A 12-year-old FS Pomeranian was presented for acute vomiting and diarrhea. On physical examination, dyspnea, coughing, and a heart murmur were present. Urinalysis, T4, coagulation profile, and CBC were all within normal limits. Abnormalities on serum biochemistry were revealed elevated total proteins, globulin, liver enzyme activity, total bilirubin, and azotemia.
A 12-year-old FS Pomeranian was presented for acute vomiting and diarrhea. On physical examination, dyspnea, coughing, and a heart murmur were present. Urinalysis, T4, coagulation profile, and CBC were all within normal limits. Abnormalities on serum biochemistry were revealed elevated total proteins, globulin, liver enzyme activity, total bilirubin, and azotemia.
Case Study
03_00189 Tiffany K Mucocele *BK*
Sonographic Differential Diagnosis
Inflamed gallbladder mucocele. Mild congestion of the common bile duct.
Image Interpretation
The liver presented mild increase in portal markings with slightly swollen contour. The gallbladder was significantly inflamed with suspended debris. This is consistent with gallbladder mucocele. Some adhesions or inflammation are suspected given the pericystic sonographic presentation. The common bile duct presented excessive amount of debris. Common bile duct was mild/moderately dilated. It measured 0.76-0.8 cm.
DX
Gallbladder: biliary mucocele. Liver: mild chronic portal inflammation with hyperplasia
Outcome
The patient had a cholecystectomy at a referral hospital.
Comments
No video is available on this patient. The patient was lost to follow up.
Clinical Differential Diagnosis
GI tract – garbage disease, dietary, infectious (bacterial, viral, protozoal, helminths), obstruction, neoplasia. Liver – vacuolar hepatopathy, neoplasia, toxins, infectious (bacterial/fungal/viral.) Gallbladder – infection, obstruction, mucocele. Pancreas – pancreatitis, neoplasia.
Sampling
Biopsy of the gallbladder and liver. Microscopic findings: 1. Gallbladder: biliary mucocele. 2. Liver: mild chronic portal inflammation with biliary ductular and arteriolar hyperplasia.
Patient Information
Gender :
Female, Spayed
Species :
Canine
Type of Imaging : Ultrasound
Status :
Complete
Clinical Signs
- Diarrhea
- Vomiting
Exam Finding
- Coughing
- Heart Murmur
- Respiratory Distress
Images
Blood Chemistry
- BUN high
- Creatinine, High
- Elevated Liver Enzymes
- Globulin, High
- Total Bilirubin, High
- Total Protein, High
Clinical Signs
- Diarrhea
- Vomiting