Case Study

Gastric foreign body and cholangitis in an 11 year old FS Spaniel mix

This 11-year-old spayed female Spaniel cross was presented for restlessness and not being herself. The physical exam revealed cranial abdominal splinting. The CBC and blood chemistry analyses were normal. Urinalysis was not performed.

This 11-year-old spayed female Spaniel cross was presented for restlessness and not being herself. The physical exam revealed cranial abdominal splinting. The CBC and blood chemistry analyses were normal. Urinalysis was not performed.

DX

Gastric foreign body. Cholangitis.

Sonographic Differential Diagnosis

The stomach shows a gastric FB (gastric medication or pill). Food material was considered less likely given the empty stomach. Gallbladder pathology could include cholecystitis, residual fibrosis secondary to previous or chronic inflammation or a combination thereof.

Image Interpretation

Hyperechoic well defined gastric luminal focus with marked shadowing artifact. Thickened, echogenic gallbladder wall.

Outcome

The patient recovered uneventfully after some initial post-op vomiting. The liver enzymes were never elevated suggesting pathology was limited to gallbladder and was not obstructive in nature. The patient was treated with enrofloxacin and ursodiol over the following 2 months. The patient was then lost to follow-up.

Clinical Differential Diagnosis

Pancreatitis, ulcerative gastritis, gastrointestinal foreign body, biliary disease, spinal disc disease causing abdominal splinting.

Sampling

Gastrotomy, cholecystocentesis and manual gallbladder expression were performed. Bile culture revealed heavy growth of mildly resistant Escherichia coli. The surgeon removed a 1.5 inch hard wooden disc from the stomach.