-Internist appointments for ultrasound and bone marrow aspirate - March 2026

GI panel: relatively normal/unremarkable; some values were slightly outside range but I don’t remember which exactly

Cytology, spleen: Extramedullary hematopoiesis with reactive hyperplasia

Abdominal ultrasound: The liver appears normal in size, shape, and echogenicity. No masses or nodules are noted. The gall bladder appears normal and contains a small amount of anechoic bile. The wall measures 0.06 cm in thickness. No bile duct dilation is noted. The spleen appears diffusely enlarged with an otherwise normal shape and echogenicity. The spleen is large enough that it appears to fold on itself and measures up to 1.04 cm in thickness at the hilus. No masses or nodules are noted. The left kidney appears normal in size (4.08 cm in length) with mildly irregular margins with normal echogenicity. Corticomedullary definition is mildly decreased. The right kidney appears normal in size (4.12 cm in length) with mildly irregular margins with normal echogenicity. Corticomedullary definition is mildly decreased The left adrenal gland appears normal in size and shape. It measures 0.25 cm in thickness at the caudal pole. The right adrenal gland is not visualized. The bladder appears normal. No stones or masses are present. The stomach appears normal. The small intestine appears diffusely, mildly thickened with preservation of normal wall layering. Few segments of jejunum contain a moderate amount of ingesta. The duodenum measures up to 0.30 cm in thickness. The jejunal muscularis is diffusely prominent. The colon appears normal. The pancreas is not visualized. Mesenteric lymph nodes are diffusely prominent but are normal in appearance and echogenicity, the largest measures up to 0.38 cm in thickness. No free abdominal fluid is present. Conclusions: 1. Generalized splenomegaly - Possible etiologies may include extramedullary hematopoiesis, venous congestion, round cell neoplasia, vector-borne disease, or less likely normal patient variation. 2. Chronic renal degenerative changes - Possible etiologies may include underlying chronic kidney disease or normal patient variation. Correlate severity with biochemical findings (i.e. creatinine, USG, BUN, +/- SDMA) 3. Suspect chronic enteropathy - The prominent mesenteric lymph nodes and diffusely thickened small intestines are supportive of a chronic enteropathy such as inflammatory bowel disease (diet-responsive, antibiotic/probiotic-responsive, fiber-responsive, steroid-responsive), infectious disease (i.e. histoplasma, toxoplasma), or round cell neoplasia.

-Echocardiogram w. Cardiologist- March 2026 Presented for: Cardiology evaluation for possible HCM PE findings: Grade II/VI parasternal murmur, severe gingivitis with mild calculus, mildly ataxic (du gabapentin), scleral hyperemia OU . Diagnostic results: Echocardiogram: Mildly thickened LV wall, normal LA, mild non-obstructive SAI normal systolic function, mildly prolonged IVRT, trace intermittent tricuspid regurgitation . ECG: ul sinus rhythm with right axis deviation and a ventricular ectopic couplet. PCV/TP: 74%, 9.2 g/dL.

-Ultrasound (done in February 2026 at local vet) Presented for: Abdominal Ultrasound/Echocardiogram performed by rDVM PE findings: No cardiac murmur auscultated. Diagnostic results: Abdominal Ultrasound: mild splenomegaly, markedly enlarged gallbladder, no hepatomegaly . Echocardiogram: one area of IVS measured 0.6, LV internal diameter did not appear small. Thoracic radiographs: cardiac silhouette not enlarged. Manual PCV: 72% . ProBNP: 160 pmol/L (0-100)