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  • Author or Editor: Laurie L. Head x
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Abstract

Objective—To evaluate the usefulness of serum biochemical variables and scintigraphic study results for differentiating between dogs and cats with complete extrahepatic biliary obstruction (EHO) and those with partial EHO or patent bile ducts.

Study Design—Retrospective case series.

Animals—17 dogs and 1 cat.

Procedure—Animals that underwent hepatobiliary scintigraphy and had either surgical or postmortem confirmation of the degree of bile duct patency were included. Scintigraphic images were evaluated and biliary tracts were classified as patent, partially obstructed but patent, or obstructed. Surgery or postmortem examination was considered the gold standard for diagnosis, and compared with those findings, sensitivity and specificity of scintigraphy were calculated.

Results—With absence of radioactivity in the intestinal tract as the diagnostic criterion for EHO, the sensitivity and specificity of scintigraphic diagnosis were both 83% when final images were acquired at 19 to 24 hours, compared with 100% and 33%, respectively, when 180 minutes was used as the cutoff time. Animals with partial biliary obstruction had less intestinal radioactivity that arrived later than that observed in animals with patent biliary tracts.

Conclusions and Clinical Relevance—Animals in which intestinal radioactivity has not been observed after the standard 3 to 4 hours should undergo additional scintigraphic imaging. Findings in animals with partial biliary obstruction include delayed arrival of radioactivity and less radioactivity in the intestine. Distinguishing between complete and partial biliary tract obstruction is important because animals with partial obstruction may respond favorably to medical management and should not be given an erroneous diagnosis of complete obstruction. (J Am Vet Med Assoc 2005;227:1618–1624)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 13-year-old neutered female Keeshond-cross was evaluated because of a history of melena, anemia, hematemesis, vomiting, and high serum liver enzyme activities over a 1.5-year period.

Clinical Findings—Abdominal ultrasonography revealed a hyperechoic mass in the gallbladder. In the gallbladder mass itself, a distinct linear blood flow pattern was detected by use of color flow Doppler ultrasonography.

Treatment and Outcome—A cholecystectomy was performed, and clinical signs resolved. Samples of the mass were examined histologically and immunohistochemically, and findings supported a diagnosis of neuroendocrine tumor of the gallbladder.

Clinical Relevance—Tumors of the biliary tree are a potential source of blood loss into the gastrointestinal tract. Color flow Doppler ultrasonography in conjunction with conventional grayscale ultrasonography may be useful in evaluation of the gallbladder in dogs. When echogenic material is detected in the gallbladder, it is important to evaluate the region for blood flow.

Full access
in Journal of the American Veterinary Medical Association