Ultrasonographic appearance and possible clinical relevance of hyperechoic foci of mineralization in the canine intrahepatic biliary tree

Background

The evidence of mineralizations in the canine liver is usually considered an incidental finding of unclear clinical significance, frequently observed in small-size old dogs.

Aim

To describe the ultrasound features of intrahepatic biliary tree foci of mineralization, to assess their clinical relevance and their possible relationship with other gastrointestinal pathological disorders.

Methods

A retrospective analysis evaluating the database of canine patients admitted to two referral veterinary centers we carried out. All dogs under study underwent an abdominal ultrasound examination in which intrahepatic biliary tree mineralization was found. Clinical and anamnestic data of the included dogs were reviewed.

Results

Approximatively 90% of the patients showed ultrasonographic abnormalities regarding the biliary system, and over 85% presented ultrasonographic abnormalities of the hepatic parenchyma. In 81.2% of dogs, ultrasonographic anomalies in the digestive tract were observed. In approximately half of our patients, we evidenced increased liver enzymes (alkaline phosphatase, alanine aminotransferase, and gamma-glutamyl transferase). At the clinical evaluation, 84.4% (23 out of 32 dogs) of patients showed signs of gastrointestinal disease that persisted for over 3 months.

Conclusion

The presence of intrahepatic biliary tree mineralizations is an unusual and frequently incidental finding that could be related to a bile stasis condition, a chronic inflammatory disease involving the biliary system and the hepatic parenchyma, and it could be associated with a liver-gut axis alteration.

Congenital porto-pulmonary shunt in a dog

Background

Congenital extra-hepatic porto-systemic shunts (CEPS) are a non-rare vascular anomaly observed in dogs, most commonly in small and toy pure breeds. Computed tomographic angiography (CTA) examination is considered the gold standard imaging modality for the diagnosis of anomalous vascular connections.

Case Description

An anomalous congenital porto-pulmonary shunt was incidentally diagnosed in a 5-year-old French Bulldog. The anomalous vessel originated from the ventral aspect of the portal vein and went cranially towards the esophageal hiatus, entering the lobar vein of the caudal left pulmonary lobe. The dog did not show any significant clinical or computed tomography angiography-perceived hepatic abnormalities and no signs of portal hypertension were evidenced. No case of porto-pulmonary shunt in veterinary medicine have ever been reported, while in humans it was rarely described secondarily to portal hypertension, severe hepatopathies or complex cardiac malformations.

Conclusion

CTA must be considered the best imaging modality for the diagnosis also of unusual CEPS and in the author's opinion the congenital porto-pulmonary shunt described in the patient was of little or no clinical relevance.

Ultrasonographic Monitoring in 38 Dogs with Clinically Suspected Acute Pancreatitis

Abdominal ultrasound examinations (AUEs) are commonly used in the diagnostic evaluation of canine acute pancreatitis (AP). The purpose of this retrospective study was to evaluate and monitor the ultrasonographic changes observed in dogs with clinically suspected AP on consecutive AUEs. The study population was constituted by 38 client-owned dogs hospitalized for no less than 48 h from January 2016 to December 2019. Dogs included in this study were suspected of AP based on the clinical examination and abnormal rapid specific canine pancreatic lipase test performed at admission. Dogs were submitted to two AUEs, the first on the first day of hospitalization, and the second between 40–52 h after the first one. Twelve dogs had both AUEs suggestive of AP. Fourteen dogs received an ultrasonographic diagnosis of AP exclusively on the second AUE. Twelve dogs remained negative on both the first and the second AUE. In 26 out of 38 patients the second AUE was suggestive of AP. If a patient is suspected of AP, it is advisable to carry out ultrasonographic monitoring at least within the first 52 h after admission, since ultrasonographic signs of AP may only become observable later after hospitalization.