Case Index - August 2003 - Case of the Month.
Click on an image for a larger view and scroll down to the bottom for the final answer.
Spots: 14 year old, Male, Castrated, Cocker Spaniel
History: Previously diagnosed with Addison's Disease and started on predisone. Seizures were controled with phenobarbital.
Presented with mildly elevated liver enzymes and hypoalbuminemia, elevated bile acids, increased lethargy.
Two images are provided of the gall bladder.
List Differentials (Scroll to bottom for answer)
Answer:
Cystic Mucinous Hypertrophy and cultured alpha hemolytic Strep, first described by Kovatch in 1965 (Pathol Vet 2:574-584), is a common cause of thickening in older small breed dogs. In the end stage form of this disease the bile becomes gelatinous (=mucocoele (sic)) and results in biliary obstruction. We recommend surgery even without signs of biliary obstruction
