History: A 5-year-old NM Shih Tzu was presented for evaluation of increased bile acids.
History: A 5-year-old NM Shih Tzu was presented for evaluation of increased bile acids.
Case Study
Microhepatica with Vacuolar Hepatopathy in a 5 year old MN Shih Tzu dog
Sonographic Differential Diagnosis
Mild Microhepatica. No portosystemic shunt. Likely acute hepatitis. Possible underlying microvascular dysplasia, Copper storage disease. .
Image Interpretation
Exam of the cranial abdomen demonstrated normal liver contour and structure. The liver was mildly subnormal in size. Ultrasound-guided 18 gauge biopsies were performed of the left lateral lobe. Parenchymal echogenicity was naturally coarse and hypoechoic to the spleen. Vascular and biliary tracts were of normal volume and no evidence of congestion was noted. The gallbladder had thin walls with normal, primarily anechoic content. The cystic and common bile ducts were normal. No periportal lymphadenopathy was evident. No overt structural evidence of inflammatory, infiltrative or regenerative pathology was noted.
DX
Vacuolar hepatopathy.
Outcome
The patient is doing well.
Comments
Broad spectrum antibiotics such as Clavamox and Metronidazole combination with continuation of L/D diet and potential Lactulose may be necessary depending on bile acid elevation.
Clinical Differential Diagnosis
Liver pathology – portocaval shunt, primary portal vein hypoplasia, vacuolar hepatopathy, acute hepatopathy (toxin, trauma, infectious), cirrhosis; Gall bladder pathology – partial obstruction, mucocele, cholecystitis; GI tract pathology – IBD, bacterial overgrowth, partial obstruction
Sampling
Ultrasound-guided biopsy was performed without evident complication. Biopsy revealed vacuolar hepatopathy.
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Patient Information
Patient Name :
Rodney Z
Gender :
Male, Neutered
Species :
Canine
Type of Imaging : Ultrasound
Book :
yes
Status :
Complete
Liz Wuz Here :
Yes
Code :
03_00278
Images
Blood Chemistry
- Post-Prandial Bile Acids, High