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
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.
The information in "Research Updates" was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS,
DVM, DACVS, Veterinary Surgical Specialists, 21 E. Mission Ave., Spokane, WA 99202.
Joseph Harari, MS, DVM, DACVS