Gallbladder Pathology

Sonopath Forum

Gallbladder Pathology

Molly is an overweight (4/5 BCS) 7 year old spayed female Beagle that come in for an exam. The owner was concerned about her “bloated” abdomen. 

Diagnostic workup included abdominal x-rays and a complete blood profile, CBC and UA. The ONLY abnormality noted on the lab work was a Trace of blood in the urine and a 3+ proteinuria. X-rays revealed hepatomegaly. My associate suggested an abdominal ultrasound.

I did the ultrasound yesterday and the only major pathology I noted was in the liver and gallbladder.

Molly is an overweight (4/5 BCS) 7 year old spayed female Beagle that come in for an exam. The owner was concerned about her “bloated” abdomen. 

Diagnostic workup included abdominal x-rays and a complete blood profile, CBC and UA. The ONLY abnormality noted on the lab work was a Trace of blood in the urine and a 3+ proteinuria. X-rays revealed hepatomegaly. My associate suggested an abdominal ultrasound.

I did the ultrasound yesterday and the only major pathology I noted was in the liver and gallbladder.

Both adrenals were normal in size with the L adrneal measuring 0.65 cm at the caudal pole and the R adrenal 0.59 cm at the caudal pole. Normal adrenal architecture and intact capsule.

The liver is brighter than I would expect and the portal vasculature not as promenent. 1 small hypoechoic nodule noted measuring around 0.58 cm and one small myelo-lipoma.

I am posting 3 cine of the gallbladder. Am I looking at really thick sludge or on one view is there a loss of the curvi-linear wall with a possible mass?

I did a FNA of the L side of the liver and cytology is pending. I looked at one slide in the hospital and I only saw normal looking hepatocytes

How would you proceed in this case?

Let me know if you need more images or cines. I have a number of views. I posted 3 representative samples.

Comments

EL

Hmmm tough to tell if adhered

Hmmm tough to tell if adhered sludge or mineralizing tumor… likely adhered sludge as the liver is that usual older beagle vac hep hyperechoic parenchyma. Try power doppler on the GB density and see if it lights up which means tumor. Suppurative hepatitis can do this as well if LEs are up but unlikely if you didnt see neuts in the slide. Chase the endocrine here… thyroid, atypical or typical cushings or idiopathic depending on the fna results Im betting vac hepatopathy on cyto.

EL

Hmmm tough to tell if adhered

Hmmm tough to tell if adhered sludge or mineralizing tumor… likely adhered sludge as the liver is that usual older beagle vac hep hyperechoic parenchyma. Try power doppler on the GB density and see if it lights up which means tumor. Suppurative hepatitis can do this as well if LEs are up but unlikely if you didnt see neuts in the slide. Chase the endocrine here… thyroid, atypical or typical cushings or idiopathic depending on the fna results Im betting vac hepatopathy on cyto.

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