Hi, I would like some reassurance on these clips.

Hi, I would like some reassurance on these clips.

“Happy” is a 7y old MN miniature poodle who on a routine blood analysis was found to have slightly elevated ALT. Was put on liver support supplements and a month later his ALT was higher. The second test was 3 days ago and his ALT was 500. ALP and rest of biochem normal (TBIL normal). Was sent for US today. Findings: a sole calculus of aprox 0.38cm diam in CBD, moderate GB dilation, no sludge nor echogenic contents in GB. Liver mildly diffusely hyperechogenic but no discrete lesions. Some hyperechoic surrounding mesentery around the calculus area, no free fluid. Mild-moderate pain at probe exam on this area.

Patient has always been asymptomatic.

Question, can you see a calculus? or I am imagining it? And…Is this currently surgical?(if your answer was yes…)

I recommended to re-scan on friday (4 days from today) if dog is still asyntomatic 9otherwise, scan straight away), re take bloods for ALT and TBIL monitoring. Basically to know whether this is a partial block or a fast progressing… and has started ursofalk. Another question, ursofalk is supposed to be used with caution when obstruction is suspected…I am prescribing 5mg/kg BID (following plumbs) and asked owners to closely monitor for any symptoms.

owners need to travel in 2 months and are not very willing to put dog through surgery if not really necessary. Also, I wanted to have your opinion on this before sending for surgery…

Would you have given a different advice?

I cannot find any other findings explaining the increase in ALT….

Thanks!