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…
Do you see porcupine quills? What would you do next?
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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.
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.
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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 💜💚💛
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Look where the Atlas found itself…Yes, the Parthenon in Athens!
Thanks to Ioannis Panopoulos for capturing the moment 🙂
If you find it any other place on this planet, send the picture along…
Calling for help.