Case Study

Gall bladder mucocele with peritonitis in a 12 year old FS Bichon Frise dog

A 12-year-old FS Bichon Frise dog with history of bladder stones was presented for vomiting for 24 hours with wanting to eat but unable to hold any food down. On physical examination the mucous membranes were tacky, light pink, and slightly icteric, the abdomen was extremely tense and painful, and there was decreased skin turgor. Abnormalities on CBC and blood chemistry were leukocytosis, monocytosis, neutrophilia, basophilia, elevated ALP activity, hyperbilirubinemia, hyperalbuminemia, and hypercholesterolemia. The patient was treated with I.V fluids, antibiotics, and anti-emetics.

A 12-year-old FS Bichon Frise dog with history of bladder stones was presented for vomiting for 24 hours with wanting to eat but unable to hold any food down. On physical examination the mucous membranes were tacky, light pink, and slightly icteric, the abdomen was extremely tense and painful, and there was decreased skin turgor. Abnormalities on CBC and blood chemistry were leukocytosis, monocytosis, neutrophilia, basophilia, elevated ALP activity, hyperbilirubinemia, hyperalbuminemia, and hypercholesterolemia. The patient was treated with I.V fluids, antibiotics, and anti-emetics. A recheck bilirubin level after several hours of fluid therapy showed a moderately elevated bilirubin.

DX

Gall bladder mucocele, inflamed

Sonographic Differential Diagnosis

Inflamed and/or perforating gall bladder mucocele with localized peritonitis.

Image Interpretation

The gall bladder is rounded, turgid with suspended, immobile stellate debris. Significant hyperechoic ill-defined peripheral fat is present suggestive for localized peritonitis. Free fluid noted in image 1 suggests bile peritonitis, inflammatory fluid or hemorrhage.