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Triditis

Sonopath Forum

Sonopath Forum

Triditis

I seem to be getting a run on these kitties lately with slightly different u/s presentations:

– 12 year old MN DSH 3 days anorexia

I seem to be getting a run on these kitties lately with slightly different u/s presentations:

– 12 year old MN DSH 3 days anorexia

– history of hyperecalcemia that has not been properly worked-up but ionozed calcium has been confirmed to be elevated in the past

– calcium actually wnl now (maybe due to pancreatic disease?)  but elevations in  bilirubin, ALT, ALP and fPLI  present and mild neutrophilia

– GB appears to have choeliths adhered all around it’s wall so hard to assess wall thickenss

 

 

–

small cholelith  in CBD close to duodenal papilla but severe dilation ofD not seen

– hypoechoic pancreas with hyperechoic fat

– small intestines showed thickened mucosal layer with regular layering pattern

– no enlarged abdominal LN’s found; ieleocecal junction normal.

So triditis?  Lymphoma? Surgical Gall bladder disease? What is your opinion?

 

[videoembed id=7422][videoembed id=7423]

 

 

 

 

Comments

EL
August 27, 2013 at 11:07 pm -

Porcelain GB jaquie and I
Porcelain GB jaquie and I dont like the 1 cm thickening at the cbd may be inflammatory but leave it open for bile duct carcinoma. Needs cholecystectomy and cbd deviation and bx. Dont see obvious mets but need to comb the liver looking for subtle isoechoic nodules as BD carcinomas are often isoechoic and tough to see. If moving cbd stones often inflammatopry d-pap hypertrophy occurs especially in older cats but sx case for sure.

EL
August 27, 2013 at 11:07 pm -

Porcelain GB jaquie and I
Porcelain GB jaquie and I dont like the 1 cm thickening at the cbd may be inflammatory but leave it open for bile duct carcinoma. Needs cholecystectomy and cbd deviation and bx. Dont see obvious mets but need to comb the liver looking for subtle isoechoic nodules as BD carcinomas are often isoechoic and tough to see. If moving cbd stones often inflammatopry d-pap hypertrophy occurs especially in older cats but sx case for sure.

Pankatz
August 28, 2013 at 2:31 am -

Where are you seeing the 1 cm

Where are you seeing the 1 cm CBD? In the clips? I think I know where you are looking but for some reason I thought this was dilated stomach with fluid but the location for CBD makes sense.

What do you think of the loops of bowel?

I didn’t see any masses in the liver but found an almost target-like lesion in the spleen (see image). I understand lesions in the cat spleen are much more worrisome than in a dog?

Thanks for your help on this one.

 

Pankatz
August 28, 2013 at 2:31 am -

Where are you seeing the 1 cm

Where are you seeing the 1 cm CBD? In the clips? I think I know where you are looking but for some reason I thought this was dilated stomach with fluid but the location for CBD makes sense.

What do you think of the loops of bowel?

I didn’t see any masses in the liver but found an almost target-like lesion in the spleen (see image). I understand lesions in the cat spleen are much more worrisome than in a dog?

Thanks for your help on this one.

 

Pankatz
August 28, 2013 at 2:34 am -

Where are you seeing the 1 cm

Where are you seeing the 1 cm CBD? In the clips? I think I know where you are looking but for some reason I thought this was dilated stomach with fluid but the location for CBD makes sense.

What do you think of the loops of bowel?

I didn’t see any masses in the liver but found an almost target-like lesion in the spleen (see image at top of post). I understand lesions in the cat spleen are much more worrisome than in a dog?

Thanks for your help on this one.

 

Pankatz
August 28, 2013 at 2:34 am -

Where are you seeing the 1 cm

Where are you seeing the 1 cm CBD? In the clips? I think I know where you are looking but for some reason I thought this was dilated stomach with fluid but the location for CBD makes sense.

What do you think of the loops of bowel?

I didn’t see any masses in the liver but found an almost target-like lesion in the spleen (see image at top of post). I understand lesions in the cat spleen are much more worrisome than in a dog?

Thanks for your help on this one.

 

EL
August 28, 2013 at 3:36 am -

At the end of both videos
At the end of both videos could be impinging panc but cbd masses look just like this as well… regardless GB needs to find another home its useless and likely causing signs. With the Bili up sx is the way to go

EL
August 28, 2013 at 3:36 am -

At the end of both videos
At the end of both videos could be impinging panc but cbd masses look just like this as well… regardless GB needs to find another home its useless and likely causing signs. With the Bili up sx is the way to go

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