Sonopath Forum

Sick Gall Bladder??

Laney is a 9 year old, spayed Sheltie. ADR for past week or so with PU/PD & vomiting/diarrhea. Laney is extremely yellow on exam…basically everywhere.

Labs show WBC of 24,780 w/ 83% PMN’s, ALT of 539, AP of >2000, GGT of 33, T. Bil of 22.

Laney is a 9 year old, spayed Sheltie. ADR for past week or so with PU/PD & vomiting/diarrhea. Laney is extremely yellow on exam…basically everywhere.

Labs show WBC of 24,780 w/ 83% PMN’s, ALT of 539, AP of >2000, GGT of 33, T. Bil of 22.

We scanned the dog and I found a large liver with overall hyperechoic paranchyma. No obvious masses. I could not readily find a Gall Bladder??? I see an area in the anatomic region of the GB with very thickened irregular hyperechoic walls that I think is a sick GB. The surrounding area irritated and inflammed. I coincidently found a very hyperechoic nodular area in the spleen that exhibited shadowing…I’m thinking more coincidental rather than significant…

Am I reading this correctly?

Thanks in advance.

Sam

Comments

September 22, 2017 at 11:59 am -

Hmmm the Gb itself looks ok

Hmmm the Gb itself looks ok but looks like stones and chronic cholangitis in the cystic duct and cbd. Any pain upon imaging there?

franklinanimalclinic

September 22, 2017 at 12:10 pm -

Thanks for the reply
If you

Thanks for the reply

If you get a chance could you point out your findings…I have a feeling that what I thought was GB is the cystic duct & cbd…and I’m embarassed to say that I don’t see a GB :(.

Sam

randyhermandvm

September 22, 2017 at 9:06 pm -

This dog needs to be

This dog needs to be explored. Something is blocking the flow of bile.

Spleen- Not sure. Calcified granulomas or possibly very thick myelo-lipomas?

September 24, 2017 at 6:56 am -

Here you go Sam the best I

Here you go Sam the best I can tell I labeled out what I believe is the geography here. When imaging the CBD anbd CD its helpful to zoom in with high resolution and lightens up the details of sludge vs tissue thickening and such. Biliary lavage procedure surgically as Randy suggested I think would be the best approach here with bile culture and liver bx.

franklinanimalclinic

September 24, 2017 at 4:01 pm -

thanks for taking the time to

thanks for taking the time to outline that for me, it’s very helpful.

Sam

September 29, 2017 at 11:19 pm -

You bet my pleasure:)

You bet my pleasure:)

franklinanimalclinic

September 29, 2017 at 11:22 pm -

just got off the phone with

just got off the phone with her and convinced her to let me sedate and fna…planning on liver, duodenum if my aims good and probably spleen just for good measure.

have a good weekend.