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Cholecystitis and cholelithiasis in a 6 year old FS Cairn Terrier

Sonopath Forum

Cholecystitis and cholelithiasis in a 6 year old FS Cairn Terrier

  • 6 year old FS Cairn Terrier on Actigall for an emerging gallbladder rmucocele fist diagnosed in October of 2014.
  • Ultraound done in Jan of 2015 showed no significant changes, however, the dog was asymptomatic and the liver enzymes had improved with medical management (antibiotics and ursodiol).
  • CBC and chem profile done 2 weeks ago were all within normal reference range.
  • Dog presented yesterday for inappetence and loose stool.  Chem profile showed ALT=1381 mcu/L, ALKP=992mcu/L, and TBil=0.9mg/dl.
    • 6 year old FS Cairn Terrier on Actigall for an emerging gallbladder rmucocele fist diagnosed in October of 2014.
    • Ultraound done in Jan of 2015 showed no significant changes, however, the dog was asymptomatic and the liver enzymes had improved with medical management (antibiotics and ursodiol).
    • CBC and chem profile done 2 weeks ago were all within normal reference range.
    • Dog presented yesterday for inappetence and loose stool.  Chem profile showed ALT=1381 mcu/L, ALKP=992mcu/L, and TBil=0.9mg/dl.
    • US done today shows a thickened gallbladder wall (2.6mm), possible pericholecystic inflammation ventral to the gallbladder body wall, and small choleliths (9mm) iin the gallbadder neck and cystic duct.  The previously seen mucocele pattern (spicules) is gone.  However, the gallbladder appears moderately distended.  The pancreas and GI appear normal as does the rest of the abdomen with the exception of a slightly rounded splenic capsule. 
    • There is no Murphy’s sign, but the dog was tense and panting throughout the exam.
    • I have recommended referral for evaluation for cholecystectomy.
    • Medical management seems less desirable to me because of the cholelithiasis and the suddend spike in liver enzymes.
    • Would you agree that this a surgical case?