A 12-year-old NM Border collie was presented for evaluation of anorexia and lethargy. Icterus was present on physical examination. Elevated liver enzyme activity was evident on serum biochemistry.
A 12-year-old NM Border collie was presented for evaluation of anorexia and lethargy. Icterus was present on physical examination. Elevated liver enzyme activity was evident on serum biochemistry.
Hepatic nodules or masses. Common bile duct calculus and tissue thickening in the common bile duct measured 2.4 cm. This is most consistent with post hepatic obstruction with strong probability of bile duct carcinoma with metastatic lesions in the liver. However, exploratory surgery would be necessary for a definitive diagnosis and appropriate biopsies of the liver nodules. Otherwise, FNA of the liver nodules could also be performed. Regardless, bile duct reconstruction would be necessary with removal of the definitive calculus. However, tissue thickening was also noted. Primary bile duct carcinoma is likely in this case. Guarded to poor prognosis.
The gallbladder was dilated with dilated cystic duct. The common bile duct was dilated at 1.44 cm with tissue thickening at the distal portion of the common bile duct. Separate nodular changes were noted throughout. Calculus was noted in the common bile duct and measured 1.5 cm. The nodular changes in the liver did destroy architecture and is suggestive of pronounced nodular hyperplasia, potential concurrent neoplasia. Lobar biliary ducts were also dilated.
The patient had an obstructed common bile duct and possible left liver mass. CBD was obstructed by 3.5 cm stone at distal duct. Duodenal papilla flushed with red rubber & was patent. Left lobectomy was performed and waiting results for histopathology. Dog doing well, no longer icteric, went home.
Liver – vacuolar hepatopathy, cirrhosis, infectious (viral/bacterial/fungal), neoplasia, abscess, toxic. Gall bladder – cholecystitis, liths, neoplasia, rupture, mucocele. Bile duct obstruction – neoplasia, pancreatic disease, duodenal foreign body/neoplasia.
waiting on histo