Comparison Between Ultrasonographic and Clinical Findings in 43 Dogs With Gallbladder Mucoceles

Abstract

Cholecystectomy is the current standard recommended treatment for dogs with gallbladder mucoceles. However, medical management with monitoring has also been recommended for asymptomatic dogs. The purpose of this retrospective study was to compare ultrasonographic patterns of gallbladder mucoceles with clinical disease status in a group of dogs. For each included dog, the ultrasonographic pattern of the mucocele was classified into one of six types: type 1, immobile echogenic bile; type 2, incomplete stellate pattern; type 3, typical stellate pattern; type 4, kiwi like pattern and stellate combination; type 5, kiwi like pattern with residual central echogenic bile; and type 6, kiwi like pattern. A total of 43 dogs were included. Twenty-four dogs, including 11 dogs with gallbladder rupture, were symptomatic. Nineteen dogs were asymptomatic. Cholecystectomy (n = 19), medical therapy (n = 17), or monitoring (n = 6) treatments were applied according to clinical signs and owners' requests. One dog suspected of having gallbladder rupture was euthanized. Frequencies of gallbladder mucocele patterns were as follows: type 1 = 10 (23%), type 2 = 13 (30%), type 3 = 5 (12%), type 4 = 11 (26%), type 5 = 4 (9%), and type 6 = 0. In dogs with gallbladder rupture, type 2 (8/13) was the most common. No significant correlations were found between ultrasonographic patterns of gallbladder mucoceles and clinical disease status or gallbladder rupture. Findings indicated that ultrasonographic patterns of gallbladder mucoceles may not be valid bases for treatment recommendations in dogs.

Gallbladder Mucocele: Variables Associated with Outcome and the Utility of Ultrasonography to Identify Gallbladder Rupture in 219 Dogs (2007–2016)

“…In contrast to its poor sensitivity, ultrasonography had good specificity (91.7%) for identification of gallbladder rupture before surgery in our study. Our findings are similar to previously reported specificities (81–100%) . The high specificity for ultrasonography to detect gallbladder rupture highlights its clinical utility in guiding therapeutic intervention in dogs with GBM.…”

“…Abdominal ultrasonography had a sensitivity of 56% to identify gallbladder wall rupture before surgery in our study. This result is lower than the sensitivity (70%) of high‐resolution ultrasound scanners used to identify gallbladder wall defects in people and lower than previously reported sensitivities (75–85.7%) of conventional ultrasonography to identify gallbladder rupture in dogs with GBM. In contrast to its poor sensitivity, ultrasonography had good specificity (91.7%) for identification of gallbladder rupture before surgery in our study.…”

“…Variations in ultrasonographic characteristics from the previously accepted generalized appearance of GBM have been proposed previously . However, it was only recently that these subjective evaluations were modified to describe the ultrasonographic characteristics of 6 types of GBM . It is therefore possible that GBM were not identified ultrasonographically before surgery in our study because the criteria defining the 6 types of GBMs were not available during the majority of the study period.…”

“…The high specificity for ultrasonography to detect gallbladder rupture highlights its clinical utility in guiding therapeutic intervention in dogs with GBM. If ultrasonography indicates the presence of gallbladder rupture, the probability of a false‐positive result is low (0–19%) . Likelihood ratios allow quantitation of probability of disease for an individual patient with a positive or negative test result and are independent of prevalence .…”

CT attenuation values and mineral distribution can be used to differentiate dogs with and without gallbladder mucoceles

“…Gallbladder mucoceles are life-threatening, commonly requiring immediate cholecystectomy, whereas sludge may require only medical intervention or monitoring. 5,[9][10][11][12][13][14] Ultrasound has been the conventional tool for diagnosis of gallbladder mucoceles and differentiation from biliary sludge; however, with the growing utilization of CT, the appearance of a potentially fatal gallbladder disease is not known.…”