Update of Inflamed Gallbladder in Akita Mix.
Highlighted Summary:
9 YO NM Akita Mix rescue(O has only had 6 months), presented for two day history of vomiting. Only known medical history is successfully treated heartworm dz. before adopting. Bloodwork done 6 months ago was normal.
Stared Trazadone 2 weeks prior to exam for situational anxiety O estimates he had up to 3 doses a week.
Afebrile, normal CBC
Elevated Liver enzymes and bilirubin.
Normal SPLI
Lepto Ab and PCR negative
Update of Inflamed Gallbladder in Akita Mix.
Highlighted Summary:
9 YO NM Akita Mix rescue(O has only had 6 months), presented for two day history of vomiting. Only known medical history is successfully treated heartworm dz. before adopting. Bloodwork done 6 months ago was normal.
Stared Trazadone 2 weeks prior to exam for situational anxiety O estimates he had up to 3 doses a week.
Afebrile, normal CBC
Elevated Liver enzymes and bilirubin.
Normal SPLI
Lepto Ab and PCR negative
Inflamed Gallbladder on Ultrasound
Treated with IV fluids, Cerenia and abs for 24 hours. Home on oral abs but did not tolerate so stopped with plan to restart pending Lepto tests, but dog drastically improved, lepto tests negative and he continued to improve over the course of a week so abs were withheld till recheck of ultrasound and possible biopsy of liver.
On follow-up ultrasound 1 week after initial presentation, gallbladder appears much improved if not normal for a 9 YO dog.
Dog is clinically back to normal, CBC, Biochem all values back to normal so biopsy was withheld.
So I’m left wondering what happened here, do we have a case of acute on chronic Cholangitis that Eric hypothesized, that responded to just 24 hours of antibiotics, possibly waiting to flare up again in the future?
Can we see changes like this in the Gallbladder from drug reactions, Trazadone in this case. Anaphylaxis like reaction?
A biopsy would be nice but with dog and blood all back to normal O wants to monitor and go from there.
Before and after video clips from two different probes.
Comments
Nice followup and
Nice followup and improvement. Im betting on cholceystitis and medical response because the bili was up and peracute lepto still in play needs convalescent titers to know. Anaphylaxis wouldnt spike the bili but the gb would look like it did originally with double layer edema pattern. If its an environmental trigger it may happen again… dog got into something (carrion) or have a patch of lepto water somewhere. ACVIM-phoenix 2019 talk on hepatitis they still say we rarely ever know the cause… as of 2 weeks ago lol. We would be stuck if we didn’t use empirical medicine we wouldnt cure anything:) Great post Marty!