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Could you review your technique for aspirating a gall bladder, including how much sedation you use? Do you aspirate when you see choleliths in asymptomatic dogs? Aerobic and anaerobic C&S + cytology?
Thank you!
Could you review your technique for aspirating a gall bladder, including how much sedation you use? Do you aspirate when you see choleliths in asymptomatic dogs? Aerobic and anaerobic C&S + cytology?
Thank you!
Comments
As rupture is possible animal
As rupture is possible animal needs to be as still as possible – although in most cases sedation is adequate, full anesthesia is recommended in animals that may move/jump.
Only aspirate if there are supportive clinical signs (fever, abdominal pain, anorexia, vomiting/diarhea, icterus) and biochemical changes (leukocytosis, elevated liver enzymes).
Aspirate for cytology and aerobic and anaerobic culture.
I agree wiht remo and never
I agree wiht remo and never do centesis on a mucocele. I do Gb centesis when the Gb is edematous or thickened or even porcelain GB, clinical signs fit (ADR), and suspended swirling bile. Sedation to a level 2 as if placing a tracheal tube, propofol or ket val or similar. You can approach subxyphoid in dorsal recumbency and push down wiht the scanning hand to minimize the distance and of course on an empty stomach. Then its just a glorified cysto. Or put him on left pateraland approach formt he right intercostal which is a shorter distance. next time I do one I will put it in interventional procedures (http://www.sonopath.com/resources/instructional-library-sonopodcasts-interventional-procedures). Aerobic and anaerobic culture.
Thank you! For choleliths in
Thank you! For choleliths in asymptomatic dogs w/o liver enzyme changes, just seriel ultrasounds? Do you ever try trial treating with antibiotics and ursodiol?
I have seen some dogs and
I have seen some dogs and cats eliminate their choleliths completely in 6 weeks on actigal and others nothing. Twedt used to say no actuigal with stones for risk of obstruction but I don’t hear that anymore and if the stones are going to move then they will with or without actigal. Any time bile stones are in the mix watching sap, bili, wbc, and alt and any “ADR” clinical behavior is key.