...
Dolly is a 10 year old Lurcher who came to the practice feeling very unwell this month...
by Laura Sullivan BVetMed, MRCVS

Dolly is a 10 year old Lurcher who came to the practice feeling very unwell this month. She had been profusely vomiting (up to 15 times a day) with some diarrhoea, eating grass and was very wobbly and lethargic.

On physical examination Dolly had a very high temperature (40C) and was tense on palpation of her abdomen. We admitted her immediately.  We took x-rays of Dolly’s abdomen to rule out a foreign body as the cause of her vomiting, and put her on intravenous fluids to support her, as she hadn’t been eating. There were no obvious abnormalities on her x-ray, which made a diagnosis of foreign body less likely. We decided to keep Dolly in overnight for intravenous fluids and antibiotics and monitoring. Dolly made a good response to the treatment and began eating again and was much brighter in herself so was sent home after making a good recovery.

Less than 2 weeks later, Dolly re-presented to us again profusely vomiting, starting to go off her food and becoming more and more lethargic. She was re-admitted at the weekend after no response to initial treatment at home. We took blood tests to check her pancreas – to rule out a disease called pancreatitis which can cause acute or chronic vomiting and can ‘wax and wane’ which fitted Dolly’s history but this test was negative ruling this out. Dolly continued to deteriorate over a few hours despite intensive treatment including intravenous fluids, antibiotics and pain relief.

At 5pm on Sunday afternoon Dolly’s signs very acutely and dramatically worsened. She was very, very flat and lethargic, unable to stand and screaming in pain if her tummy was touched. This lead us to the diagnosis of a syndrome called Acute Abdomen. We needed to investigate the cause of this and we elected to do exploratory surgery to find the cause of the problem. Dolly was therefore anaesthetized and opened up which revealed that her gallbladder had burst and was emitting greeny-bloody pus into her abdomen. Two thirds of the gallbladder looked chronically thickened and ulcerated so a ‘cholecystectomy’ (removal of the gallbladder) was performed. All of the surrounding organs were checked thoroughly. This revealed a gallstone present in the common bile duct so a ‘choledocotomy’ (incision into the bile duct) was performed to remove the stone. These samples were sent off to the lab for expert analysis.

The results from the lab confirmed that the condition Dolly had was ‘Ulcerative Cholecysitis’ i.e. ulcers and inflammation of her gallbladder and there was no evidence of any tumour involvement.

Dolly made an excellent recovery after such a major operation and is doing very well at home.