-12 yo MC large breed dog

-presented for weight loss, ADR, dyspnea; noted to be pot-bellied on physical exam

-chest x-rays unremarkable, brief cardiac echo normal

-bilateral adrenomegaly and mottled liver noted

-ALP ~200, ALT normal; all other values normal

-Bony material in stomach on rads the day before, not noted in stomach on U/S, eating during hospital stay.  No vomiting.

-my working hypothesis was a PTE secondary to likely HAC but then I reviewed my images at home and noted the gall bladder

-12 yo MC large breed dog

-presented for weight loss, ADR, dyspnea; noted to be pot-bellied on physical exam

-chest x-rays unremarkable, brief cardiac echo normal

-bilateral adrenomegaly and mottled liver noted

-ALP ~200, ALT normal; all other values normal

-Bony material in stomach on rads the day before, not noted in stomach on U/S, eating during hospital stay.  No vomiting.

-my working hypothesis was a PTE secondary to likely HAC but then I reviewed my images at home and noted the gall bladder

-I am trying to fit his clinical signs with his U/S.  Obviously this gall bladder shows signs of mucocele but his enzymes are not exciting and he was not obviously painful on abdominal palpation.  I did not notice positive murphy but it’s possible I missed it.

-I also see the shower curtain effect in the thorax and am trying to put the puzzle pieces together to make sense.

Comments?

Thanks!

Suzanne