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 25-28 September, 2018 | Singapore
the association with hypothyroidism since many dogs were tested after the mucocele was diagnosed, introducing a significant source of bias. However, in a study of iatrogenic hyperadrenocorticism in 12 beagles, no increase in biliary sludge and no mucoceles were reported about 3 months of treatment with 8 mg/kg hydrocortisone every 12 hours.
asymptomatic mucocoeles progress nor if they do, how fast. It is also unknown if medical management will delay progression but the author uses ursodeoxycholic acid routinely in asymptomatic cases and monitors them with repeat ultrasound examinations every 2-4 months.
References
Aguirre, A. L., Center, Sharon A, Randolph, J. F., Yeager, A. E., Keegan, A. M., Harvey, H. J., & Erb, H. N. (2007). Gallbladder disease in Shetland Sheepdogs: 38 cases (1995–2005). Journal of the American Veterinary Medical Association, 231(1), 79–88.
Bennett, S. L., Milne, M., Slocombe, R. F., & Landon, B. P. (2007). Gallbladder mucocoele and concurrent hepatic lipidosis in a cat. Australian Veterinary Journal, 85(10), 397–400.
Gookin, J. L., Correa, M. T., Peters, A., Malueg, A., Mathews, K. G., Cullen, J., & Seiler, G. (2015). Association of Gallbladder Mucocele Histologic Diagnosis with Selected Drug Use in Dogs: A Matched Case-Control Study. Journal of Veterinary Internal Medicine,
Kook, P. H., Schellenberg, S., Rentsch, K. M., Reusch, C. E., & Glaus, T. M. (2012). Effects of iatrogenic hypercortisolism on gallbladder sludge formation and biochemical bile constituents in dogs. The Veterinary Journal, 191(2), 225–230.
Kutsunai, M., Kanemoto, H., Fukushima, K., Fujino, Y., Ohno, K., & Tsujimoto, H. (2013). The association between gall bladder mucoceles and hyperlipidaemia in dogs: A retrospective case control study. The Veterinary Journal.
Li, Y. F., Moody, F. G., Weisbrodt, N. W., Zalewsky, C. A., Coelho, J. C., Senninger, N., & Gouma, D. (1986). Gallbladder contractility and mucus secretion after cholesterol feeding in the prairie dog. Surgery, 100(5), 900–904.
Malek, S., Sinclair, E., Hosgood, G., Moens, N. M. M., Baily, T., & Boston, S. E. (2013). Clinical Findings and Prognostic Factors for Dogs Undergoing Cholecystectomy for Gall Bladder Mucocele. Veterinary Surgery,
Mesich, M. L. L., Mayhew, P. D., Paek, M., Holt, D. E., & Brown, D. C. (2009). Gall bladder mucoceles and their association with endocrinopathies in dogs: a retrospective case-control study. Journal of Small Animal Practice, 50(12), 630–635.
Newell, S. M., Selcer, B. A., Mahaffey, M. B., Gray, M. L., Jameson, P. H., Cornelius, L. M., & Downs, M. O. (1995). Gallbladder mucocele causing biliary obstruction in two dogs: ultrasonographic, scintigraphic, and pathological findings. American Animal Hospital Association (USA), 31(6), 467–472.
Pike, F. S., Berg, J., King, N. W., Penninck, D. G., & Webster, C. R. (2004). Gallbladder mucocele in dogs: 30 cases (2000-2002). Journal of the American Veterinary Medical Association, 224(10), 1615–1622.
Walter, R. et al., 2008. Nonsurgical resolution of gallbladder mucocele in two dogs. Journal of the American Veterinary Medical Association, 232(11), pp.1688–1693.
Woods, K. S., Brisson, B. A., Defarges, A. M., & Oblak, M. L. (2012). Congenital duplex gallbladder and biliary mucocele associated with partial hepatic cholestasis and cholelithiasis in a cat. The Canadian Veterinary Journal, 53(3), 269.
There are plausible reasons why high serum lipids should predispose to gall bladder disease. Studies in prairie dogs fed high cholesterol diets have shown an increase in bile viscosity, a reduction in bile flow and gall bladder mucosal hyperplasia presumably due to the irritant effects of the bile acids in the thick, stationary bile. However, similar studies have not been reported in dogs and cholesterol and fat metabolism differ between species.
The pathophysiological relationship between hyperlipidemia and gall bladder mucocele
therefore remains poorly understood, but evidence
to date suggests that any dog with persistent hypertriglyceridaemia and/or hypercholesterolaemia should be investigated for clinically significant biliary tract disease.
Gall bladder mucoceles are rarely reported in cats. There are two single case reports in cats and one case report was a cat with concurrent hepatic lipidosis, which does suggest a potential association with hyperlipidemia in this species also, albeit rare.
Treatment
Clinically significant gall bladder mucocoeles should
be treated and most authors recommend surgery for cholecystectomy. The prognosis is reasonable if the
gall bladder has not ruptured and if biliary diversion surgery is not necessary. However, there is a real
risk of perioperative mortality and bile leakage and cholecystectomy is generally considered to be a referral procedure. Successful medical management has been reported – particularly when the underlying cause is also identified and treated. Complete resolution has been reported in two hypothyroid dogs after supplementing thyroid hormones together with medical management. Medical management should only be attempted where there is no evidence of bile leakage or gall bladder wall thinning or necrosis on ultrasound. The owners should be warned of the potential risk of gall bladder rupture and the mucocoele should be regularly monitored for this with ultrasound. Medical treatment involves feeding a low fat diet and giving ursodeoxycholic acid and anti- oxidants.
It is unknown whether there is any benefit to medically managing asymptomatic mucocoeles. Surgical management would not be advisable in the absence of any clinical or clinicopathological abnormalities because of the risk of perioperative mortality. It is not known if
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43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS






































































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