- 2 year old mn Miniature Schnauze in good physical condition presented for anorexia, vomiting, lethargy of 3-4 days duration.
- Chemistry profile shows increased T.Bil=18.2mg/dl, ALT=260 U/L, and GGT=9 U/L. Normal chemistries include BUN=11, ALB=3.5 and ALKP=131. CBC is wnl. Chemistries done 1 year ago were all normal…BUN was 25.
- 2 year old mn Miniature Schnauze in good physical condition presented for anorexia, vomiting, lethargy of 3-4 days duration.
- Chemistry profile shows increased T.Bil=18.2mg/dl, ALT=260 U/L, and GGT=9 U/L. Normal chemistries include BUN=11, ALB=3.5 and ALKP=131. CBC is wnl. Chemistries done 1 year ago were all normal…BUN was 25.
- Abdominal US shows a small liver and some echogenic fat just caudal to the stomach. The pancreas itself appeared normal. The gallbladder and CBD also appeared normal with no evidence of mucocele, inflammation, or obstruction. There were no visible bladder or renal stones.
- I found a vein branching dorsally off of the PV but could not connect it to the CVC. The dog did not tolerate pressure to the right abdomen and will likely require sedation for a shunt hunt.
- The dog improved greatly just on IV fluids. Recheck lab values are pending. Bile acids were elevated…will post as soon as I get them.
- Would you pursue a shunt hunt on this dog or is this more likely some kind of cholangiohepatitis/toxin?
Comments
there is echogenic fat ion
there is echogenic fat ion region of right pancreas so pancreatitis likley. The PV banches fine in th evideo and has solid volume so no EHPSS. PV hypoplasia possible but with the clinical signs/profile I would consider Lepto or bacterial toxin as Lepto will spike BA into shunt levels as well.
there is echogenic fat ion
there is echogenic fat ion region of right pancreas so pancreatitis likley. The PV banches fine in th evideo and has solid volume so no EHPSS. PV hypoplasia possible but with the clinical signs/profile I would consider Lepto or bacterial toxin as Lepto will spike BA into shunt levels as well.
Ok, thanks!
Ok, thanks!
Ok, thanks!
Ok, thanks!
Bile acid test
Bile acid test results:
Pre=2.3 micromol/L (N=0.0-6.9)
Post=30.3 micromol/L (N=0-14.9)
Bile acid test
Bile acid test results:
Pre=2.3 micromol/L (N=0.0-6.9)
Post=30.3 micromol/L (N=0-14.9)
This is typical of acute
This is typical of acute liver insult and/or portal hypoplasia. Macroscopic shunt parameters are usually post > 70… with rare exception. Nice post
See our study on this:
ECVIM 2009 abstract number 2
http://sonopath.com/resources/research-publications
also go to the basic search and use key word shunt from computer or the sonopath ap to see all the shunts you can imagine from the clinical and sonographic perspective:
http://sonopath.com/resources/research-publications
This is typical of acute
This is typical of acute liver insult and/or portal hypoplasia. Macroscopic shunt parameters are usually post > 70… with rare exception. Nice post
See our study on this:
ECVIM 2009 abstract number 2
http://sonopath.com/resources/research-publications
also go to the basic search and use key word shunt from computer or the sonopath ap to see all the shunts you can imagine from the clinical and sonographic perspective:
http://sonopath.com/resources/research-publications
Great, thanks!
Great, thanks!
Great, thanks!
Great, thanks!