Case Study

03_00510 Holly S Decreased to absent GB emptying with food challenge

A 10-year-old SF German shepherd was presented for evaluation of the gall bladder as a prior ultrasound had shown excessive debris accumulation.

Sonographic Differential Diagnosis

Gallbladder motility study demonstrated minimal to no function of the gallbladder, overdistension and atypical mucocele formation was noted. The striating bile was immobile. Recommend cholecystectomy with bile culture. Given that the gallbladder is non functional and over distended, it is at high risk for eventual inflammation and rupture. This is likely causing low grade clinical signs in this patient of potential hyporexia, lethargy and poor activity levels. These are typically the kind of clinical signs associated with this type of gallbladder.

Image Interpretation

Gallbladder motility study. Baseline measurements: long axis 10.52 x 3.6 cm, short axis 5.95 cm.
15 minute long axis measured 10.7 x 10.93 cm and short axis measured 5.0 cm.
Excessive debris and striating bile was noted at 30 minutes post prandial. The gallbladder in long axis measured 9.4 x 4.5 cm. Striating debris and thickened wall. Short axis at 30 minutes measured 4.16 cm.
The gallbladder was overdistended in all views with suspended bile and striating bile. No pericapsular inflammatory pattern was noted. The cystic duct was non-visible and no overt distension of the neck.