Use of color flow Doppler ultrasonography to diagnose a bleeding neuroendocrine tumor in the gallbladder of a dog

Case Description-A 13-year-old neutered female Keeshond-cross was evaluated because of a history of melena, anemia, hematemesis, vomiting, and high serum liver enzyme activities over a 1.5-year period. Clinical Findings-Abdominal ultrasonography revealed a hyperechoic mass in the gallbladder. In the gallbladder mass itself, a distinct linear blood flow pattern was detected by use of color flow Doppler ultrasonography. Treatment and Outcome-A cholecystectomy was performed, and clinical signs resolved. Samples of the mass were examined histologically and immunohistochemically, and findings supported a diagnosis of neuroendocrine tumor of the gallbladder. Clinical Relevance-Tumors of the biliary tree are a potential source of blood loss into the gastrointestinal tract. Color flow Doppler ultrasonography in conjunction with conventional grayscale ultrasonography may be useful in evaluation of the gallbladder in dogs. When echogenic material is detected in the gallbladder, it is important to evaluate the region for blood flow. (J Am Vet Med Assoc 2009;235:1326-1329)