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What’s in this C-Loop

Sonopath Forum

Sonopath Forum

What’s in this C-Loop

Jack: 7 year old MN Weimaraner.

Prior work-up in August of 2018 with the following Sonopath DDx: 

Common bile duct dilation with partially obstructive calculus and gallbladder mucocele. 
And possible low grade pancreatic inflammation….Bloodwork at that time was supportive of liver/biliary Dz.   Also had a nodule in spleen at that time deemed likely insignificant.  Responded well to Tx and returned to normal

Jack: 7 year old MN Weimaraner.

Prior work-up in August of 2018 with the following Sonopath DDx: 

Common bile duct dilation with partially obstructive calculus and gallbladder mucocele. 
And possible low grade pancreatic inflammation….Bloodwork at that time was supportive of liver/biliary Dz.   Also had a nodule in spleen at that time deemed likely insignificant.  Responded well to Tx and returned to normal

Seen yesterday with Hx of decreasing appetite over past month. Owner would only let me U/S thinking it was a relapse of GB disease…To me the GB is not near as bad as before although I feel the GB wall is more hyperechoic than normal and the area around the pancreas has some inflammation present. I think the CBD is slightly dialated w/ some debre present.  I’m more suspicious of some chronic gastric inflammation as the muscularis layer is uniformly thickened…but wouldn’t mind thoughts on the C-Loop images…I always question my interpretations in this area. 

I’ve posted some stills from the video posted labeled with what I think I see…Hopefully it’s what is actually there  🙂   The spleen still has the nodule from last visit but basically unchanged in appearance.  I’ve started more of a helicobacter protocol for now.

 

Thanks in advance for any comments.

Sam

 

Comments

franklinanimalclinic
March 21, 2019 at 3:00 pm -

Here the stills that didn’t

Here the stills that didn’t load…

DrMac
March 22, 2019 at 7:09 pm -

Sam I agree that the GB looks

Sam I agree that the GB looks like chronic cholecystitis while possible chronic hepatitis if elevated liver enzymes. The stomach is not really jumping out at me as being thickened but you would be coivering gastritis with the Helicobacter protocol. 

Unfortunately, the stills are giving me much so its hard to comment on those. If you can, post some video of the CBD. The pancreas look somewhat remodeled but not consistent with active inflammation. 

 

franklinanimalclinic
March 22, 2019 at 7:30 pm -

Dan,
Thanks for the

Dan,

Thanks for the thoughts…the stills I attached are all grabbed from the third video in this post…I’m hoping as I scanned through the loop that I saw what I thought I saw….

DrMac
March 22, 2019 at 11:44 pm -

Sorry I didnt realize the

Sorry I didnt realize the stills were from the clips. 

There is minor CBD dilation with possible debris but it doesnt look dilated. There is omental inflammation around the area of the pylorus, CBD and pancreas base. The area where you are suspecting pancreas is a little cranial of the pylorus but there could be some pancreatic inflammation with reactive peripancreatic inflammation. It looks more chronic than acute to me. 

Assessing for pain in the area may point toward chronic pancreatitis if present. 

franklinanimalclinic
March 23, 2019 at 1:35 pm -

thanks for the

thanks for the confirmation

Have a good weekend.

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