Cholecystitis is a disease of the canine gallbladder characterized by infections, idiopathic inflammation or urolith obstruction.
In many cases, infections are of intestinal origin and ascend the common bile duct or arise from hematogenous spread. Cholecystitis can also spread to the surrounding bile ducts and liver parenchyma, resulting in bacterial cholangitis and cholangiohepatitis.
Causes of cholecystitis include:
- - predisposition in the Shetland Sheepdog, associated with concurrent pancreatitis, hyperlipidemia, corticosteroid excess, hypothyroidism, protein-losing nephropathy, diabetes mellitus, cholelithiasis and gallbladder dysmotility
- - Metorchis bilis, Parametorchis complexus, Clonorchis sinensis, Opisthorchis spp, Metagonimus yokogawai
- - Escherichia coli, Enterococcus spp, Bacteroides spp, Streptococcus spp and Clostridium spp
- - Leptospira spp
- Necrotizing gall bladder torsion and rupture, secondary to trauma or gastric dilatation-volvulus
- Bile duct carcinoma
In dogs, the infection can remain within the gallbladder, resulting in either necrotizing or emphysematous cholecystitis. With necrotizing cholecystitis, the wall of the gallbladder is damaged, and bile leaks into the abdomen causing a severe septic peritonitis, which can be lethal. If the bile that leaks is inspissated, then peritonitis will be local.
Radiographic evidence of gas in the area of the gallbladder is consistent with emphysematous cholecystitis.
The hematological abnormalities are inconsistent and may include mild to moderate leukocytosis with a left shift or a nonregenerative anemia, increases in ALT, AST, delayed clotting times and hyperbilirubinemia.
Diagnosis can be confirmed by biopsy for both aerobic and anaerobic cultures and for histopathology. Prognosis is favorable if appropriate antibiotic therapy is initiated early.
Stabilizing the animal, cholecystectomy, appropriate antibiotic therapy, and management for peritonitis are necessary for treatment. Prognosis is poor, unless diagnosis and treatment are early in the disease.
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