An 11-year-old SF Maltese with a history of elevated ALT activity and vomiting was presented for evaluation of vomiting after eating ham. Abnormalities on serum biochemistry were elevated ALT activity (>1000), CPL, and lipase.
An 11-year-old SF Maltese with a history of elevated ALT activity and vomiting was presented for evaluation of vomiting after eating ham. Abnormalities on serum biochemistry were elevated ALT activity (>1000), CPL, and lipase.
Aggressive cholecystitis with regional inflammation. There is a strong potential for emerging bile peritonitis, inflammatory hepatopathy.
Recommend immediate cholecystectomy and liver biopsy. The gastric wall was slightly thickened, yet unremarkable. Medical therapy can be considered in an early phase in this patient; however, given the transmural pathology it is unlikely that the gallbladder will maintain function and there is significant potential for gallbladder perforation.
The liver presented mildly increased portal markings. The gallbladder in this patient presented a double-layered wall with multi focal, echogenic changes. This is consistent with remodeling and potential mural infarcts. Echogenic fat was noted around the gallbladder, especially at the neck of the gallbladder. This is suggestive for aggressive cholecystitis. Cholecystectomy and liver biopsy are strongly recommended in this patient.
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Pancreas – acute pancreatitis, neoplasia
Liver – acute hepatitis (viral, bacterial, toxins), neoplasia, abscessation
Gall bladder – cholecystitis, mucocele
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