These images are from a 9 yr old Shih-Tzu mc. Had 2 courses of palladia for a mast cell tumor. Had a liver biopsy 10-9-2011 that was read as a hepatopathy with centrilobular cholestasis and rare individual cell necrosis. He was on pred ursodiol. 2 weeks ago he got sick. sonogram done then were read as a minimaly distended gall bladder with hyperechoic wall with echogenic material.He continued to deteriorate, vomiting and anorexia. His t bili was 5.1, his ggt124 alt 681 alk phos 1476. He was mentally dull. Was dx as hepatic encephalopathy. Do you think this gall bladder ruptured and that is why the dog became so ill?
Comments
Jeff this Gb is a mixed bag
Jeff this Gb is a mixed bag of polypoid mucinous hyperplasia and mucocele/cholecystitis given the suspended stellate debris and wall thickening. This is a common occurrence in pred treated patients and in a predisposed breed (Shih-Tzu). Needs cholecystectomy but I also dont know what the shadowing material is in the stomach. Don’t see any evidence of rupture such as echogenic pericapsular fat or fluid. Check out these 2 links regarding our studies on this matter. http://www.sonopath.com click on the highlight topic and go to articles page and check out number 2 ECVIM 2009.
Eric Lindquist DMV (Italy) DABVP
Cert./Pres. IVUSS
Director SE NJ Mobile Associates
Founder/CEO: SonoPath.com
Jeff this Gb is a mixed bagJeff this Gb is a mixed bag of polypoid mucinous hyperplasia and mucocele/cholecystitis given the suspended stellate debris and wall thickening. This is a common occurrence in pred treated patients and in a predisposed breed (Shih-Tzu). Needs cholecystectomy but I also dont know what the shadowing material is in the stomach. Don’t see any evidence of rupture such as echogenic pericapsular fat or fluid. Check out these 2 links regarding our studies on this matter.
Eric Lindquist DMV (Italy) DABVP
Cert./Pres. IVUSS Director SE NJ Mobile Associates Founder/CEO: SonoPath.com