– 11 yr MN DSH with weight loss, decreased appetite and vomiting
– marked elevations in bilirubin and ALT, hyperercalcemia (not fasted sample), mild hyperglycemia, ALP normal
– a cPLI was not run
– bilirubinuria
– multiple choleliths throughout liver, distended cystic and CBD
– distended pancreatic duct with a small “lith” present and evidence of what looks like pancreatitis to me in the left limb of the pancreas
– owner declines FNA of the pancreas
– 11 yr MN DSH with weight loss, decreased appetite and vomiting
– marked elevations in bilirubin and ALT, hyperercalcemia (not fasted sample), mild hyperglycemia, ALP normal
– a cPLI was not run
– bilirubinuria
– multiple choleliths throughout liver, distended cystic and CBD
– distended pancreatic duct with a small “lith” present and evidence of what looks like pancreatitis to me in the left limb of the pancreas
– owner declines FNA of the pancreas
Would the lesions in the pancreas be the main reason for EHBO in this kitty or are the choleliths also a problem here or just secondary to everything that is going on in this kitty? What can you do about the choleliths anyway? We are treating for pancreatitis and keeping our fingers crossed in this case.
[videoembed id=7274][videoembed id=7275]
Comments
Jacquie this might as be Mick
Jacquie this might as be Mick Jagger and the boys because these are rolling stones but blocked up in the cbd and is now a surgical emergency. Needs sx cholceystotomy or ectomy stones removal and cbd lavage liver and panc bx. I see pancreatitis with biliary stones all the time and i believe the stones to maybe be a sequelae form chronic triad disease because i can’t remember seeing biliary stones in a non triad looking cat. Your last video has also dilated panc duct with stones. Any time the cbd is obstructed in cats at the d-pap like this one gives the cat panc duct dilation just like the cbd dilation. So both the ducts need lavage and sometimes pus comes out of these.The fuzzy fat around the left panc is likely form inflammation.
Great post! Hope you like the new format and site.
Still tweaking and developing but its like getting to know a new car with cool gadgets:)
Jacquie this might as be Mick
Jacquie this might as be Mick Jagger and the boys because these are rolling stones but blocked up in the cbd and is now a surgical emergency. Needs sx cholceystotomy or ectomy stones removal and cbd lavage liver and panc bx. I see pancreatitis with biliary stones all the time and i believe the stones to maybe be a sequelae form chronic triad disease because i can’t remember seeing biliary stones in a non triad looking cat. Your last video has also dilated panc duct with stones. Any time the cbd is obstructed in cats at the d-pap like this one gives the cat panc duct dilation just like the cbd dilation. So both the ducts need lavage and sometimes pus comes out of these.The fuzzy fat around the left panc is likely form inflammation.
Great post! Hope you like the new format and site.
Still tweaking and developing but its like getting to know a new car with cool gadgets:)
Hello,
I agree with Eric
Hello,
I agree with Eric the great. The EHBO is more likely to be due to the gallstones. Personally, I’d try to take out the GB and flush the papilla.
BUT if a stone is blocking the CBD, rerouting will be the more appropriate option.
Good luck & please keep us posted.
Phil Zeltzman DVM DACVS
Hello,
I agree with Eric
Hello,
I agree with Eric the great. The EHBO is more likely to be due to the gallstones. Personally, I’d try to take out the GB and flush the papilla.
BUT if a stone is blocking the CBD, rerouting will be the more appropriate option.
Good luck & please keep us posted.
Phil Zeltzman DVM DACVS
Thank-you both! Will chat
Thank-you both! Will chat with the owner and see what he wants to do. Fisrt time I have seen choleliths in a cat causing this problem so nice to know this is a medical emergency and not a wait and see type case!
The new site looks great and makes posting images and clips much easier. My computer is just not liking the clips on the site for some reason and I can’t view them?
Thank-you both! Will chat
Thank-you both! Will chat with the owner and see what he wants to do. Fisrt time I have seen choleliths in a cat causing this problem so nice to know this is a medical emergency and not a wait and see type case!
The new site looks great and makes posting images and clips much easier. My computer is just not liking the clips on the site for some reason and I can’t view them?
If by chance you are using
If by chance you are using Explorer as browser we don;t recommend it as its clunky and full of issues. try Mozilla/Firefox browser if this is the case. I use firefox exclusively and never have issues anywhere viewing sites and content. (www.mozilla.org)
Glad you like the new development:)
If by chance you are using
If by chance you are using Explorer as browser we don;t recommend it as its clunky and full of issues. try Mozilla/Firefox browser if this is the case. I use firefox exclusively and never have issues anywhere viewing sites and content. (www.mozilla.org)
Glad you like the new development:)
Well – did not take this one
Well – did not take this one to surgery. In fact owner even declined hospitalization so loaded up on SQ fluids, pain meds and antibiotics and sent home. At recheck he is doing great and blood values are almost normal – only slight elevation in ALT. No telling how long this will last, but for now this kitty has pulled through 🙂
Any chance that you did a
Any chance that you did a follow up ultrasound?. If liths are still there the kitty is sitiing on a time bomb.
Remo
I hear you Remo! I am worried
I hear you Remo! I am worried about this as well but the owner has our hands tied on this one – barely let us run follow-up bloodwork.
Well – did not take this one
Well – did not take this one to surgery. In fact owner even declined hospitalization so loaded up on SQ fluids, pain meds and antibiotics and sent home. At recheck he is doing great and blood values are almost normal – only slight elevation in ALT. No telling how long this will last, but for now this kitty has pulled through 🙂
Any chance that you did a
Any chance that you did a follow up ultrasound?. If liths are still there the kitty is sitiing on a time bomb.
Remo
I hear you Remo! I am worried
I hear you Remo! I am worried about this as well but the owner has our hands tied on this one – barely let us run follow-up bloodwork.
The nature of veterinary
The nature of veterinary medicine!
Yep!
Yep!
The nature of veterinary
The nature of veterinary medicine!
Yep!
Yep!