Case Study

Inflamed gall bladder mucocele and cholangiohepatitis in a 12 year old FS Beagle dog

A 12½-year-old FS Beagle was presented for evaluation of vomiting, lethargy, and anorexia. On physical examination, painful cranial abdomen was present. Abnormalities on CBC and serum biochemistry were neutrophilia, monocytosis, low BUN (8.8), hyperphosphatemia (5), and severely elevated ALT (1000), ALP (993) and GGT (44) activity.

DX

Inflamed gallbladder mucocele.

Sonographic Differential Diagnosis

Inflamed gallbladder mucocele.

Image Interpretation

The liver in this patient was coarse in architecture with increased portal markings. Gallbladder mucocele was noted with pericapsular inflammatory pattern. The gallbladder presented striating debris, dilated cystic duct and neck of the gallbladder. The gallbladder measured approximately 6.0 x 4.0 cm. Periserosal inflammatory pattern was noted at the neck of the gallbladder. This is consistent with inflamed gallbladder mucocele. Concurrent hepatic disease was noted with increased portal markings. This is consistent with cholangiohepatitis.

Outcome

Immediate cholecystectomy and common bile duct lavage would be recommended. Guarded prognosis. Surgery is essential in this case. The common bile duct was not overtly visible owing to the inflammatory pattern. Significant common bile duct disease is not suspected.

Clinical Differential Diagnosis

Acute hepatitis (viral, bacterial, toxins, trauma), chronic-active hepatitis, neoplasia, abscess, granuloma
Gall bladder – cholecystitis, mucocele
Pancreas – pancreatitis, neoplasia