Case Study

Inflamed Gallbladder Mucocele in an 8 year old Miniature Schnauzer

An 8-year-old SF Miniature Schnauzer was presented for evaluation of elevated liver enzyme activity on routine pre-anesthetic blood work. Physical examination was normal. Abnormalities on CBC and serum biochemistry were mild non-regenerative anemia (37%) and elevated ALT (295) and pre-and postprandial bile acids 101 and 98, respectively. cPL was within reference range.

DX

Inflamed gallbladder mucocele. This is a surgical emergency. Immediate cholecystectomy is recommended.

Image Interpretation

The liver was mildly enlarged with uniform vacuolar hepatopathy pattern. However, the gallbladder in this patient presented an inflamed gallbladder mucocele. A double layered wall and suspended immobile debris were noted. Concentric inflammation was noted completely around the gallbladder. Minor, heterogenous parenchymal changes were noted. This is a surgical emergency. The common bile duct did not appear to be involved.

Outcome

Cholecystectomy was performed in this patient and

Clinical Differential Diagnosis

Gall bladder – mucocele, cholecystitis, neoplasia
Liver – chronic-active hepatitis, neoplasia, reactive hepatopathy, nodular regeneration, cirrhosis

Sampling

Liver and gallbladder biopsy was performed. The gallbladder biopsy revealed a mucocele with chronic ulcerative/necrotizing, mixed, cellular and fibrosing transmural cholecystitis. Liver biopsies revealed mild, multifocal lymphoplasmacytic portal hepatitis and diffuse, moderate, hepatocellular vacuolar degeneration.