– 11 yr old MN Yorkie with history of v/d, anorexia and abdominal pain
– had a past history of suspected pancreatitis
– bloodwork: ALP 800’s, ALT and GGT wnl, UREA elevated with normal CRE
– elevated K, amylase and lipase, cPLI positive
– urine SG 1.015
– GB and cystic duct distended with hyperechoic bililary sludge that appears to be mobile (not very mucocele like to me); could not see the CBD
– 11 yr old MN Yorkie with history of v/d, anorexia and abdominal pain
– had a past history of suspected pancreatitis
– bloodwork: ALP 800’s, ALT and GGT wnl, UREA elevated with normal CRE
– elevated K, amylase and lipase, cPLI positive
– urine SG 1.015
– GB and cystic duct distended with hyperechoic bililary sludge that appears to be mobile (not very mucocele like to me); could not see the CBD
– no evidence of active pancreatitis but pancreas is slightly hypoechoic with irregular margins (perhaps evidence of chronic pancreatitis or past pancreatic disease/scarring)
– both kidneys: hyperechoic cortices, poor CM distinction, cortical cysts, some mineral, irregular capsule and pyelectasia
So chronic interstital nephrosis pattern w chronic changes, possible pyelonephritis, r/o late blooming renal dysplasia (but would be strange at 11 years old). Anything else?
Any concerns with the GB? I did recommend starting urosodiol (once feeling better and working up the kidneys better) just because this is a Yorkie.
Comments
The Gb is sludgy and has
The Gb is sludgy and has polypoid hyperplasia… I would use actigall and I sort of want to call it an emerging mucocele but the sludge is still mobile so I would hold off. But I sure like to watch actigal do its thing on these for about 6 weeks and then rescan. I also like to put a 25 g needle in the dilated renal pelvis on that left kidney and culture becauise those kidneys need all the help they can get like tx any uti or any hypertension. They look about 60% conpromised so the isosthenuria maybe be yelling at the azotemia to come join him:).