Clinical utility of two-dimensional shear wave elastography in two dogs with presumptive toxic hepatopathy

Abstract

Importance: Shear wave elastography (SWE) is a non-invasive ultrasound technique for assessing tissue stiffness. This study examined the clinical utility of two-dimensional SWE (2D-SWE) in two dogs diagnosed with presumptive toxic hepatopathy.

Case presentation: The first case involved a 9-year-old Pompitz that presented with anorexia, vomiting, and diarrhea following garlic and onion ingestion. Laboratory tests revealed anemia, elevated liver enzyme levels, and diabetic ketoacidosis. Ultrasonography demonstrated increased hepatic echogenicity and elevated SWE values. Despite intensive treatment, the dog's condition deteriorated, with progressive increases in liver enzyme levels and SWE values, resulting in euthanasia. The second case involved a 1-year-old Maltipoo that presented vomiting, depression, and abdominal pain, with no reported history. Laboratory findings indicated elevated liver enzyme and bile acid levels. Ultrasonography revealed increased hepatic echogenicity and SWE values. Following treatment for acute toxic hepatopathy, the dog exhibited significant improvement within 3 days, with normalization of hepatic echogenicity, SWE values, and liver enzyme levels.

Conclusions and relevance: These cases demonstrate the clinical relevance of 2D-SWE in assessing hepatic damage, tracking therapeutic response, and informing prognosis in presumptive toxic hepatopathy.

Keywords: Ultrasonography; acute toxicity tests; dogs; liver; shear wave velocity.

Fig. 1. Ultrasonographic hepatic features on B-mode (A, C) and two-dimensional SWE (B, D) on days 1 and 3 after treatment in the first patient. On day 1, the SWE value was elevated to 22.2 kPa, with increased hepatic echogenicity and fine echotexture. Despite intensive treatment, both liver echogenicity and SWE value (45.8 kPa) increased further by day 3.

SWE, shear wave elastography.

Fig. 2. Ultrasonographic hepatic features on B-mode (A, C) and two-dimensional SWE (B, D) on days 1 and 13 after treatment in the second patient. On day 1, the SWE value was elevated to 41.8 kPa, accompanied by increased hepatic echogenicity and fine echotexture. However, by day 13 of treatment for liver toxicity, a notable reduction in hepatic echogenicity and SWE values (6.9–10.9 kPa) was observed.

SWE, shear wave elastography.

Fig. 3. Ultrasonographic images of the gallbladder and portal vein velocity on days 1 (A, B) and 13 (C, D) after treatment in the second patient. Abdominal ultrasonography on day 1 revealed gall bladder dilation with wall edema and decreased portal velocity (5.4 cm/s; RR, 12.0–26.0 cm/s). By day 13, treatment for liver toxicity resulted in notable improvement in gall bladder edema and portal velocity (14.8 cm/s; RR, 12.0–26.0 cm/s).

RR, reference range.