Sonopath Forum

Cocoa is an almost 16 year old poodle/pappion mix that presented july 18. Owners were on vacation with the dog and she didnt eat well the whole time she was there (US from Canada) vomited once. Grade 2 systolic murmur, no cough only finding on PE. CBC normal, Chem showed elevated alt 619 (10-125) alkp 651 (23-212).  Treated with low dose metronidazole and amoxil, cerenia and gastro and sulcrate, and the dog improved. In for a recheck Aug 2nd (yesterday) as dog is having seizures. The Alt is now 276 and the alkp 329. The owner was concerned about cancer, so I did a breif ultrasound (presented late in the afternoon. Too late for full US or bile acids) The liver was mildly diffusely hypoechoic, but I wanted to get your opinion on the gallbladder. the Tbil was normal so it may just be super sludge and incidental, but it looked like a tissue density??



Excessive sludge, mild

Excessive sludge, mild overdistention, no striating bile or peripheral inflammation. I would call this an emerging gb mucocele. Ursodiol 6 weeks and recheck it or do a gb motility study. May be contributing to the anorexia but not likely the whole story here.

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