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Icterus

Sonopath Forum

Sonopath Forum

Icterus

-10 year old FS terrier

-history of cholecystectomy 2 years ago due to mucocele

-currently diagosed with Cushing’s and PLN

-on Vetoryl & enalapril

-presented for anorexia and intermittent vomiting

-ALT & SAP unable to be read, presumed high

-tBili 6.5

-amylase ~2000

-all other bloodwork normal or close to it

 

-10 year old FS terrier

-history of cholecystectomy 2 years ago due to mucocele

-currently diagosed with Cushing’s and PLN

-on Vetoryl & enalapril

-presented for anorexia and intermittent vomiting

-ALT & SAP unable to be read, presumed high

-tBili 6.5

-amylase ~2000

-all other bloodwork normal or close to it

 

I have not scanned many animals with a history of a cholecystectomy.  There is an area in the body of the pancreas/pylorus that appears to have some cystic change (no color on Doppler) as well as some mural changes in the pylorus.  Is this a real lesion or secondary to the surgery?

His liver looked typical for Cushing’s with a single focal hyperechoic lesion but no other focal lesions.

Thanks!

 

Comments

EL
October 8, 2015 at 1:08 pm -

Surgical post hepatic

Surgical post hepatic obstruction in light of elevated Bilirubin is a cbd of > 0.4 cm and this one is sort of there and the wall of the duodenum is thickened. I would fna the liver parenchyma and consider lepto but treat for mucoduct and if not resolving medically (dexamethazone injection may reduce inflammation to liberate bile) then may nee to do a cbd lavage. Often cholecystectomy for Gb mucoceles come back for similar signs because of mucoduct and d-pap strictures but post hepatic obstruction is not overwhelming here so I would rule out causes of chepatitis first and im assuming no anemia from hemolytic disease…

smbrowndvm
October 8, 2015 at 2:02 pm -

Interesting!  I have never

Interesting!  I have never heard of mucoduct.

 

His PCV is over 50 so no hemolytic disease.  We are treating empirically for lepto for the moment.  I think CBD lavage is beyond my skill levels but have offered referral if he doesn’t improve.  

Thanks!

suzanne

 

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