“hepatized”gall bladder?

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“hepatized”gall bladder?

This is a 12 yr old neutered male  husky with history of 11 lb weight loss.energetic at home picky eating.episodic vocalizing with no known cause to owner. stiff movement. thinning hair coat with patchy appearance. no reported vomiting diarrhea.chem increased alk phos 1672 ,alt 136 all else wnl. today imaged  and  most notable gall bladder with immobile sediment is this mucocoele or other? no aspirates obtained. adjacent liver rounded focal region no other lesions. decreased cortico medullary definition both kidneys increased bladder wall thickness.

This is a 12 yr old neutered male  husky with history of 11 lb weight loss.energetic at home picky eating.episodic vocalizing with no known cause to owner. stiff movement. thinning hair coat with patchy appearance. no reported vomiting diarrhea.chem increased alk phos 1672 ,alt 136 all else wnl. today imaged  and  most notable gall bladder with immobile sediment is this mucocoele or other? no aspirates obtained. adjacent liver rounded focal region no other lesions. decreased cortico medullary definition both kidneys increased bladder wall thickness. ua today revealed cystitis. spleen normal contour heterogenous texture. one prescapular ln elnd rounded uniform texture echo no change in continuity of capsule., fna no mitotic changes. I am most interested in thoughts on gall bladder.thanks all!

Comments

EL
February 11, 2015 at 10:48 pm -

Looks like an expansive

Looks like an expansive nodule in the left liver expanding on the capsule and the GB. Needs a core bx to diff hepatoma, nodular hyperplasia, from low grade carcinoma. Its resectable if no lesions on the right liver. Core because fna wont give you much on these as its a coarse structural pathology.

The Gb is a little sludgy but not overdistended. Not likely a player. Check for other causes of clinical signs like pain related disease… disc and such.

EL
February 11, 2015 at 10:48 pm -

Looks like an expansive

Looks like an expansive nodule in the left liver expanding on the capsule and the GB. Needs a core bx to diff hepatoma, nodular hyperplasia, from low grade carcinoma. Its resectable if no lesions on the right liver. Core because fna wont give you much on these as its a coarse structural pathology.

The Gb is a little sludgy but not overdistended. Not likely a player. Check for other causes of clinical signs like pain related disease… disc and such.

sherilin
February 12, 2015 at 12:21 pm -

Ok , I would like more

Ok , I would like more guidance on when to jump in on treating these sludgy gall bladders. I am familar with the most recent paper on this. This lacks striations etc classic mucocoele criteria but I have treated some of these with urosidol and there is improvement in their appetite etc. Any more references I can explore? Thanks

sherilin
February 12, 2015 at 12:21 pm -

Ok , I would like more

Ok , I would like more guidance on when to jump in on treating these sludgy gall bladders. I am familar with the most recent paper on this. This lacks striations etc classic mucocoele criteria but I have treated some of these with urosidol and there is improvement in their appetite etc. Any more references I can explore? Thanks

randyhermandvm
February 12, 2015 at 12:38 pm -

I think the GB is fine. I

I think the GB is fine. I would be more concerned about the nodule.

I have followed some GB with ultrasound after starting urosidol and have seen very little

if any change in the contents of the GB.

randyhermandvm
February 12, 2015 at 12:38 pm -

I think the GB is fine. I

I think the GB is fine. I would be more concerned about the nodule.

I have followed some GB with ultrasound after starting urosidol and have seen very little

if any change in the contents of the GB.

EL
February 12, 2015 at 12:49 pm -

Consider a GB motility study

Consider a GB motility study when wondering if a Gb is functional or not. See in sonopath resources

http://sonopath.com/resources/interventional-procedures

Not necessarily in this case as I’m also more cocerned about the nodule.

sherilin
February 12, 2015 at 2:01 pm -

Your reading my mind. I was

Your reading my mind. I was just wondering if in practice anyone is regularly looking at the ejection fraction on such a sludgy gall bladder and is it useful ,practical or just academic? I too am certainly more interested in the mass. I have only two patients in practice this year that I followed posturosidol one a cairn one corgi both at 30 days had no sludge present, they gained weight ate better, did I help them I do not know? I did not measure functional parameters .I’ll check out the above link. I appreciate the input everyone!

EL
February 12, 2015 at 12:49 pm -

Consider a GB motility study

Consider a GB motility study when wondering if a Gb is functional or not. See in sonopath resources

http://sonopath.com/resources/interventional-procedures

Not necessarily in this case as I’m also more cocerned about the nodule.

sherilin
February 12, 2015 at 2:01 pm -

Your reading my mind. I was

Your reading my mind. I was just wondering if in practice anyone is regularly looking at the ejection fraction on such a sludgy gall bladder and is it useful ,practical or just academic? I too am certainly more interested in the mass. I have only two patients in practice this year that I followed posturosidol one a cairn one corgi both at 30 days had no sludge present, they gained weight ate better, did I help them I do not know? I did not measure functional parameters .I’ll check out the above link. I appreciate the input everyone!

sherilin
February 12, 2015 at 5:29 pm -

Thanks went thru the link on

Thanks went thru the link on GB motility study–answered all my questions. I would love to know how many dysfunctional GB are found .

sherilin
February 12, 2015 at 5:29 pm -

Thanks went thru the link on

Thanks went thru the link on GB motility study–answered all my questions. I would love to know how many dysfunctional GB are found .

EL
February 12, 2015 at 5:43 pm -

GB motility a current study

GB motility a current study of ours so please contribute according to the protocol and we can have  a great study:) Just submit images and patient info@sonopath.com marked “GB motility study contribution.” With our resources we can do great practical studies and large numbers as you can see in resources abstracts and articles so far.

sherilin
February 16, 2015 at 4:32 pm -

I absolutely will I very

I absolutely will I very interested in seeing the outcome!

EL
February 12, 2015 at 5:43 pm -

GB motility a current study

GB motility a current study of ours so please contribute according to the protocol and we can have  a great study:) Just submit images and patient info@sonopath.com marked “GB motility study contribution.” With our resources we can do great practical studies and large numbers as you can see in resources abstracts and articles so far.

sherilin
February 16, 2015 at 4:32 pm -

I absolutely will I very

I absolutely will I very interested in seeing the outcome!

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