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

Jaffey, Jared A.; Graham, Amber; VanEerde, E.; Hostnik, Eric T.; Alvarez, Walter C.; Arango, Johnattan; Jacobs, Casandra; DeClue, Amy E.

doi:10.1111/jvim.14898

Cited by 51 publications

(106 citation statements)

References 20 publications

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“…Gall bladder rupture was not shown to have a negative effect on survival although this could reflect a type II error due to the low numbers of dogs with rupture in this study. A recent larger study found that dogs with rupture of the gall bladder were 2.7 times more likely to die than dogs without rupture . In this study, dogs that underwent cholecystectomy and survived the initial perioperative period had an extended survival time (MST still not reached), in agreement with previous studies …”

Section: Discussionsupporting

confidence: 92%

“…The 10% (6/63) incidence of positive culture of gallbladder contents (bile or gallbladder wall) is within the 3%‐70% range of previous reports and might have been underestimated by pre‐operative antibiotic therapy (not investigated in this study). Pathogens identified in the gallbladder contents and liver in this study have been reported …”

Section: Discussionsupporting

confidence: 67%

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Gall bladder mucoceles in Border terriers

Allerton

Swinbourne

Barker

et al. 2018

Veterinary Internal Medicne

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BackgroundGall bladder mucoceles (GBM) are a leading cause of biliary disease in dogs with several breeds, including the Shetland Sheepdog, American Cocker Spaniel, Chihuahua, Pomeranian, and Miniature Schnauzer apparently predisposed.ObjectiveTo determine risk factors, clinical features, and response to treatment of GBM in Border terriers (BT).AnimalsMedical records of 99 dogs (including 51 BT) with an ultrasonographic (±histopathologic) diagnosis of GBM from three referral centers in the United Kingdom were collected. A control group of 87 similar‐aged BT with no ultrasonographic evidence of gall bladder disease was selected for comparison.MethodRetrospective case‐control study. Odds ratios were calculated to establish breed predisposition. Signalment, presence of endocrine disease, clinicopathologic results, and outcome were compared between the BT, other breeds, and control BTs.ResultsThe odds of identifying a GBM in a BT in this hospital population was 85 times that of all other breeds (95% confidence interval 56.9‐126.8). BT had similar clinical signs and clinicopathologic changes to other breeds with GBM. There was no evidence that endocrinopathies were associated with GBM in BT.Clinical SignificanceA robust breed predisposition to GBM is established for the BT.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 67%

Gall bladder mucoceles in Border terriers

Allerton

Swinbourne

Barker

et al. 2018

Veterinary Internal Medicne

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“…Population characteristics of this cohort have been previously reported . As stated in Jaffey et al, 219 dogs fulfilled inclusion criteria of the study from January 2007 to November 2016 from Iowa State University College of Veterinary Medicine (n = 23), Oklahoma State University Center for Veterinary Health Sciences (19), The Ohio State University Veterinary Medical Center (51), University of Florida College of Veterinary Medicine (40), University of Georgia College of Veterinary Medicine (50), and University of Missouri Veterinary Health Center (36).…”

Section: Resultsmentioning

confidence: 99%

“…Data retrieved from medical records included: signalment, gallbladder histological findings, antimicrobial administration within 48 hours preceding (preoperative) surgery or intraoperatively, the presence of bacteriological growth, outcome (ie, survival to discharge), and cause of death. Some data from this cohort of dogs were previously reported in a separate study with different objectives and hypotheses . Cholecystitis was defined by the identification of cholecystitis within the histopathology report or mention of various forms of inflammation (eg, suppurative, lymphocytic, lymphoplasmacytic, histiocytic, granulomatous) or inflammatory immune cells (eg, neutrophils, macrophages, lymphocytes, plasma cells) within the gallbladder wall.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and impact of cholecystitis on outcome in dogs with gallbladder mucocele

Rogers

Jaffey

Graham

et al. 2019

J Vet Emergen Crit Care

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Background: Gallbladder mucocele is a potentially life-threatening extrahepatic biliary disease in dogs. The primary aims of this study were to evaluate the prevalence of cholecystitis in dogs with gross and histopathologically confirmed gallbladder mucocele and to investigate if there is an association between cholecystitis, including its subtypes (eg, acute, acute on chronic, with necrosis, chronic), and survival. Our secondary objective was to evaluate if there is an association between cholecystitis and intraoperative bacteriological culture positivity.Key Findings: Two hundred nineteen dogs with gallbladder mucocele were included in this multiinstitutional retrospective study, of which 63 (28.8%) dogs had histopathological evidence of cholecystitis. The most common forms of cholecystitis were acute on chronic (n = 22/63, 34.9%) and with necrosis (n = 20, 31.7%). Thirty-one (14.1%) dogs had growth of at least 1 bacterial isolate; however, 88.7% had antimicrobials administered within the 48 hours before surgery or intraoperatively. There was not an association between cholecystitis or its subtypes and survival. Furthermore, there was not an association between cholecystitis and intraoperative bacteriological culture positivity. A total of 38 (17.4%) dogs either died or were euthanized during hospitalization.Significance: Cholecystitis is a common comorbidity in dogs with gallbladder mucocele but was not associated with decreased survival.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Fuerst

Hostnik

2019

Vet Radiology Ultrasound

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Gallbladder mucoceles are potentially fatal in dogs. Multiphase CT angiography was performed to evaluate the canine gallbladder in three conditions: no sludge, sludge occupying ≥25% of the lumen, and mucoceles. Twenty dogs with normal hepatobiliary bloodwork and no‐to‐minimal gallbladder sludge, 13 dogs with normal bloodwork and ≥25% sludge in the gallbladder lumen, and 18 dogs with histologically confirmed gallbladder mucoceles were enrolled in a prospective, observational diagnostic accuracy study. Three regions of interest (ROI) were stratified in the dorsal‐ventral orientation and a single ROI was measured within the hepatic parenchyma. Mean attenuation and presence of mineral were recorded. Average Hounsfield units (HU) were recorded for precontrast, arterial, portovenous, and late venous phases. The overall median HU value for mucoceles was significantly higher than gallbladders without sludge and with sludge; precontrast median overall attenuation was 49.3, 35.8, and 39.7 HU, respectively (P < .000004). Mineral was seen in four (20%) dogs with no sludge, seven (56%) dogs with sludge, and nine (50%) dogs with mucoceles. Mineral in the dogs with mucoceles was located within the central aspect of the gallbladder lumen in 67% of mucoceles; this mineral distribution was not seen in any dog without a mucocele. Computed tomography can differentiate a subset of gallbladder mucoceles from dogs with and without gallbladder sludge, especially in the precontrast series. An HU value of 48.6 is 52% sensitive and 96% specific for a gallbladder mucocele. A hyperattenuating gallbladder on precontrast CT images and centrally distributed mineral can be a gallbladder mucocele.

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

Cited by 51 publications

References 20 publications

Gall bladder mucoceles in Border terriers

Gall bladder mucoceles in Border terriers

Prevalence and impact of cholecystitis on outcome in dogs with gallbladder mucocele

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

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