Porcupine Quills

You all detected the numerous quills embedded in the shoulder of this dog, described very well their appearance: thin discrete, hyperechoic interfaces with an anechoic center. Despite being there for a while, we often don’t see well-defined fluid collection along these foreign bodies. It is not uncommon with porcupine quills…making them especially difficult to detect!
During surgery, 26 quills were removed from the shoulder region under ultrasound guidance. Five additional quills were removed from the thorax (sternotomy performed).
Ultrasound is very useful in detecting foreign material during surgery. Commonly, surgeons ask our assistance and even use ultrasound to confirm that no FB is left behind…

Porcupine quills or not?

Do you see porcupine quills? What would you do next?
Please send your comments!

Reply to play again…

Thank you for all your comments on this case!

Please watch again the video posted below, I added some pointers.  The liver is enlarged and hypoechoic with regional hyperechoic fat.  The GB is collapsed and has a thickened wall.  On the right side of the liver, a poorly defined mass is present and contains numerous small hyperechoic foci associated with reverberation and weak shadowing, likely representing gas.  The presence of gas could be confirmed by radiographs.  Presence of intra-parenchymal gas supports anaerobic infection.  As it seems localized, surgery is recommended.

Josie went to surgery; the abnormal right medial and lateral liver lobes were partially removed. The GB was collapsed and edematous, but intact.  The histopathological diagnosis was necro-suppurative hepatitis, multifocal to coalescing, severe with intralesional bacilli.  The liver samples also contain multifocal nodular regeneration.

Time to play again!

Josie, a 14-year-old Cairn Terrier presented for acute weakness, and vomiting.  Her liver enzymes are elevated.

Look at this video centered on her liver.  On the insert, the dog is lying on its back, and the left of the dog is on the top.

Please share your thoughts and comments.  The answer is coming soon!

The Atlas among Wiley’s top 3 selling books of 2016!

The Atlas was a lot of work. It’s nice to find out it sits next to two significant bibles in our veterinary practices :-).  Thank you all for that!

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Happy sound 2017😊

Thank you for your continuous support and many likes through 2016!   We can only hope that 2017 will enhance joy, peace and happiness on our little planet!  We look forward a 2017 full of intriguing cases, dirty shadows, amusing comets, and colored hearts 💜💚💛

Fun learning ultrasound in Sicily?!

The Atlas went on a trip…

Look where the Atlas found itself…Yes, the Parthenon in Athens!

Thanks to Ioannis Panopoulos for capturing the moment 🙂

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If you find it any other place on this planet, send the picture along…

Nice EVDI meeting at Wroclaw!

The European Veterinary Diagnostic Meeting was held a few days ago in the city of Wroclaw, Poland.

The speakers had the chance to shine on the stage of the opera house.  This was such an energizing and well organized meeting!

Next year, the EVDI meeting will be in Verona, Italy…

Lost elephant…

elephant

Calling for help.