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Abstract Background Information is limited regarding the prevalence and importance of hepatic histologic abnormalities in dogs with gallbladder mucocele (GBM). Objectives To (a) report prevalence of hepatic histologic abnormalities in dogs with GBM (b) evaluate for association between hepatic abnormalities and outcome in dogs with GBM (c) evaluate whether neutrophil-to-lymphocyte ratio (NLR) differs in dogs with GBM with and without specific hepatic lesions. Animals Fifty-two dogs with grossly and histologically confirmed GBM. Methods Multicenter, retrospective study of dogs with GBM undergoing cholecystectomy with concurrent liver biopsy. Archived histological sections of gallbladder and liver evaluated by investigators blinded to data. Proportions of dogs with each histologic abnormality alive vs deceased at 1, 3, and 12 months post-cholecystectomy compared. Mann-Whitney U performed to determine if NLR differed in dogs with or without selected lesions. Results 51/52 (98%, 95% CI [89%, 99%]) dogs with GBM had at least 1 hepatic histologic abnormality. Hepatic fibrosis (37/51; 73%, 95% CI [59%, 83%]), biliary hyperplasia (29/52; 56%, 95% CI [42%, 68%]), and portal inflammation (25/52; 48%, 95% CI [35%, 61%]) were most common. The proportion of dogs alive vs dead differed based on the fibrosis score at 1, 3, and 12 (P ≤ .04) months post-cholecystectomy. Dogs with hepatic necrosis (P = .006) and cholangitis/cholangiohepatitis (P = .02) had higher NLRs compared to dogs without these lesions. Conclusions and Clinical Importance Histologic abnormalities of the liver are common in dogs with GBM. A higher portal fibrosis score might be associated with shortened long-term survival after cholecystectomy for dogs with GBM. An increase in NLR might predict hepatic necrosis and cholangitis/cholangiohepatitis in dogs with GBM.

Objective To report a case of a ruptured gallbladder intramural haematoma with a concurrent ruptured gallbladder mucocele in a dog. Animal A 10‐year‐old neutered male Poodle mix. Study Design Case report. Case History The patient was presented for assessment of anorexia, vomiting and a severe mixed hepatopathy. Abdominal ultrasound revealed peritoneal effusion and a ruptured gallbladder mass with a concurrent gallbladder mucocele suspected. Evaluation of the abdominal fluid was supportive of a haemoabdomen with simultaneous bile peritonitis. Emergent cholecystectomy was pursued and two points of rupture were noted, one at the gallbladder neck and a second associated with the mass‐like lesion. The gallbladder was submitted for histopathologic analysis. Results Cholecystectomy was performed routinely. Histopathology revealed a ruptured intramural gallbladder haematoma with concurrent gallbladder mucocele. The dog recovered well from surgery and was discharged 2 days post‐operatively. Owner reports no clinical concerns at 2 months post‐operatively. Conclusion Gallbladder intramural haematoma is a rare clinical finding in veterinary medicine, but should be considered in diagnostic workup for gallbladder masses. A 10‐year‐old, neutered male, Poodle mix presented for evaluation of anorexia, vomiting and elevated liver enzymes. The patient underwent emergent cholecystectomy for suspicion of a ruptured gallbladder mucocele with a possible concurrent mass effect within the gallbladder. Histopathogy of the gallbladder revealed an intramural haematoma with concurrent ruptured gallbladder mucocele. Intramural haematomas are rarely reported within veterinary medicine and should be considered as a possible differential when evaluating gallbladder masses.

Abstract Background Patients undergoing cholecystectomy have not been reported previously to develop clinically relevant postoperative hypernatremia. Objectives Describe the frequency of postoperative hypernatremia in dogs undergoing cholecystectomy and its clinical relevance (duration of hospitalization and survival). Animals Thirty-seven dogs undergoing cholecystectomy at 2 private referral hospitals. Methods Retrospective study of dogs undergoing cholecystectomy with available preoperative and postoperative serum sodium concentrations. Results Postoperative hypernatremia (>150 mEq/L) was common (56%; 95% confidence interval [CI], 40%-70%) and was associated with significantly higher mortality compared to nonhypernatremic patients (52%; 95% CI, 30%-70% vs 12.5%; 95% CI, 2%-40%; P = .02). Nonsurvivors had higher mean postoperative peak serum sodium concentrations (155 mEq/L; range, 146-172) than survivors (150 mEq/L; range, 142-156; P = .01). Dogs developing hypernatremia within 6 hours after surgery had 7.7 higher odds of nonsurvival (odds ratio [OR], 7.7; 95% CI, 5.9-9.4). A delta value (serum sodium concentration on admission [T0] − serum sodium concentration 6 hours postoperatively [T2]) of ≥10 mEq/L carried 3.3 higher odds of mortality (OR, 3.3; 95% CI, 1.6-5.1). All dogs with a postoperative peak sodium concentration >160 mEq/L did not survive. Admission acute patient physiologic laboratory evaluation fast (APPLEfast) scores were not different between survivors and nonsurvivors or between postoperative hypernatremic and normonatremic patients. Hospitalization time was no different between hypernatremic and normonatremic patients (6 days vs 4.5 days; P = .15). Dogs with gallbladder mucocele were more likely to develop postoperative hypernatremia and have poorer outcomes. Conclusions Hypernatremia was a common and clinically relevant postoperative complication in dogs after cholecystectomy. Detection of hypernatremia within 6 hours after surgery may be associated with poorer outcomes.

Abstract Background Biliary sludge (BS) frequently is identified on ultrasonographic examination and is described as incidental. It is hypothesized that biliary stasis and hypersecretion play a role in both BS and gallbladder mucocele (GBM) formation. Recent studies have documented similarities in composition of BS and GBM, and there are several examples of progression from BS to GBM in the veterinary literature. Objectives To assess the relationship between the presence of BS and later development of GBM in dogs, over time periods >12 months. Animals A total of 154 dogs with BS and ultrasonographic follow-up >12 months. Methods Medical records were retrospectively collected from 9 UK-based referral centers for all available time points. A semiobjective scoring system was used to track volume of BS within the gall bladder (GB) over time. Results Twenty dogs developed GBM during the study period. Shetland Sheepdogs (odds ratio [OR], 40.99; 95% confidence interval [CI], 3.61-465.95; P = .003) and Border Terriers (OR, 11.66; 95% CI, 3.28-46.63; P < .001) were independent risk factors for the development of GBM. Non–gravity-dependent BS (NDBS) was noted to form before GBM development in 9/20 dogs, and breeds at-risk for GBM were more likely to have NDBS. Odds for the development of GBM increased with BS score. Conclusions and Clinical Importance Dogs with NDBS may be at risk for the development of GBM and a stratified BS scoring system could allow for semiobjective monitoring over time, particularly in at-risk breeds.

Abstract Background The pathogenesis of gallbladder (GB) mucoceles in dogs is unknown. It has been proposed that hyperlipidemia could impair GB motility and contribute to GB mucocele formation. Hypothesis/Objectives The objective of this study was to compare GB motility in dogs with hyperlipidemia to control dogs using ultrasonography. We hypothesized that hyperlipidemic dogs will have decreased GB motility compared with controls. Animals Twenty-six hyperlipidemic and 28 healthy, age-matched control dogs were prospectively enrolled. Methods Cholesterol and triglyceride concentrations were measured in all dogs. Hyperlipidemia was defined as hypercholesterolemia (>332 mg/dL) and/or hypertriglyceridemia (>143 mg/dL) using a biochemical analyzer. Ultrasound was performed before feeding, and 60 and 120 minutes after ingestion of a high fat diet. Gallbladder volumes (GBV) and ejection fractions (EF) were calculated. Results Hyperlipidemic dogs had significantly larger GBVs (ml/kg) before feeding and 60 minutes after feeding of 1.2 (0.4-7.5; P = .008) and 0.6 (0.1-7.2; P = .04) compared with controls 0.6 (0.2-2.6) and 0.4 (0.1-1.9), respectively. Severely hyperlipidemic dogs had significantly larger GBV at baseline, 60 minutes, and 120 minutes of 1.7 (0.6-7.5; P = .03), 1.3 (0.4-7.2; P = .02), and 1.3 (0.2-8.2; P = .04), respectively compared with mildly hyperlipidemic dogs. EFs at 60 and 120 minutes between controls, hyperlipidemic, and severely hyperlipidemic were all 0.3 at 60 minutes and 0.5, 0.3, and 0.3 at 120 minutes, respectively which were not statistically different. Conclusions and Clinical Importance Hyperlipidemia leads to GB distention in dogs which could lead to retention of bile and gallbladder disease.

Gallbladder mucocele (GBM) in dogs is a condition characterized by the excessive accumulation of mucin within the gallbladder, potentially leading to bile duct obstruction and serious complications. While cholecystectomy remains the treatment of choice for symptomatic cases, medical management is often considered in dogs with subclinical GBM. This study evaluated the effects of different hepatoprotectants on disease progression in subclinical GBM. Sixty dogs diagnosed with GBM were randomly assigned to one of the three treatment groups: Group 1 (Ursodeoxycholic acid (UDCA) alone), Group 2 (S-adenosylmethionine (SAMe) and silymarin), and Group 3 (UDCA, SAMe, and silymarin). Hepatic biochemical markers (GGT, ALP, ALT, AST, bilirubin, cholesterol) and ultrasound parameters (gallbladder sludge percentage, liver echogenicity) were assessed at baseline, day 30, day 60, day 180, and day 365. Group 3 exhibited the most significant improvement, with substantial reductions in GGT, ALP, ALT, and AST levels (p < 0.05). Group 3 also demonstrated a significant decrease in gallbladder sludge percentage and improved liver echogenicity (p < 0.05). Group 1 showed mild improvement, whereas Group 2 had minimal impact on markers of cholestasis or gallbladder health. These findings suggest that a combination therapy of UDCA, SAMe, and silymarin may offer the most effective medical approach for managing subclinical GBM in dogs.

Porcelain Gallbladder (PGB) is a condition marked by extensive calcification and thickening of the gallbladder wall. PGB is extremely rare in dogs. The exact mechanism of PGB remains unclear. However, chronic cholecystitis and factors such as biliary hyperplasia, mucin hypersecretion, and cystic duct obstruction can lead to fibrosis and calcification of the gallbladder wall, potentially resulting in PGB. A 13-year-old spayed female Shih Tzu presented with anorexia, lethargy, vomiting, and weight loss. Physical exams showed mild epigastric pain. Blood tests indicated mild alanine aminotransferase (ALT) elevation, significant alkaline phosphatase, and gamma-glutamyl transferase (GGT) increases. Hyperlipidemia, hypercholesterolemia, and elevated canine pancreatic lipase (cPL) were also noted. Diagnostic imaging revealed extensive gallbladder wall calcification and thickening, choleliths, mild bile duct dilation, pancreatitis, and duodenitis. Cholecystectomy was performed, and symptomatic treatment for pancreatitis and duodenitis was administered. Histopathological examination is essential for confirming PGB by identifying calcification of the gallbladder wall. Histopathological examination of the gallbladder revealed severe papillary hyperplasia, mucin hypersecretion, multiple ulcers, diffuse calcification, and fibrotic changes. These findings confirmed the diagnoses of gallbladder mucocele and PGB. Postoperatively, biochemical markers normalized or significantly decreased, with clinical improvement observed. This study presents the rare occurrence of PGB in dogs and emphasizes the importance of appropriate veterinary intervention for improving clinical outcomes.

Gallbladder mucocele is a major cause of biliary disease in dogs, particularly affecting elderly and small-breed populations. Background: This study retrospectively evaluated 65 dogs that underwent cholecystectomy at a referral hospital in Seoul, Korea, (2022–2025) to characterize clinical features, bile culture results, antimicrobial susceptibility, and histopathologic findings. Methods: Signalment, ASA grade, preoperative laboratory data, bile culture and susceptibility results, and postoperative outcomes were reviewed. Results: Bile culture was positive in 21.3% (13/61) of cases, most frequently isolating Escherichia coli 38.5% (5/13) and Enterococcus spp. 30.8% (4/13). Approximately 18% of isolates were multidrug- or extensively drug-resistant, showing reduced susceptibility to β-lactams but retained sensitivity to imipenem and florfenicol. Preoperative increases in liver enzyme activities and C-reactive protein were common. Histopathology revealed gallbladder mucosal hyperplasia 90.4% (47/52) and inflammation 61.5% (35/52), often accompanied by hepatic inflammation or fibrosis. Toy Poodles were significantly over-represented (35.4%; OR = 3.1, p < 0.001). Antibiotic matching was not significantly associated with complications or the length of hospital stay (LOS). Conclusions: Although the bile-culture positivity rate was modest, the frequent detection of multidrug-resistant (MDR) and extensively drug-resistant (XDR) organisms highlights the clinical value of culture-guided antibiotic therapy. Routine bile culture with susceptibility testing, concurrent liver biopsy, and careful perioperative management may improve diagnostic accuracy and outcomes in canine gallbladder disease.

Abstract Background Leptin and its receptor play a role in several disease processes such as pancreatitis and heart disease. However, their association with gallbladder mucocele (GBM) in dogs has not been reported. Hypothesis/Objectives To evaluate differences in the expression of leptin and leptin receptor between dogs with and without GBM. Animals Twenty-five healthy dogs, including 9 laboratory beagle dogs, and 22 client-owned dogs with GBM. Methods Serum leptin concentration was determined in blood samples of all dogs by ELISA. Canine gallbladder samples were collected from 9 dogs with GBM that underwent surgery for therapeutic purposes and from 9 healthy laboratory beagle dogs as a normal control group. Samples were analyzed for leptin and leptin receptor mRNA by real-time polymerase chain reaction. Results Serum leptin concentration was significantly higher in dogs with GBM than in healthy dogs (medians of 7.03 and 2.18 ng/mL, respectively; P < .001). Patients with GBM that had undergone surgery had significantly higher serum leptin concentrations than those that had not (medians of 12.2 and 4.09 ng/mL, respectively; P = .001). However, no difference in serum leptin concentration was found between dogs with GBM with or without endocrinopathies. The mRNA expression levels of leptin and its receptor were significantly increased in the gallbladder tissues of dogs with GBM. Conclusions and Clinical Importance Dysregulation of leptin might be involved in the pathophysiology of GBM, and leptin concentrations might be associated with GBM severity.

Gallbladder mucocele (GM) is a common extrahepatic biliary disease recognized in dogs and is defined as the expansion and extension of the gallbladder by an accumulation of semi-solid bile or bile acid. Histopathological diagnosis of necrotizing cholecystitis and transmural coagulative necrosis of the gallbladder wall shows poor prognosis. Conversely, histopathological diagnosis with partial necrotic findings is often achieved. We hypothesized that histopathological partial necrosis of the gallbladder wall is the primary lesion of necrotic cholecystitis or transmural ischemic necrosis. Therefore, we investigated the relationship between histopathological necrosis/ partial necrosis findings and their clinical conditions. We retrospectively analyzed 55 dogs diagnosed with GM that had undergone cholecystectomy at the Yamaguchi University Animal Medical Center. The group with histopathological necrosis/partial necrosis of the gallbladder wall showed elevated levels of preoperative white blood cells, alanine transaminase, alkaline phosphatase, y-glutamyltransferase, total bilirubin, and C-reactive protein compared to the non-necrotic group. Partial necrosis of the gallbladder wall may affect the progression of the disease and hematological abnormalities. Additionally, all death cases until 2 weeks were included in the histopathological necrosis/partial necrosis group. In this study, we found that poor prognosis factors were associated with partial necrosis of the gallbladder wall. Furthermore, these cases of partial necrosis showed elevated levels of blood test parameters. These results suggest that necrosis of the gallbladder wall is associated with poor prognosis and poor pathophysiological conditions.