My approx 5 year old Path Valley boy, Willard, has recently recovered from
an unusual illness.  He had been pronounced in excellent health, besides an
enlarged spleen, the week before.  I'd like to recount what happened to him
so that I can see if anyone else has experienced something similar, and
also so that there will be a record in the archives (I love the searchable
archives and use them almost daily, thanks *tons* for those, BIG!) that
might help someone else someday.  I'm also getting concerned about
Willard's spleen and overall condition, and I wonder if anyone has any
advice.
 
In early December of last year, Willard *very* suddenly came down with a
high fever and moderate hind end weakness.  He went from slightly off to
absolutely critical overnight.  Luckily, I have a fantastic vet - Dr.
Powers at Timberlyne Animal Clinic in Chapel Hill, North Carolina - and she
saw us first thing in the morning and treated the case very aggressively.
She felt a large mass in the retro-peritoneal area, and upon x-ray, we
could see it.  It was huge, and of course we assumed it was probably a
tumor, most likely lymphosarcoma involving lymph nodes.  Upon biopsy,
though, it spurted pus, and we learned it was an abscess.  There was no
external wound, no cats in the house, nothing that you would typically
think of to cause an abscess.  A CBC showed somewhat-elevated levels of
bilirubin and ALT, both liver functions - all other values were normal.
His urine was also very dark, another indication of the high bilirubin
level.
 
IV fluids and antibiotics were started, and surgery was performed the next
day.  During surgery, it was found that there were actually two large
abscesses next to each other, giving the appearance of a big heart-shaped
mass on the x-ray.  These were not prostatic cysts, and there was no
evidence of neoplasia of any sort (normal adrenals, pancreas, etc...).
There were two other interesting findings during the surgery.  First, there
were a few weird-looking cysts along his intestine.  Biopsy showed that
these were lymph nodes that had turned into cysts.  Second, there was a bit
of free-floating liver tissue in the abdomen - a liver infarct, I think she
called it.  The liver itself looked fine.
 
Willard recovered well from surgery and came home a few days later.  The
cystic lymph nodes were not cancerous.  The bacteria inside the abscess was
Clostridia perfringens, not one of the usual abscess bacteria.  However,
this bacteria is common and does exist in the gut (and everywhere else,
it seems).  We wonder if perhaps there was some swallowed object that
penetrated the gut and set up the abscess.  However, he never showed any
blockage-type symptoms or any pain or tarry stools like it seems like would
be seen had this happened.  There is also the possibility that the liver
infarct (trauma?) started a circuation of bacteria which infected the lymph
nodes that drain that area of the body, leading to the abscess.
 
The bilirubin and ALT levels were normal when re-checked a couple of weeks
later.
 
Has anyone seen anything like this before?  I completely trust Dr. Powers;
it's amazing that she pulled Willard through this - if she hadn't moved so
quickly there is no doubt that he would have died. She also went way above
and beyond, seeking help from other vets and doing research into what this
could be.  We'd both love to hear from anyone who has seen a similar case
or who has any ideas on this, as we're pretty mystified.
 
He improved really quickly at home, with lots of TLC and handfeeding, and
he gained back the weight he had lost during this illness.  Now, it's over
two months later, and I'm taking him back to the vet Monday morning to
check on his spleen, which seems to be getting larger to me.  Also, his
back feels bonier than I would like, and I want him checked over.  I'm
wondering if it's time for that spleen to come out... It's been enlarged
and monitored for a couple of years, but it really seems huge now (it's
also possible I'm imagining this, and it's the same as it's always been).
He just doesn't seem "quite right" to me now, so I'm curious about what Dr.
Powers thinks.
 
Thanks for any thoughts,
 
-Pam S.
[Posted in FML issue 2592]