinical complaint (musculoskeletal abnormality/abnormalities), MSK signs (trauma), Current clinical
signs/ ortho exam summary (On Saturday, Patient jumped off her cat tree and made a large cry that she was in pain.
Patient is walking fine now and E/D well with no V/D/C/S. Owner states that whenever she picks up patient, patient is
vocal and when P attempts to jump she vocalizes as if in discomfort.)
Physical Exam: Additional PE findings (PE WNL - P seemingly healthy. No pain elicited on palpation of abdomen. Spinal
palpation yielded some vocalization.), T (101.3F/38.5C), P (130), R (20), MM (Pink/Healthy), Patient attitude/demeanor
(bright)
Diagnostics: Pending diagnostics (Full blood work panel)
Treatment: Tx Plan (yes), Current treatment plan (Patient is going home with meloxicam for 7 days for pain management
and advised client no more jumping and to keep patient rested/quiet. )
Other: Additional information (no)
ABDOMINAL RADIOGRAPHS August 28, 2023: 3 views are included.
FINDINGS: The included musculoskeletal structures are unremarkable. There are no narrowed intervertebral disc
spaces or fractures or luxations or signs of irregular bone proliferation or lysis. The surrounding soft tissues are normal.
In the abdomen, there is mild gas/fluid distention of a couple segments of small bowel. The spleen is equivocally mildly
enlarged. No other significant abnormalities are seen. The stomach is empty. The colon contains normal feces. No
radiopaque GI foreign body is seen. Peritoneal serosal detail is within normal limits, there is no evidence of peritoneal
fluid or inflammation. There is no mass. The liver, kidneys, and urinary bladder are unremarkable.
The included thorax is unremarkable.
CONCLUSIONS:
1. Mild gas/fluid dilation of a couple segments of small intestine is likely a normal variation, differentials are enteritis or
functional ileus.
2. Equivocal mild splenomegaly, very likely a normal variation/artifact although could indicate congestion, extramedullary
hematopoiesis, lymphoid hyperplasia, or neoplasia.
Alejandro Caos
Requested By: Do you have feedback on this report? We want to
hear from you. Visit
We want to hear from you Survey.
Report provided by:
re: Elsa TERESA BORREGO (1251)

 

[silent meowlook]

Hi. I am not a Vet. I can only tell you what I would do if this was my cat.
I would keep the cat very quiet for the next couple of weeks restricting any areas that would allow jumping. Monitor eating drinking etc.
If I had the ability, I would also schedule an appointment with a specialty hospital for a board certified internal medicine specialist to dvm o an abdominal ultrasound. That is the best way to image the spleen,

I have posted a link below. It is written for veterinarians and gets complicated but it might add some insight.

if this was my cat, I would probably not use the medical. But of course I am not going to tell you not to use your prescribed medications. Just always do research any medication you are given for your cat.

 

[terestrife]

Hi. I am not a Vet. I can only tell you what I would do if this was my cat.
I would keep the cat very quiet for the next couple of weeks restricting any areas that would allow jumping. Monitor eating drinking etc.
If I had the ability, I would also schedule an appointment with a specialty hospital for a board certified internal medicine specialist to dvm o an abdominal ultrasound. That is the best way to image the spleen,

I have posted a link below. It is written for veterinarians and gets complicated but it might add some insight.

if this was my cat, I would probably not use the medical. But of course I am not going to tell you not to use your prescribed medications. Just always do research any medication you are given for your cat.

Elsa is already better from the injury she had. I gave her the medicine they prescribed, and it helped the inflammation go down. They already did an imaging on her spleen at my vet's office, does she need another one?. I just dont want to spend money on another scan that isn't necessary. I'm still trying to pay off my care credit card from all the vet visits. I don't have a lot of money and I'm trying to save up to get my other cat a dental. I only want to go to a specialist if its actually necessary. I took Elsa to a dermatologist once and it was a huge waste of money and very expensive.

edit: spelling

 

[FeebysOwner]

Hi. The report is indicative of radiographs being done and in conclusion it does recommend an ultrasound. When you say the vet already did imaging - what was it?

My cat has had an enlarged spleen for 2 years now. Nothing has come of it per se, but she has since been found to have cancerous cells in her intestinal lymph nodes. No one knows if the spleen is involved in that as no tissue has been sampled. So, an enlarged spleen doesn't have to mean cancer, but it does likely mean inflammation of some sort somewhere in Elsa's body.

I would pursue the recommendation for an ultrasound, if not done already - and it would probably be best if done by an internal med vet in a specialty group if at all possible. If an ultrasound was already done, an internal med vet could be consulted for a second opinion of the results, which may not require yet another ultrasound.

 

[terestrife]

Hi. The report is indicative of radiographs being done and in conclusion it does recommend an ultrasound. When you say the vet already did imaging - what was it?

My cat has had an enlarged spleen for 2 years now. Nothing has come of it per se, but she has since been found to have cancerous cells in her intestinal lymph nodes. No one knows if the spleen is involved in that as no tissue has been sampled. So, an enlarged spleen doesn't have to mean cancer, but it does likely mean inflammation of some sort somewhere in Elsa's body.

I would pursue the recommendation for an ultrasound, if not done already - and it would probably be best if done by an internal med vet in a specialty group if at all possible. If an ultrasound was already done, an internal med vet could be consulted for a second opinion of the results, which may not require yet another ultrasound.

I apologize I guess I assumed what they did was a sonogram since they took images from her stomach. I will look into this, thank you!

 

[FeebysOwner]

It might cost more initially, but if you pursue the ultrasound, make sure there is an authorization for a fine needle aspiration (FNA) to be done during the ultrasound if they find any suspicious tissue that they might want to analyze. My cat's first ultrasound did not include this, so she was put through a second one to do an FNA. Ultimately, she was put through a 3rd ultrasound with FNA, followed up by a PARR Assay in order for them to identify the cancerous cells. The PARR Assay is just a more detailed analysis of the tissue that has already been collected from the FNA, so that can be arranged for after the fact. I am just telling you this so you don't end up paying for multiple ultrasounds if at all possible.

The FNA is non-invasive and requires nothing more beyond what might be required for an ultrasound. Some cats need a light sedation, others do not. Feeby had a light sedation for her first ultrasound, but that was primarily needed to calm her for her abdomen being shaved. The other two ultrasounds, she didn't need anything. The light sedation they used on her was a small dose of butorphanol which is fast acting and short lived, and Feeby was not even groggy afterwards.

 

[terestrife]

ght want to analyze. My cat's first ultrasound did not include this, so she was put through a second one to do an FNA. Ultimately, she was put through a 3rd ultrasound with FNA, followed up by a PARR Assay in order for them to identify the cancerous cells. The PARR Assay is just a more detailed analysis of the tissue that has already been collected from the FNA, so that can be arranged for after the fact. I am just telling you this so you don't end up paying for multiple ultrasounds if at all possible.

The FNA is non-invasi

thank you for the help! I will keep that in mind. that is very helpful info. Did you go to an internal medicine vet? or to your regular vet? Elsa had a lump caused from a weird reaction to a collar and the specialist want to put her under to get a sample, and then put her under again to remove the lump. My normal vet just removed it and tested it at the same time. Which was more affordable. I dont make much money.

Elsa has had a lot of issues since she was a kitten. About 6 years ago she had a dental cleaning with a bunch of extractions, then she had the growth on her neck (not malignant) and at the same time she had 2 more teeth removed. Then a few months ago she hurt herself while jumping (my fault since I made her eating area too high.) I feel bad mentioning money but my care credit card is maxed out from all the tests and procedures I have had to do for her.

Thank you for responding and caring.

 

[FeebysOwner]

My regular vet wanted me to go to a specialist for the ultrasound, so that is what I did. Tbh, I think the FNA should have been something pursued with the first ultrasound, but I was not aware of what it was at that time, and I think I had a 'rookie' IM vet (she was a very thorough vet otherwise). The second ultrasound was done at the same place, but a different IM vet told me about the FNA, as an option if anything was found that needed additional analysis. It is possible most specialty groups would mention the FNA to begin with, but I just thought I would tell you in case they don't.

 

[terestrife]

My regular vet wanted me to go to a specialist for the ultrasound, so that is what I did. Tbh, I think the FNA should have been something pursued with the first ultrasound, but I was not aware of what it was at that time, and I think I had a 'rookie' IM vet (she was a very thorough vet otherwise). The second ultrasound was done at the same place, but a different IM vet told me about the FNA, as an option if anything was found that needed additional analysis. It is possible most specialty groups would mention the FNA to begin with, but I just thought I would tell you in case they don't.

Okay thank you! I will reach out to my regular vet to see if he recommends anyone.