- 14yr FS DMH with inappetence, weight loss, and jaundice
- TBil=5.3, ALT= 345, ALP=230, GGT=6
- Abdominal ultrasound shows a turbid gallbladder with an echogenic, thickened wall (2-3mm), dilated and tortuous cystic and CBD with thickened walls. Gravity-dependent sludge is present in the GB but I do not see any slude or bile stones in the CBD and no masses at the level of the duodenal papilla. The pancreas is echogenic. Mildly reactive mesenteric lymph nodes are present and the intra-abdominal fat shows increased echogenicity.
- 14yr FS DMH with inappetence, weight loss, and jaundice
- TBil=5.3, ALT= 345, ALP=230, GGT=6
- Abdominal ultrasound shows a turbid gallbladder with an echogenic, thickened wall (2-3mm), dilated and tortuous cystic and CBD with thickened walls. Gravity-dependent sludge is present in the GB but I do not see any slude or bile stones in the CBD and no masses at the level of the duodenal papilla. The pancreas is echogenic. Mildly reactive mesenteric lymph nodes are present and the intra-abdominal fat shows increased echogenicity.
- Differential diagnoses include cholecystitis, cholangiohepatitis, cholangitis, pancreatitis, hepatic lymphoma, FIP and also adverse drug reaction (patient on methimazole).
- While awaiting cytology results, do I need to be concerned about GB rupture? The gb looks quite distended. When would you consider this surgical?
Comments
Still waiting to hear any
Still waiting to hear any other thoughts on this case….????..I did rescan the gallbladder today, and it still looks turgid, although folded in half. Primary vet says liver aspirate showed inflammation. The cystic and CBD ducts remain thick walled and tortuous. Still no visible masses or stones in or near the extrahepatic biliary tract. The cat has improved slightly clinically in hospital on tube feeding, fluids, antibiotics. Today the stomach was quite distended, but she has a PT tube in and was fed within the last 3 hours. No gastric outflow obstructions seen. Still wondering…should this be surgical? Waiting for primary clinic to recheck TBil.
oops sorry we missed this
oops sorry we missed this one.
its a mix of mucocele and chronic cholangitis but the cbd looks a bit dilated so you need to follow that to the d pap and look for an obstuiction. This is a surgical GB but depends what is downstream at the dpap as to stone, mucoduct, stricture or tumor.
I did follow the the cbd down
I did follow the the cbd down to the d pap, but could not find an obvious obstruction. Can you tell me, please, what makes this gallbladder a mucocele?
In cats its not well defined
In cats its not well defined but overdistention with immobile bile not owing to anorexia. Its usually secondary to cholangitis and gb wall fibrosis in cats which fits here. We have a study working…
I just read summary of a
I just read summary of a study called ” The Feasibility of Ultrasound-Guided Percutaneous Cholangiography in Feline Biliary Disease” by Wang C-I, Liu H. Any thoughts on injecting a <5 ml of iodixanol 300 into the cytic duct to see if patent. In the study, radiographs of the instestine, mean time 68 minutes, showed contrast in the intestine if not completely obstructed. It could reduce sx time by only doing a cholecystectomy and not having to do an enterotomy as well to see if CBD patent.
sounds cool, if no allergic
sounds cool, if no allergic reaction I guess it would be ok but Ive never done it so can’t say.