Gallbladder Mucocele In Dogs

A gallbladder mucocele (hydrops) is an ailment where the gallbladder is overdistended and filled with mucoid or clear and watery content. This is caused by prolonged obstruction of the cystic duct, generally by an impacted gallstone.

Simply, Gallbladder mucoceles are asymptomatic cysts in the gallbladder containing an excessive accumulation of mucus. The main gross irregularity associated with Gallbladder mucoceles is cystic mucinous hypertrophy in the gallbladder. Although the clinical presentation is variable and signs may even be absent, Mucoceles have become a significant cause of extrahepatic biliary tract disease in dogs.

Gallbladder mucocele also results in aggravation in the gallbladder as impacted gallstones can get trapped inside the gallbladder. This can lead to a bile duct obstruction and inflamed lining of the gallbladder that will, in turn, lead to a rupture. Overdistended gallbladder causes cholecystitis and by definition means inflammation of the lining of the Gallbladder.

Ruptured gallbladder results in Bile peritonitis and it is a serious disorder that pertains to injury affecting the lining of the abdominal cavity or the peritoneum. Bile peritonitis caused by an infection kills almost 75 percent of pets. Early intervention is necessary for recovery.

• Enlargement of the gall bladder.
• Abdominal distension, Abdomen swollen due to fluid accumulation.
• Hyperthermia
• Bloating
• Nausea
• Icterus or jaundice (yellowed eyes and gums).
• Hypothermia
• Collapse (if infectious).
• Anorexia
• Vomiting
• Inappetence
• Hyperbilirubinemia
• Hypercholesterolemia

The treatment of your dog will be directed on the underlying cause of the detachment.

Treatment will be based on the cause of the mucus accumulation or impact of gall stones in the dog's gallbladder.

Broad-spectrum antibiotics are initially started and once cultures and blood tests have been obtained, then the antibiotic choice may be changed.

For the anorexic, nauseated, and systemically ill dogs, hospitalization for supportive therapy such as intravenous fluids might be required.

When immune-mediated complications exacerbate infectious mucocele - corticosteroids (prednisone, prednisolone, dexamethasone, triamcinolone) and other immunomodulating medications (such as Cyclosporine (CsA), Azathioprine, Mycophenolate mofetil) are provided.

Gall Bladder stones:

1. Surgical removal: Cholecystectomy.
2. Non-surgical removal: Urohydropropulsion (special catheter with a saline solution flushed through the bladder to expel the stones).
3. Dietary dissolution: High-protein, low-fat diet.

Follow the instructions given to you by your veterinarian for the entire recommended time period. No matter how badly you want relief for your dogs or what you hear from other dog owners, talk with your vet before trying any home remedy.

If any specific diet has been suggested to your dog, follow the diet very strictly, and never provide or allow others to give your dog treats or other food.

Prevention of gallbladder mucocele can be done only by preventing underlying causes.

Precautionary use of antimicrobials (β-lactam (e.g., Cefaxolin) combined with a fluoroquinolone or aminoglycoside) has been used to control the risk of peritonitis; though, if this is overused, it may spawn antibiotic-resistant organisms in due course.

Pet owners should discuss how to prevent or decrease the possibility of recurrence of gallbladder problems with their vet.

Shetland Sheepdog, American Cocker Spaniel,Border Terrier, Chihuahua, Pomeranian, Miniature Schnauzer.

There is no breed disposition. Female dogs are at a much higher risk of infection.

1. Causes:

Bacteria:

• Salmonella - Spread through contaminated food, easily passed by dogs in their saliva and feces.
• Campylobacter jejuni - This microaerophilic enteric bacterium’s transmission is through undercooked or contaminated meat/meat products and raw milk.
• Coccidiosis - This protozoan parasite destructs your dog’s intestinal walls, transmission through eating dirt or feces infected with coccidia.
• Streptococcus spps - This facultatively anaerobic is commonly found in the throat and skin that occasionally turns into an infection (like humans - strep throat)

Conditions that can cause the bacterial movement in a bile duct:

• Cholestasis (decrease in bile flow or complete stopping).
• Inflammatory bowel disease (IBD).
• Gallbladder stones
• Chronic pancreatitis (inflammation of the pancreas).
• Unhealthy gut
• A weakened immune system.

Other causes:

• Cystic mucinous hyperplasia, causes excessive mucus to secrete into the gallbladder.
• Chronic interstitial nephritis (a form of kidney disease).
• Tumors
• Gallstones
• Thickened Gallbladder secretions that are unable to be excreted by your dog.
• Disorders that impede bile flow.

2. Mortality:

Gallbladder mucocele may result in Rupture of the gallbladder which is considered a medical emergency. The mortality rate due to gallbladder rupture is 20% - 50%.

3. Diagnosis:

• Complete blood count (CBC).
• Biochemical profile
• Ultrasound and Abdominal x-rays in the liver and gallbladder.
• Abdominal fluid biopsy
• Endoscopic retrograde cholangiopancreatography (ERCP).
• Percutaneous transhepatic cholangiogram (PTCA).

4. Prognosis:

The cause of Gallbladder mucocele is indefinite or highly variable, and so is the prognosis. Mucocele of a gallbladder may be difficult, as the signs of this condition are often subtle or absent. When you identify that your pet has a predisposing condition, such as chronic pancreatitis (inflammation of the pancreas), treatment directed to prevent pancreatitis will be performed.

Contact your vet right away, if you notice any of the following:

• Enlargement of the gall bladder.
• Abdominal distension, Abdomen swollen due to fluid accumulation.
• Icterus or jaundice (yellowed eyes and gums).

• Protein (moderate levels of bioavailable protein).
• Appropriately formulated fresh food diet / A big ‘NO’ to dry foods.
• Leafy greens, fresh vegetables, and antioxidants.
• Add safe dairy products (cottage cheese, ricotta cheese, and yogurt).
• Omega fats: Omega-6 and omega-3 in a 4:1 ratio.
• Low in Phosphorus (0.2% - 1% dry matter).
• Regulated treats that are part of the daily calorie intake.
• Avoid foods high in copper (organ meats).

As in many cases, the Gallbladder mucocele etiology is often serious in nature and it can be treated efficiently if it is diagnosed early.

There is no evidence to support the reoccurrence of mucocele. However, always follow the progress with regular checkups and keep an eye on any appearance of symptoms you noticed in the past.