Gallbladder disease, a common condition in dogs, is associated with choleliths, mucoceles, neoplasia, or hepatic disorders causing bile stasis and possible subsequent infection. The vagueness and nonspecificity of clinical signs (abdominal discomfort, inappetence, vomiting) can make the initial diagnosis difficult. Ultrasonographic examination of the hepatic and biliary systems has proven to be extremely useful in identifying lesions such as tumors, mucoceles, ruptures, and stones.
In this retrospective study of 45 patients seen at a veterinary teaching hospital, the clinical, ultrasonographic, and laboratory findings of gallbladder disease and, in some cases, subsequent rupture were described. The most prevalent (8.8% each) breeds examined were cocker spaniels and Shetland sheepdogs. The median weight of all dogs was 24.75 lb (11.25 kg), and the median age at diagnosis was 10 years.
The most common (> 70% each) clinical signs were vomiting, lethargy, and anorexia. The most common (≥ 80% each) hematologic and serum chemistry abnormalities were leukocytosis, increased serum alkaline phosphatase and serum alanine transaminase activities, and increased bilirubin concentrations. The most frequent ultrasonographic findings in all dogs were peritoneal fluid or echogenic reaction in the gallbladder fossa (24 and 22 dogs, respectively), thickened gallbladder wall (23 dogs), and a gallbladder mucocele (21 dogs).
Eighteen dogs had a ruptured gallbladder, and all 18 had histologic gallbladder necrosis; nine of these dogs had a mucocele. Rupture was associated with peritoneal effusion identified ultrasonographically and with decreased serosal detail identified radiographically.
Overall, only one of 18 dogs with a preoperative diagnosis of biliary rupture and subsequent surgical treatment died. The survival rate (86%; 37 of 43) of dogs undergoing surgery was not related to preoperative bile leakage, positive bacterial culture results, or the presence of a mucocele.
The clinical and laboratory features described by the authors in this study will help practitioners identify and treat gallbladder disease. Ultrasonographic findings of inflammatory changes in and around the gallbladder, as described in this report, had a sensitivity of nearly 95% for predicting gallbladder rupture. For practitioners, this imaging will improve diagnosis and hasten appropriate surgical therapy. Gastrointestinal signs and elevations in white blood cell counts and liver-related enzyme activities would be expected to resolve after surgical therapy. Although this retrospective review is limited in that mildly affected dogs or only medically managed patients may not have been examined, the survival rate for all treated dogs is encouraging given the variable nature and severity of disease.
Crews LJ, Feeney DA, Jessen CR, et al. Clinical, ultrasonographic, and laboratory findings associated with gallbladder disease and rupture in dogs: 45 cases (1997-2007). J Am Vet Med Assoc 2009;234(3):359-366.