Boo is a FS, 8 Year Old Chihuahua. Has been on Phenobarbitol for several years. Currently also on Vetmedin and Temaril P.
Presented last night ADR…Owner thought dying…Didn’t find anything that bad…
Exam normal except for already Dx’d MVD; Stage B2
Lab Work: elevated WBC @ 30,000; ALT up at356; GGT up at 39 and Alk Phos up at 903.
Boo is a FS, 8 Year Old Chihuahua. Has been on Phenobarbitol for several years. Currently also on Vetmedin and Temaril P.
Presented last night ADR…Owner thought dying…Didn’t find anything that bad…
Exam normal except for already Dx’d MVD; Stage B2
Lab Work: elevated WBC @ 30,000; ALT up at356; GGT up at 39 and Alk Phos up at 903.
Abd. U/S was normal w/ the exception of the prostate (slightly enlarged w/ some capsular irregularities and cystic changes). My main area of concern is GB and CBD area. The dog had a + Murphy’s sign in this area (6-7/10 intensity) I feel like the GB has some more formed Debri/Stone/Concretion??? and the ventral wall is thickened? I’m also trying to convince myself that there is inflammation and possible debri in the CBD…Having said that, I never feel comfortable interpreting this area unless the lesion is one of those “smack you in the face” things. I’m also a little unsure w/ the Phenobarbitol Hx. Overall the liver has a more dense, hyperechoic pattern w/ some benign looking nodular changes that I assume are pheno related.
I’m leaning towards some biliary disease/infection/inflammation….Maybe some prostatiitis??? (couldn’t get UA)
As always, thanks for any comments or concerns.
Comments
I’m really not seeing much
I’m really not seeing much with the GB. The is mild, nonmineralized debris which may be adhered to the wall. The GB walls a slightly more echogenic than normal without thickening. Maybe some mild inflammation but I don’t see evidence of peri GB inflammation. The visualized pancreas seems normal.
The liver enzymes suggest hepatic inflammation and cholestasis. The Pheno and possible the Temaril P may be playing a role in the liver as well. I become concerned about Pheno liver toxicity if the ALT is increasing.
The prostate is consistent with BPH with parenchymal cysts. I’m assuming Boo is an intact male (says FS in the history:).
May consider amoxicillin / metro combo and hepatic support meds including Ursodiol for 2-3 weeks with recheck GB ultrasound and monitor liver enzymes to see if they improve. Continue to monitor for cranial abdominal pain via palpation.
Thanks for the reply…
Of
Thanks for the reply…
Of course she’s an intact male 🙂 Honestly, I’m not confused.
Sam