Double wall sign of gall bladder.

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Double wall sign of gall bladder.

Hello everyone,

My name is Poondej from Thailand. I’m new to ultrasound and of course, to Sonopath as well.

I’d love to hear your comments about anything (e.g. my technique, machine settings, picture quality).

Here’s my first case on Sonopath.

Lemon is a 5 y.o Poodle that was diagnosed with blood parasite induced IMHA. The dog is on steroid and Azathioprine.

 

I saw a double wall gall bladder which  interpreted as gall bladder wall edema (could be cholecystitis?).

Hello everyone,

My name is Poondej from Thailand. I’m new to ultrasound and of course, to Sonopath as well.

I’d love to hear your comments about anything (e.g. my technique, machine settings, picture quality).

Here’s my first case on Sonopath.

Lemon is a 5 y.o Poodle that was diagnosed with blood parasite induced IMHA. The dog is on steroid and Azathioprine.

 

I saw a double wall gall bladder which  interpreted as gall bladder wall edema (could be cholecystitis?).

From my judgement, liver seems to be isoechoic to spleen, can I say that this liver has diffuse hyperechoic lesion?.

I see a calculus in the left kidney, which I’m not quite sure, would love to hear your comments.

Kidneys still have corticomedullary distinction. Also I tried to measure RI and not so sure if I did it right.

Right limb of pancreas looked normal. But cranial to right kidney I saw anechoc fluid (which I couldn’t determine if it’s in retroperitoneal space or peritoneal space.

This dog has:

Alkaline phosphatase = 3,235

SGPT = 835

BUN and Creat = WNL

 

Thanks 

Poondej

 

 

 

Comments

EL

Beautiful images Poondej! For
Beautiful images Poondej! For a novice you have very nice images keep it up. Re the calculus in the kidney it has true acoustic shadowing but non obstructive and not a problem at the moment. Regarding the GB this is an edema pattern with double layered wall that you can see in cholecystitis, ascites/edema, and autoimmune disease (mechanism unknown). With those liver values this could be cholecystitis or autoimmune GB edema so I would cover for cholecystitis (baytril/metronidazole is my preference) and recheck the GB in a week.

Note: Typically in the forum we prefer you keep the post to 3-5 images (still/video) and post as much as you like in that format on different subjects…. i.e (Title “Double layered GB”, “Is this a true kidney stone”). If you would like a full case consultation then contact info@sonopath.com and we can tell you how to do that after a minor screening process.

Great post and welcome to the community!

Anonymous

Thanks for your comment

Thanks for your comment Eric!

Next time I will do exactly what you suggest!

 

Poondej

EL

Beautiful images Poondej! For
Beautiful images Poondej! For a novice you have very nice images keep it up. Re the calculus in the kidney it has true acoustic shadowing but non obstructive and not a problem at the moment. Regarding the GB this is an edema pattern with double layered wall that you can see in cholecystitis, ascites/edema, and autoimmune disease (mechanism unknown). With those liver values this could be cholecystitis or autoimmune GB edema so I would cover for cholecystitis (baytril/metronidazole is my preference) and recheck the GB in a week.

Note: Typically in the forum we prefer you keep the post to 3-5 images (still/video) and post as much as you like in that format on different subjects…. i.e (Title “Double layered GB”, “Is this a true kidney stone”). If you would like a full case consultation then contact info@sonopath.com and we can tell you how to do that after a minor screening process.

Great post and welcome to the community!

Anonymous

Thanks for your comment

Thanks for your comment Eric!

Next time I will do exactly what you suggest!

 

Poondej

rlobetti

Hi Poondej.  Is this dog

Hi Poondej.  Is this dog vaccinated? as with that pattern of gall bladder edema together with the elevated liver enzyme activity, you should also consider infectious canine hepatitis.

Anonymous

Dear Remo
The dog is

Dear Remo

The dog is vaccinated, annually. Infectious canine hepatitis didn’t come into my mind often, but still a good consideration.

Thanks for reminding me to take that into my differentials again!

 

 

rlobetti

Hi Poondej.  Is this dog

Hi Poondej.  Is this dog vaccinated? as with that pattern of gall bladder edema together with the elevated liver enzyme activity, you should also consider infectious canine hepatitis.

Anonymous

Dear Remo
The dog is

Dear Remo

The dog is vaccinated, annually. Infectious canine hepatitis didn’t come into my mind often, but still a good consideration.

Thanks for reminding me to take that into my differentials again!

 

 

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