Do you have a set of differentials for GB wall edema? I see this mostly in very acutely sick dogs. This image came from a dog that seems to have had an anaphylactic reaction and was shocky and the incident had only happened within the last hour. This patient also had mild anechoic ascites and pseudothickening of the LV with much reduced LV chamber size (volume depletion). Working diagnosis is shock.
Do you have a set of differentials for GB wall edema? I see this mostly in very acutely sick dogs. This image came from a dog that seems to have had an anaphylactic reaction and was shocky and the incident had only happened within the last hour. This patient also had mild anechoic ascites and pseudothickening of the LV with much reduced LV chamber size (volume depletion). Working diagnosis is shock.
I’ve got one set of images from a different case that I scanned at 10:30pm at an EC and had a GB like this (more hypoechoic than the attached image) and then I saw it the next morning at 10am at the primary DVM and the GB edema was gone and had gone back to normal after stabilization and supportive care at the EC.
This seems to be a non-specific finding when I see a GB like this but every time it’s in a really sick animal that is acutely sick – never chronic disease.
Comments
Cholecystitis, autoimmune
Cholecystitis, autoimmune disease, and anything that causes ascites… passive congestion, protein loss disease, infiltrative neoplasia… If cholecystitis is the case then I do a centesis either from subxyphoid or right intercostal approach as long as it doesnt look like a mucocele.
Hi Eric, Seeing this post
Hi Eric, Seeing this post now, Do you also do cholecystocentesis in emphysematous cholecystitis?
Yes I do veronica I have
Yes I do veronica I have never had a complication
Cholecystitis, autoimmune
Cholecystitis, autoimmune disease, and anything that causes ascites… passive congestion, protein loss disease, infiltrative neoplasia… If cholecystitis is the case then I do a centesis either from subxyphoid or right intercostal approach as long as it doesnt look like a mucocele.
Hi Eric, Seeing this post
Hi Eric, Seeing this post now, Do you also do cholecystocentesis in emphysematous cholecystitis?
Yes I do veronica I have
Yes I do veronica I have never had a complication
Marty, I am so glad you
Marty, I am so glad you posted this case! It reminded me of a dog that I scanned with a similar GB wall thickness/edema but without ascites (had normal alb and no RHF). The primary vet believed the patient had an anapylactic episode with elevated liver enzymes. So the working diagnosis was anaphylaxis with hypovolemic shock. It would seem reasonable to have liver involvement in that the primary target organs in the anaphylactic dog are liver and GI tract.
I ran across this article:
Tom, this is very helpful. I
Tom, this is very helpful. I assumed portal hypertension was the primary explanation in this and prior cases and that it was connected somehow to shock, but I was NOT sure. This makes a lot of sense now. In this particular case, the dog even had mild-moderate anechoic ascites! This was almost certain to be an acute anaphalaxis based on the history and clinical signs.
Marty, I am so glad you
Marty, I am so glad you posted this case! It reminded me of a dog that I scanned with a similar GB wall thickness/edema but without ascites (had normal alb and no RHF). The primary vet believed the patient had an anapylactic episode with elevated liver enzymes. So the working diagnosis was anaphylaxis with hypovolemic shock. It would seem reasonable to have liver involvement in that the primary target organs in the anaphylactic dog are liver and GI tract.
I ran across this article:
Tom, this is very helpful. I
Tom, this is very helpful. I assumed portal hypertension was the primary explanation in this and prior cases and that it was connected somehow to shock, but I was NOT sure. This makes a lot of sense now. In this particular case, the dog even had mild-moderate anechoic ascites! This was almost certain to be an acute anaphalaxis based on the history and clinical signs.
I recently attended a lecture
I recently attended a lecture by veterinary criticalist Greg Lisciandro and he also indicated that anaphylaxis is a prime differential for gall bladder edema detected on us in sick patients presented to the ER. Goes away once treated.
GB edema can also be seen pericardial effusion cases but not sure if anything is published on this.
I recently attended a lecture
I recently attended a lecture by veterinary criticalist Greg Lisciandro and he also indicated that anaphylaxis is a prime differential for gall bladder edema detected on us in sick patients presented to the ER. Goes away once treated.
GB edema can also be seen pericardial effusion cases but not sure if anything is published on this.
I recently attended a lecture
I recently attended a lecture by veterinary criticalist Greg Lisciandro and he also indicated that anaphylaxis is a prime differential for gall bladder edema detected on us in sick patients presented to the ER. Goes away once treated.
GB edema can also be seen pericardial effusion cases but not sure if anything is published on this. (of course there are better ways to diagnose PE)
I recently attended a lecture
I recently attended a lecture by veterinary criticalist Greg Lisciandro and he also indicated that anaphylaxis is a prime differential for gall bladder edema detected on us in sick patients presented to the ER. Goes away once treated.
GB edema can also be seen pericardial effusion cases but not sure if anything is published on this. (of course there are better ways to diagnose PE)