Abdominal ultrasonographic findings and post mortem diagnosis of a haemocholecyst in a case of canine leptospirosis

Authors: McGregor O, O'Brien K, Harrington N, Di Donato P
Publication: Australian Veterinary Practitioner, Volume 51, Issue 2, pp 97-103, Jun 2021
Publisher: Australian Veterinary Association

Animal type: Dog
Subject Terms: Abdomen, Clinical examination, Disease surveillance, Emergency medicine/critical care, Imaging
Article class: Clinical Article

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Abstract:

A 2-month-old male entire Bichon-Frise cross was referred to an emergency and critical care service in the United Kingdom with a 24-hour history of vomiting, diarrhoea, anorexia and lethargy. Physical examination revealed icteric mucous membranes and hypersalivation but was otherwise unremarkable. Haematology and biochemistry revealed a leucocytosis with neutrophilia, normocytic hypochromic anaemia, thrombocytopenia, hypoproteinemia, hyperkalaemia, hypochloraemia, hypercalcaemia, hyperphosphataemia, azotaemia, and hyperbilirubinaemia. Microbiology and parasitology performed on a faecal sample were unremarkable. Polymerase chain reaction (PCR) performed on a blood sample confirmed leptospirosis. An abdominal ultrasound revealed bilateral nephropathy, retroperitoneal fluid and a marked amount of heterogeneous hyperechoic material within the gallbladder lumen. The patient developed anuria while hospitalised and despite attempting peritoneal dialysis, humane euthanasia was eventually elected. Post-mortem examination revealed moderate diffuse icterus, multifocal petechial haemorrhages and multifocal neutrophilic and lymphoplasmacytic interstitial nephritis with tubular degeneration and necrosis, consistent with leptospirosis. The gallbladder contained a moderate amount of dark red, gelatinous material, consistent with a blood clot (haemocholecyst).

To the authors’ knowledge, only one other report has correlated sonographic and post mortem findings of gallbladder haemocholecyst formation in a dog affected by leptospirosis. Haemocholecyst formation may therefore be taken into consideration in the list of ultrasonographic differential diagnoses for intraluminal echogenic, poorlymobile, non-vascularised and non-shadowing material within the gallbladder lumen, in patients affected by leptospirosis.

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