A 1-year-old MN Cockapoo was presented for a history of staggering. CBC was within normal limits and blood chemistry showed elevated ALT. Pre- and postprandial bile acids were severely elevated.
A 1-year-old MN Cockapoo was presented for a history of staggering. CBC was within normal limits and blood chemistry showed elevated ALT. Pre- and postprandial bile acids were severely elevated.
Case Study
03_00180 Reilly M Acute hepatitis, leptospirosis
Sonographic Differential Diagnosis
Cholangiohepatitis. Mild pancreatic edema owing to secondary portal hypertension.
Image Interpretation
The liver presented diffuse hyperechoic changes with thickened gallbladder and poor portal vein velocity of 15-18 cm/sec (mildly subnormal potential emerging portal hypertension.) Minor pancreatic edema was noted secondary to portal hypertension. A minor amount of ascites was noted in this patient. This is likely owing to portal hypertension. No evidence of intrahepatic or extrahepatic shunting was present.
DX
Acute hepatitis, leptospirosis
Clinical Differential Diagnosis
Portosystemic shunt, microvascular dysplasia, hepatitis toxic or infectious (Leptospirosis), other inflammatory hepatopathy, copper storage disease, primary CNS disease.
Sampling
US-guided 16-gauge core biopsy revealed acute hepatitis with no evidence of parenchymal dysplasia. A plasma transfusion, coagulation panel, testing for Leptospirosis and stabilization for a biopsy procedure were all recommended for the patient. I.V. ampicillin and Baytril along with broad spectrum antibiotics were also advised. Bile acids returned to normal.
Video
Patient Information
Gender :
Male, Neutered
Species :
Canine
Type of Imaging : Ultrasound
Status :
Complete
Clinical Signs
- Staggering
Images
Blood Chemistry
- ALT (SGPT), High
- Post-Prandial Bile Acids, High
- Pre-Prandial Bile Acids, High
Clinical Signs
- Staggering