Case Study

03_00169 Scarlet C Cholangiohepatitis

A 7-year-old FS English Springer Spaniel was presented for vomiting and anorexia. The dog had been recently treated for tapeworms and given an injection of dexamethasone. She began vomiting blood clots and was hospitalized soon after the above treatment. The dog was quiet, had pale and tacky mucous membranes and she had ascites, based upon a distended abdomen and a positive fluid wave on ballotment. A blood chemistry profile showed a leukocytosis of 20.7 x 109/L consisting of a neutrophilia, lymphocytosis, monocytosis.

A 7-year-old FS English Springer Spaniel was presented for vomiting and anorexia. The dog had been recently treated for tapeworms and given an injection of dexamethasone. She began vomiting blood clots and was hospitalized soon after the above treatment. The dog was quiet, had pale and tacky mucous membranes and she had ascites, based upon a distended abdomen and a positive fluid wave on ballotment. A blood chemistry profile showed a leukocytosis of 20.7 x 109/L consisting of a neutrophilia, lymphocytosis, monocytosis.

DX

Severe hepatocellular vacuolation and suppurative cholangiohepatitis.

Sonographic Differential Diagnosis

Infiltrative liver disease such as lipidosis or suppurative hepatitis. Potential for neoplasia. Likely portal hypertension secondary to a diffuse pathological process owing to normal albumin level and no evidence of passive congestion from thoracic disease. Lymphatic obstruction with secondary ascites possible if a neoplasia is present.

Image Interpretation

The liver is uniformly swollen, diffusely hyperechoic suggestive for an infiltrative process such as lipidosis, suppurative disease, or neoplasia such as lymphoma. The surrounding anechoic free fluid in light of the prominent portal vein suggests portal hypertension which would need to be supported by subnormal portal vein velocities on PW spectral Doppler (N.L 18-30 cm/sec).