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Objective: To assess the thickness of each layer of the gallbladder wall with different diseases in dogs., Sample: 72 gallbladders., Methods: Retrospective study of dogs that underwent cholecystectomy. Histopathological specimens of the gallbladders were reviewed. Histopathological diagnosis was made as gallbladder mucocele or cholecystitis, and cholecystitis was further categorized into chronic cholecystitis, acute-on-chronic cholecystitis, acute cholecystitis, and necrotic cholecystitis. The thickness of each layer of the gallbladder wall was measured., Results: 22 dogs were diagnosed with gallbladder mucocele without cholecystitis, 24 with gallbladder mucocele and cholecystitis, 20 with only cholecystitis, and 6 as normal. Histopathological subclassification of cholecystitis in 44 gallbladders led to diagnosis of chronic cholecystitis in 21 gallbladders, acute-on-chronic cholecystitis in 10 gallbladders, acute cholecystitis in 6 gallbladders, and necrotic cholecystitis in 7 gallbladders. The thickness of the entire wall of the gallbladder (P < .0001) and the thickness of the mucosa (P < .0001) and subserosa (P < .0001) were affected by the different disease processes., Clinical Relevance: Layers of the gallbladder wall were affected by diseases present in the gallbladder. It resulted in a difference in the thickness of the wall of the gallbladder among the gallbladder diseases in this study. Histopathological changes should be taken into consideration before surgery while deciding what technique to use to perform a cholecystectomy.

The aims of this retrospective study were to characterise the epidemiological, clinical, histopathological, and microbiological findings as well as surgical outcomes in dogs admitted to a specialist veterinary hospital in Hong Kong for surgical management of gallbladder mucocoele (GBM). Inclusion criteria were cases with histopathological diagnosis of GBM and accompanying abdominal imaging, serum biochemistry, bile culture, and liver biopsy histology results. Fifty-six cases met the inclusion criteria. The median age at diagnosis was 12 years (range, 5-16 years). Miniature or toy pure-breed dogs were most commonly affected, including Poodles, Pomeranians, Schnauzers, Bichon frises and Chihuahuas. However, no breed was over-represented compared with their expected proportions among annual hospital admissions. Histological evidence of cholecystitis was present in 84% of cases, including acute cholecystitis in 18%, chronic cholecystitis in 37.5%, acute on chronic cholecystitis in 28% and acute with necrosis in 6%. The most common liver lesions were cholestasis in 64%, along with portal fibrosis in 55%, oedema in 50% and bile duct hyperplasia in 50%. Bile culture was positive in 29.6% of cases. Escherichia coli and Enterobacter species were most commonly isolated. Stentrophomonas maltophili was cultured from one case. Of the 16 cases where bacteria were isolated from bile culture, 94% had evidence of chronic cholecystitis and 81% had evidence of cholangiohepatitis. Fifty dogs (89.3%) survived to discharge including 5/5 dogs with ruptured gallbladders. Of 34 dogs with follow-up data, 21/34 (61.8%) were still alive 12 months later. Gallbladder mucocoeles were frequently associated with both acute and chronic inflammation. High survival rates to discharge were achieved., Competing Interests: Conflict of interest statement None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: To describe a laparoscopic approach for performing intraoperative cholangiography (IOC) and bile duct flushing (BDF) during laparoscopic cholecystectomy (LC) in dogs. To investigate the clinical outcomes of dogs undergoing these procedures for the treatment of benign gallbladder disease, ie gallbladder mucocele (GM) or cholecystitis., Study Design: Retrospective study., Animals: Forty-seven client-owned dogs., Methods: Medical records of client-owned dogs with benign gallbladder diseases that underwent IOC and BDF during LC between September 2016 and December 2019 were reviewed. Of these dogs, only dogs with GM or cholecystitis were included in the study. The fundus dissection first method was used for LC. Intraoperative cholangiography and BDF procedures were performed laparoscopically using a catheter inserted into the cystic duct following dissection within the subserosal layer of the gallbladder. Videos recorded during each procedure were reviewed, and data on procedure duration, completion, outcome, and technical approach were recorded., Results: Forty-seven dogs were included in the study. The median procedure time for BDF and IOC was 4 min (range, 2-48 min), and no intraoperative or postoperative complications occurred., Conclusion: During LC, BDF and IOC were performed safely and successfully. Intraoperative cholangiography identified obstructions and strictures in the common bile duct that were not detected using BDF alone., Clinical Significance: Our findings suggest that BDF and IOC are both safe and time effective and should be considered for routine use by surgeons during LC., (© 2021 American College of Veterinary Surgeons.)

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, γ-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., (Copyright© by the Polish Academy of Sciences.)

Anicteric gallbladder rupture has been rarely described in veterinary medicine, and, generally, it has been related to gallbladder wall necrosis secondary to gallbladder mucocele. A 5 yr old, male, neutered Labrador retriever presented for acute onset anorexia, lethargy, and vomiting. Cholecystitis was diagnosed based on the ultrasonographic findings and bactibilia, and, consequently, medical treatment was established. Despite improvement of the patient, a focal ultrasound of the hepatobiliary tract was performed 72 hr after admission for reassessment, revealing gallbladder wall thickening and abdominal effusion. Intracellular bacteria were present in nondegenerated neutrophils, and the effusion was categorized as septic exudate, compatible with septic peritonitis. Exploratory laparotomy confirmed an anicteric gallbladder rupture potentially secondary to cholecystitis and/or previous cholecystocentesis. The patient was not icteric the day of the surgery, serum bilirubin was within normal limits, abdominal fluid bilirubin concentration was below that of serum, and no bile pigment was detected; however, bile acids were significantly higher in the abdominal effusion compared with the serum concentration. This case describes an anicteric gallbladder rupture in a dog with concomitant cholecystitis and raises the question about the sensitivity of bile acid evaluation as a tool for diagnosis of gallbladder rupture and bile peritonitis in dogs., (© 2022 by American Animal Hospital Association.)

Across Southeast Asia and China, more than 17000 Asian bears are kept under suboptimal conditions and farmed for their bile to meet the consumer demand for traditional medicine products. Years of unsterile and repetitive bile extraction contribute to the development of chronic sterile or bacterial cholecystitis, a pathology commonly diagnosed in formerly bile-farmed bears. In both human and veterinary medicine, the diagnostic value of the macroscopic bile examination for assessing gallbladder disease is unclear. The objective of this study is to identify the role of gallbladder bile color, viscosity, and turbidity, while comparing them with established markers of cholecystitis. Moreover, it aims to define the optimal duration of oral antibiotic treatment for chronic bacterial cholecystitis in bears associated with bile farming. Thirty-nine adult, formerly bile-farmed Asiatic black bears (Ursus thibetanus) were examined under anesthesia and underwent percutaneous ultrasound guided cholecystocentesis. A total of 59 bile samples were collected with 20 animals sampled twice to evaluate the therapeutic success. All bile aspirates were assessed macroscopically and microscopically followed by submission for bacterial culture and antimicrobial sensitivity. In the majority of bears, samples with cytological evidence of bactibilia lacked inflammatory cells and did not always correlate with positive bacterial cultures. The most common bacterial isolates were Enterococcus spp, Streptococcus spp and Escherichia coli. Based on our findings, the optimal duration of antibiotic treatment for chronic bacterial cholecystitis is 30 days. Moreover, unlike Gamma-glutamyl Transferase (GGT) and gallbladder wall thickness, the organoleptic properties of bile were found to be reliable markers of chronic gallbladder inflammation with color and turbidity indicating cholestasis. The current study highlights the importance of cholecystocentesis for the management of gallbladder disease and provides initial results on the possible diagnostic value of macroscopic bile examination., Competing Interests: The authors have declared that no competing interests exist.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

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 multi-institutional 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., (© Veterinary Emergency and Critical Care Society 2019.)

Primary epithelial tumors of the gallbladder are rarely reported in animals. In this study, 9 aged pigs (6-12 years old) were histopathologically examined for gallbladder proliferative lesions. At necropsy, a large gallstone occupied the lumen of the gallbladder of 3 pigs. Histopathological examination revealed chronic cholecystitis in all 9 pigs, mucosal hyperplasia in 2 pigs, adenoma in 1 pig, and adenocarcinoma in 2 pigs. Bacilli were detected in the gallbladder lumen of 6 pigs by Warthin-Starry stain. Mucosal hyperplasia, adenoma, and adenocarcinoma were characterized by papillary projections of the mucosa with occasional acinar structures. Tumor invasion of the surrounding tissue was observed in the cases of adenocarcinoma. On Alcian blue and periodic acid-Schiff double-stained sections, the acinar structure of gallbladder mucosa in chronic cholecystitis and mucosal hyperplasia was stained in a mosaic pattern, indicating pyloric gland metaplasia. The results of immunohistochemistry revealed a CD10-positive epithelial brush border and mucin (MUC) 2-positive goblet cells in chronic cholecystitis, adenoma, and adenocarcinomas, indicating intestinal metaplasia. Immunoreactivity of MUC5 AC and cytokeratin 19 was weaker in adenoma and adenocarcinomas compared with the normal and hyperplastic gallbladder mucosa. The number of p53-positive nuclei and the Ki-67 index were higher in adenocarcinomas compared with benign lesions. These results suggest that chronic cholecystitis associated with gallstones and/or bacterial infections may contribute to metaplastic changes and development of gallbladder tumors in aged pigs. Alteration of mucin, cytokeratin, and p53 profiles in gallbladder proliferative lesions in pigs were similar to that in humans, suggesting a common pathogenesis in tumor development.

A 9-year-old female neutered domestic shorthair cat diagnosed with immune-mediated thrombocytopenia that was treated with prednisolone and cyclosporine, was presented for anorexia, vomiting, increased liver enzymes, and hyperbilirubinemia. Abdominal ultrasound revealed a markedly thickened gallbladder and common bile duct wall. Bile cytology detected severe neutrophilic inflammation and protozoal zoites. Suspected Toxoplasma gondii infection was confirmed by real-time PCR of bile. The cat was treated with clindamycin and ursodeoxycholic acid for 6 weeks, recovered and remained stable for 2 years despite ongoing immunosuppressive treatment. Thereafter, the cat was presented with suspicion of intestinal lymphoma, and recurrence of toxoplasmosis was diagnosed. Following treatment with clindamycin and prednisolone over 4 weeks the cat was euthanized. This is the first report of Toxoplasma gondii zoites detected in bile fluid from a cat with cholecystitis. Pathogenesis of toxoplasmosis in cats is still not fully understood. Although immunosuppression can represent a relevant predisposing factor, other factors, such as virulence of the parasite and genetic polymorphism of the host, can also play an important role. Toxoplasmosis should be included as a differential diagnosis in cats developing clinical signs of an inflammatory disease while receiving immunosuppressive treatment., Competing Interests: The authors confirm that they do not have any conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

A 2-year-old entire female mixed-breed dog was presented with signs of cholestasis. Abdominal ultrasonography revealed a gallbladder with a thickened and hyperechoic wall and luminal calculi. Exploratory laparotomy with cholecystectomy was performed and histopathological examination of the specimens from the cholecystectomy demonstrated extensive proliferation of large, prominent nerves containing ganglion cells with no atypia mainly located in the gallbladder mucosa. The neural nature of these components was confirmed by immunohistochemical labelling with antibodies specific for synaptophysin, glial fibrillary acidic protein, S100 protein and neurofilaments. Based on these findings, the lesion was diagnosed as ganglioneuromatosis. Reports of ganglioneuromatosis in animals have so far been restricted to the intestine. This is the first case of ganglioneuromatosis affecting the gallbladder in an animal in which no intestinal involvement was apparent., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Bacterial cholecystitis often is diagnosed by combination of gallbladder ultrasound (US) findings and positive results of bile culture. The value of gallbladder US in determining the likelihood of bile bacterial infection in cats and dogs with suspected biliary disease is unknown., Hypothesis/objectives: To determine the value of gallbladder US in predicting bile bacterial culture results, identify most common bacterial isolates from bile, and describe complications after cholecystocentesis in cats and dogs with suspected hepatobiliary disease., Animals: Cats (70) and dogs (202) that underwent an abdominal US and submission of bile for culture were included in the study., Methods: A cross-sectional study design was used to determine the association of gallbladder US abnormalities and the results of bile cultures, and complications of cholecystocentesis., Results: Abnormal gallbladder US had high sensitivity (96%) but low specificity (49%) in cats with positive and negative results of bile bacterial culture, respectively. Cats with normal gallbladder US findings were unlikely to have positive bile bacterial culture (negative predictive value of 96%). Gallbladder US had lower sensitivity (81%), specificity (31%), positive predictive value (20%), and negative predictive value (88%) in dogs. The most common bacterial isolates were of enteric origin, the prevalence being higher in cats. Incidence of complications after cholecystocentesis was 3.4%., Conclusions and Clinical Importance: Gallbladder US has a high negative predictive value for bile culture results in cats. This modality is less predictive of infection in dogs. Percutaneous US-guided cholecystocentesis has a low complication rate., (Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Background: Bacterial cholangitis and cholecystitis are rarely reported, poorly characterized diseases in the dog., Objectives: To characterize the clinical features of these conditions., Animals: Twenty-seven client-owned dogs with bacterial cholangitis, cholecystitis, or both., Methods: Multicenter, retrospective cases series of dogs with bacterial cholangitis, cholecystitis, or both, presenting January 2000 to June 2011 to 4 Veterinary Schools in Ireland/United Kingdom. Interrogation of hospital databases identified all cases with the inclusion criteria; histopathologically confirmed cholangitis or cholecystitis and bile culture/cytology results supporting a bacterial etiology., Results: Twenty-seven dogs met the inclusion criteria with approximately 460 hepatitis cases documented over the same study period. Typical clinical pathology findings were increases in liver enzyme activities (25/26), hyperbilirubinemia (20/26), and an inflammatory leukogram (21/24). Ultrasound findings, although nonspecific, aided decision-making in 25/26 cases. The most frequent hepatobiliary bacterial isolates were Escherichia coli (n = 17; 16 cases), Enterococcus spp. (n = 8; 6 cases), and Clostridium spp. (n = 5; 5 cases). Antimicrobial resistance was an important feature of aerobic isolates; 10/16 E. coli isolates resistant to 3 or more antimicrobial classes. Biliary tract rupture complicated nearly one third of cases, associated with significant mortality (4/8). Discharged dogs had a guarded to fair prognosis; 17/18 alive at 2 months, although 5/10 re-evaluated had persistent liver enzyme elevation 2-12 months later., Conclusion and Clinical Significance: Bacterial cholangitis and cholecystitis occur more frequently than suggested by current literature and should be considered in dogs presenting with jaundice and fever, abdominal pain, or an inflammatory leukogram or with ultrasonographic evidence of gallbladder abnormalities., (Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Objective-To characterize historical, clinicopathologic, ultrasonographic, microbiological, surgical, and histopathologic features of bacterial cholecystitis and bactibilia in dogs and evaluate response to treatment and outcomes in these patients. Design-Retrospective case-control study. Animals-40 client-owned dogs (10 with bacterial cholecystitis on histologic analysis or bactibilia on cytologic examination [case dogs] and 30 without bactibilia [controls]) evaluated at a veterinary teaching hospital between 2010 and 2014. Procedures-Signalment, history, clinicopathologic findings, ultrasonographic features, microbiological results, surgical findings, histopathologic changes, treatments, and outcomes of case dogs were derived from medical records and summarized. Demographic and clinicopathologic data and ultrasonographic findings were compared between case and control dogs. Relationships among prior antimicrobial treatment, sediment formation in the gallbladder, presence of immobile biliary sludge, and presence of bactibilia or bacterial cholecystitis were assessed. Results-No finding was pathognomonic for bactibilia or bacterial cholecystitis in dogs. Case dogs were significantly more likely to have immobile biliary sludge and had a greater degree of biliary sediment formation than did control dogs. All case dogs for which gallbladders were examined histologically (6/6) had bacterial cholecystitis. Five of 10 case dogs were Dachshunds. Medical or surgical treatment resulted in good outcomes. Conclusions and Clinical Relevance-Bactibilia and bacterial cholecystitis were important differential diagnoses in dogs with signs referable to biliary tract disease. Dachshunds were overrepresented, which may suggest a breed predisposition. Cytologic evaluation of bile should be considered in the routine assessment of dogs with hepatobiliary disease if immobile biliary sludge is present. (J Am Vet Med Assoc 2015;246:982-989).

A 14.5-yr-old female kinkajou (Potos flavus) was diagnosed with cholelithiasis after an episode of vomiting; diagnostics included biochemical analysis and abdominal ultrasound exam. Despite antimicrobial treatment, cholelithiasis led to cholecystitis. A cholecystotomy was performed to remove choleliths and inspissated bile. Morphological and spectroscopic properties of the choleliths were similar to those of gallstones from the brown pigment family and Streptococcus sp. and Escherichia coli were isolated from the bile. Biliary tract infection is directly related to pathogenesis of brown pigment gallstones. Serial ultrasound exams revealed that cholecystitis developed secondary to the presence of gallstones in the biliary tree. Despite full recovery postsurgery, the patient died 15 mo later from gallbladder necrosis. Based on the progression of this case, a cholecystectomy would be preferred over a cholecystotomy in similar cases, and the efficacy of long-acting antibiotics may not be adequate in nontarget species. Gallstones and biliary tract infection are rarely described in small domestic carnivores, and this is the first reported case in a kinkajou.

A 13-year-old female Boer goat with a history of chronic arthritis and recurrent episodes of recumbency, increased serum gamma-glutamyl transferase, and complete inability to stand was submitted for necropsy. Gross changes included the presence of a white, firm, smooth, 6 cm × 4 cm × 3 cm mass that diffusely expanded and partially effaced the gall bladder and infiltrated the adjacent hepatic parenchyma. On cut surface, the mass was pale yellow and had small, irregular, dark yellow areas. Scattered through the pancreas were 2 gray, well-demarcated, soft, homogeneous, 1 cm in diameter nodules that bulged out from the capsular surface. The right femoral head had a locally extensive area of cartilage erosion. Histological and immunohistochemical evaluation of the gall bladder and pancreatic nodules revealed a primary cholecystic adenocarcinoma and multifocal insulinomas, respectively. A metastatic focus from the gall bladder neoplasm was observed infiltrating the right adrenal gland medulla. The goat also had mild pulmonary infestation by Muellerius capillaris. Primary hepatobiliary and pancreatic neoplasia is rare in goats, and to the authors' knowledge, neither cholecystic adenocarcinoma nor pancreatic insulinomas have been previously reported in this species., (© 2014 The Author(s).)

A Boxer puppy from the island of Rügen, which was properly vaccinated according to its age, was presented with acute gastrointestinal symptoms. The presumptive diagnosis of leptospirosis with acute renal failure, hepatic damage, and jaundice was confirmed by seroconversion (increased titre to 1 : 800 in a non-vaccine serogroup 4 weeks after disease onset). Cholecystitis was diagnosed based on clinical symptoms and sonographic results. After an initial improvement, the puppy's condition deteriorated and cholecystectomy was performed. Histopathological diagnosis indicated a haemorrhagic necrotizing cholecystitis.

A 7 yr old castrated male Australian shepherd dog was examined for acute change in iris color, lethargy, and anorexia. Uveitis, acute renal failure, and presumed cholecystitis were diagnosed. Based on clinical findings, leptosporosis was suspected, and the dog was treated with antibiotics and supportive care. The dog made a complete recovery, and leptospirosis was confirmed on convalescent titers. Due to the zoonotic potential, leptospirosis should be considered in cases of uveitis, as well as possible cholecystitis.

A 15-year-old domestic shorthair cat was presented with severe haematuria, stranguria, anorexia and lethargy of 10 days' duration. Physical examination revealed a large painful urinary bladder and pain in the cranial abdomen. Abdominal ultrasound revealed severe generalised mural thickening of both the gall bladder and the urinary bladder. Lymphoma was diagnosed on cytology of urine sediment and fine-needle aspirates of the gall bladder. Despite a transitory clinical improvement and partial remission following chemotherapy, the cat was euthanased six weeks after initial presentation due to recurrent clinical signs. Post-mortem examination confirmed a B-cell lymphoma in the urinary bladder. This report is the first description of gall bladder and bladder lymphoma in a cat.

Postmortem examinations on 160 otters found dead in Great Britain from 2005 to 2007 showed a high prevalence of infection with the bile fluke Pseudamphistomum truncatum in otters from Somerset and Dorset but no infection in otters from other areas, including Cornwall, the western half of Devon, north-east England and Scotland. Cases were also recorded for the first time in Gloucestershire and East Anglia. Eighteen of the 28 infected otters were male and no cubs were infected, but there was no significant correlation between infection status and sex or age. There was a strong positive correlation between bile fluke infection and gall bladder pathology. Thirty otters had thickened gall bladders resulting from hyperplasia of the epithelial and smooth muscle layers, fibrosis and infiltration by inflammatory cells and 19 of these were infected. No flukes were detected in the other 11 otters with abnormal gall bladders, possibly as a result of a successful immune response. The majority of otters with thickened gall bladders were in good physical condition but a positive association was not confirmed statistically. Fluke infection was also detected in nine of the 130 otters with apparently normal gall bladders. Liver pathology ranged from mild bile duct hyperplasia and periportal fibrosis to severe sclerosing cholangitis, hepatocyte necrosis and bile stasis. No otters were found to have died as a result of fluke infection, but there was a negative association, approaching significance, between infection and body condition.

A 10-year-old cat was presented with a history of inappetence, pyrexia and weight loss. Clinical investigations showed anaemia, hyperbilirubinaemia, septic peritonitis and a double gall bladder with choleliths in an extrahepatic duct. Initial medical stabilisation was performed. At laparotomy, a duplex gall bladder with two separate cystic ducts was identified. The left gall bladder was thickened and had ruptured at the apex. Multiple choleliths were identified in the left cystic duct. The right gall bladder and cystic duct were grossly normal. The ruptured gall bladder was repaired, the gallstones were removed via a choledochotomy of the left cystic duct and a choledochoduodenostomy was created from the dilated left cystic duct. The cat remained depressed and anorexic, and it was euthanased 72 hours postoperatively at the owners' request. This is the first ante-mortem investigation of extrahepatic biliary disease associated with gall bladder duplication in the cat.

A 6-year-old desexed female German Shepherd dog was referred to the Murdoch University Veterinary Hospital for assessment and management of acute onset vomiting, diarrhoea, polydipsia and lethargy of 2 days duration. Surgical, microbiological and histological findings were consistent with necrotising cholecystitis secondary to gall bladder torsion, resulting in gall bladder rupture and secondary non-septic bile peritonitis. A chronic peritoneopleural perforation resulting from an abdominal cavity foreign body and congenital peritoneopericardial hernia were also present. The dog made a full recovery following cholecystectomy, foreign body removal, repair of the peritoneopleural perforation and peritoneopericardial herniorrhaphy. This is the first recorded case of gall bladder torsion in the dog.

A 7-year-old, male, castrated, Labrador Retriever with a history of pancreatitis and inflammatory bowel disease presented for vomiting and anorexia. Serum biochemistry findings were indicative of cholestasis, hepatocellular insult, and decreased hepatic function. Ultrasound examination showed sediment and gas within the gallbladder, and a diagnosis of emphysematous cholecystitis was made. Emergency gallbladder resection was performed. Cytologic examination of bile fluid collected at surgery showed a mixed population of bacteria (bactibilia) together with fungal organisms consistent with Cyniclomyces guttulatus (previously known as Saccharomycopsis guttulatus). Similar fungal organisms were seen on a fecal smear. Bacteria cultured were normal gastrointestinal flora, supporting ascending infection; the fungal organisms were interpreted as incidental. Histopathology of the gallbladder indicated active (suppurative) and chronic (lymphocytic) cholecystitis and sections of liver tissue had evidence of chronic liver disease. A positive liver culture indicated concurrent bacterial hepatitis or cholangiohepatitis. Despite supportive care, the dog continued to decline and was euthanized 30 days later. Necropsy results confirmed end stage liver disease, but an initiating cause was not found. This case highlights the role of bactibilia in the development of acute cholecystitis and the unique cytologic appearance of C guttulatus as an incidental finding in bile fluid.

A 10-year-old, neutered male, keeshond was presented for vomiting, lethargy, icterus, and anorexia. Obstructive cholelithiasis was diagnosed based on analysis of a serum biochemical profile, abdominal radiographs, and ultrasonography. Choleliths were removed from the gall bladder and common bile duct via a cholecystotomy.

Objectives: To evaluate the clinical, clinical pathology, diagnostic imaging, microbiological and pathological features of cholangitis/cholangiohepatitis in the dog., Methods: The study design was a retrospective review of cases of bacterial cholangitis/cholangiohepatitis presented to the University of Bristol during the period 1995 to 2000. The diagnosis was made based on hepatic histopathological findings and positive bile culture results., Results: Four dogs met the inclusion criteria. Common presenting signs included anorexia (n=4), jaundice (n=4), vomiting (n=4) and pyrexia (n=2). All four dogs had a leucocytosis or neutrophilia reported at some time in their history along with serum bilirubin elevation. In addition, serum alkaline phosphatase and alanine transaminase activity was increased in all of the dogs in which it was measured both before and at the time of referral. In general, the diagnostic imaging findings were non-specific. Organisms cultured from bile aspirates were Escherichia coli (n=3), Clostridium species (n=2) and a faecal Streptococcus species (n=1). Two cases resolved with medical treatment alone; two with concurrent cholecystitis required cholecystectomy. Following surgery, both of these cases showed a resolution of clinical signs., Clinical Significance: This report highlights the fact that bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis should be considered as a potential differential in dogs presenting with signs referable to biliary tract disease.

Between 1988 and 2004, postmortem examinations were carried out on 445 otters found dead, mostly as a result of road traffic accidents, in southern and south-west England. Thickened, shrunken gall bladders were observed in 10 cases, the first in 2000 and the others between February 2002 and August 2004. A digenean fluke, Pseudamphistomum truncatum, was found in the gall bladders of three cases and also in three of seven American mink examined. Nine of the 10 otters and all the mink came from a localised area of Somerset, indicating that the fluke has become established in the local fish population. P. truncatum has not been recorded previously in Britain, and the results suggest that it has been introduced recently, possibly in imported fish.

This report describes a case of septic peritonitis and gall bladder rupture in German shepherd dog that developed 7 d after surgical treatment for gastric dilation-volvulus. Histological examination confirmed gall bladder necrosis, secondary to an acute ischemic event. Postoperative acute necrotizing cholecystitis has not been a previously reported complication in dogs.

Objective: To report clinical findings and define clinical variables associated with outcome in dogs undergoing extrahepatic biliary surgery., Study Design: Retrospective study., Animals: Sixty dogs that had extrahepatic biliary tract surgery., Results: Primary diagnoses included necrotizing cholecystitis (36 dogs, 60%), pancreatitis (12 dogs, 20%), neoplasia (5 dogs, 8%), trauma (4 dogs, 7%), and gallbladder rupture from cholelithiasis without necrotizing cholecystitis (3 dogs, 5%). Bile peritonitis occurred in 19 (53%) dogs with necrotizing cholecystitis, 4 dogs with trauma, and 3 dogs with cholelithiasis without evidence of necrotizing cholecystitis. Cholecystectomy (37 dogs, 62%) and cholecystoduodenostomy (14 dogs, 23%) were the 2 most commonly performed procedures. Median hospitalization for survivors was 5 days (range, 1-15 days). There were 43 surviving dogs (72%) and 17 nonsurvivors (28%, 4 died, 13 euthanatized). Presence of septic bile peritonitis (P=.038), elevation in serum creatinine concentration (P=.003), prolonged partial thromboplastin times (PTTs; P=.003), and lower postoperative mean arterial pressures (P=.0001) were significantly associated with mortality., Conclusions: Extrahepatic biliary surgery is associated with high mortality and a relatively long hospitalization time for survivors. Cholecystectomy and cholecystoduodenostomy were the most common surgical procedures to treat the 4 major biliary problems (necrotizing cholecystitis, pancreatitis, neoplasia, and trauma) observed in this cohort of dogs. The relatively high mortality rate likely reflects the underlying diseases and their effects on the animal (septic bile peritonitis, higher serum creatinine, prolonged PTT, and lower postoperative mean arterial pressure) rather than complications of surgery., Clinical Relevance: Septic bile peritonitis, preoperative elevated creatinine concentration, and immediate postoperative hypotension in dogs undergoing extrahepatic biliary tract surgery are associated with a poor clinical outcome. Adequate supportive care and monitoring in the perioperative period is critical to improve survival of dogs with extrahepatic biliary disease.

The pathogenicity of a serotype-1 fowl adenovirus (FAV-99ZH), which causes adenoviral gizzard erosion by oral inoculation in chickens, was investigated in specific pathogen-free white leghorn chickens. In trial 1, 14 chickens were inoculated intravenously with the virus at 21 days of age and euthanatized for necropsy within 1-14 days of inoculation. Gizzard erosion was grossly observed from day 7 postinoculation (PI), and histologically, FAV-99ZH antigen-positive, basophilic intranuclear inclusion bodies were seen in the gizzard lesions from day 7 to 11 PI. Necrotizing pancreatitis, and cholecystitis and cholangitis associated with the inclusions were observed from day 3 to 14 PI (pancreatitis) and from day 5 to 9 PI (cholecystitis and cholangitis), respectively. The inclusions were also observed in the epithelial cells of the cecal tonsils from day 3 to 5 PI. The virus was recovered from samples of the lesions. It was revealed that FAV-99ZH causes not only gizzard erosion but also pancreatitis, cholecystitis, and cholangitis by intravenous inoculation in chickens. In trial 2, 10 chickens were inoculated orally with the virus twice, at 13 and 36 days of age, and euthanatized for necropsy within 4-17 days after reinfection. Macroscopically, focal gizzard lesions were observed; however, neither necrosis nor inclusions were observed by microscopy. Moreover, FAV was not recovered from the gizzard or rectum of any of the chickens at necropsy. This suggests that the gizzard lesions occurred as a result of the primary infection, and that the chickens were able to resist reinfection.

A blue-naped mousebird (Urocolius macrourus) was diagnosed by gross necropsy and histopathology as having a chronic, fibrosing bacterial cholecystitis. Acute, severe, necrotizing pneumonia and myocarditis also were present with intralesional gram-negative bacteria. The bacteria within the lungs and heart were suspected to have spread from the biliary tract because of the pattern of distribution and similar gram-staining characteristics. Enterobacter sp. and Escherichia coli were cultured from the pulmonary lesions. Cloacal cultures in clinically normal blue-naped mousebirds and speckled mousebirds (Colius striatus) yielded both Enterobacter sp. and E. coli. We hypothesize a pathogenesis in this bird consisting of biliary stasis of unknown etiology and eventual infection of the biliary tract by the normal gram-negative gastrointestinal flora. Death was believed to be a result of cardiac and respiratory dysfunction secondary to the bacterial dissemination from the biliary tree and endotoxemia.

A 6-year-old, intact male Siberian husky was evaluated for a 24-hour history of vomiting and lethargy. Diagnosis of emphysematous cholecystitis was achieved based on survey abdominal radiographs, a barium contrast gastrointestinal series, and abdominal ultrasound. Diagnosis and medical and surgical management of the condition are discussed.

A four-year-old female Japanese akita was admitted with icterus, ascites and chronically elevated serum bilirubin and liver enzymes. Abdominal ultrasonography revealed a diffusely thickened, hyperechoic gallbladder wall with a focal defect, hepatic lymphadenopathy and a large volume of anechoic fluid within the peritoneal space. Diagnosis of biliary tract rupture with bile peritonitis was based on the findings of bile and suppurative exudate in peritoneal aspirates. A perforated gallbladder and cholelithiasis were found on exploratory celiotomy, while histopathology revealed chronic suppurative cholecystitis. The dog recovered uneventfully after cholecystectomy. Although rare, the triad of cholelithiasis, cholecystitis and gallbladder perforation should be considered after detection of one of these conditions.

Enterocytozoon bieneusi is the most common microsporidian parasite recognized in human patients with AIDS. Recently, we identified a virtually identical organism causing a spontaneous infection associated with hepatobiliary and intestinal disease in simian immunodeficiency virus (SIV)-infected macaques. To examine the natural history of the infection, we examined captive rhesus macaques for E. bieneusi by PCR, in situ hybridization, and cytochemical techniques. PCR performed on fecal DNA detected enterocytozoon infection in 22 (16.7%) of 131 normal rhesus macaques (Macaca mulatta), compared to 18 (33.8%) of 53 rhesus macaques experimentally inoculated with SIV. In normal rhesus macaques, persistence of infection was demonstrated for up to 262 days and was usually not associated with clinical signs. In six of seven normal rhesus animals, E. bieneusi was detected by PCR in bile obtained through percutaneous cholecystocentesis but not by in situ hybridization performed on endoscopic biopsies of duodenum and proximal jejunum.

A 9-year-old Holstein cow was evaluated for colic and decreased milk production of 2 days' duration. Preoperative serum biochemical results suggested hepatic damage and cholestasis. On the basis of persistent signs of abdominal pain that were nonresponsive to analgesics, exploratory laparotomy was performed. The cow was found to have choleliths. Cholecystocentesis was performed, and samples were submitted for cytologic examination and bacterial culture. Bacterial culture yielded Escherichia coli and Clostridium perfringens. Using digital pressure, choleliths were reduced until they could be passed through the bile duct into the duodenum. The cow recovered from surgery without complications, and all serum biochemical test results returned to reference ranges. Cholelithiasis is rare in cattle but can result in signs of abdominal pain.

Canine cholecystitis is diagnosed infrequently. Clinical signs, physical examination findings, and clinicopathological abnormalities are nonspecific. Few reports exist of associated ultrasonographic findings which also are nonspecific for the disorder. Ultrasonographic-guided, percutaneous cholecystocentesis has been suggested for diagnostic confirmation. The present report further documents ultrasonographic findings associated with canine acalculous cholecystitis and demonstrates the utility of ultrasonographic-guided, percutaneous cholecystocentesis in confirmation of the diagnosis in a prospectively acquired clinical case series.

Bile samples were obtained from adult owl monkeys by ultrasound-guided percutaneous cholecystocentesis, using a transhepatic approach. Sampling frequency was once weekly over a 5-week period. Clinical recovery from each procedure was rapid. Animal body weights fluctuated within 22% of baseline over the study period, but maximal weight loss in any animal was less than 3% at the study's end. At necropsy, gross lesions in the liver and gallbladder were minimal. Histologic examination revealed mild focal cholecystitis in the gallbladder of four of six animals, focal pericholecystitis in three of six animals, and foci of gallbladder fibrosis in two animals. Changes were consistent with repeated trauma from the centesis procedure. Gallbladder mucosa was judged normal in all animals. Body weight fluctuations were attributed to a change in diet, part of a concurrent study, rather than to the centesis procedure. Ultrasound-guided cholecystocentesis provides a rapid, minimally traumatic, and safe method for repeated bile sampling in a small nonhuman primate.

Naturally occurring ulcerative cholecystitis was present in a flock of 21-day-old turkey hens that were accidentally given at least 0.004% 3-nitro-4-hydroxy-phenylarsonic acid (3-NITRO) in their water for 2 days. Similar lesions were reproduced by administering 0.002% 3-NITRO to 2-day-old turkey poults for 6 days. Turkeys 31 days old were given up to 0.004% 3-NITRO in their water for 6 days, but no gall bladder ulcers were present in these poults. The toxicity to turkeys of 3-NITRO in the water appears to be age-dependent.

We performed a retrospective study of 15 cases of extrahepatic biliary tract rupture in dogs. Nine of the 15 dogs had ductal rupture associated with blunt abdominal trauma. The remaining 6 dogs had gallbladder rupture associated with cholelithiasis and/or cholecystitis. The relationship between site of rupture and cause of rupture was significant (p = 0.0002). A review of 60 dogs with extrahepatic biliary tract rupture reported in the veterinary literature revealed a similar relationship (p = 0.0001). Thirty-two of 33 cases of ductal rupture were associated with blunt abdominal trauma and 25 of 27 cases of gallbladder rupture were associated with cholelithiasis and/or cholecystitis. Totals after combining our cases with those from the literature suggests the most frequent area of ductal rupture is the common bile duct distal to the last hepatic duct, followed by the junction of the common bile duct with the duodenum.

Diseases that lead to the need for surgery of the extrahepatic biliary system in dogs and cats are mainly acquired diseases, and these include obstructive biliary disease, traumatic injury, and cholecystitis. The main goal of surgery is to achieve an intact, patent biliary system while minimizing intra- and postoperative complications.

Mature Fasciola gigantica obtained from naturally infected cattle were surgically transferred into the gallbladders of six fluke-free goats. Two of the goats died at two and 19 weeks and the remaining four were slaughtered at 12, 48, 48 and 80 weeks after the transfer. Nine of 20 transferred F gigantica were recovered from the gallbladder and common hepatic duct of the experimental goats. The walls of gallbladders and bile ducts were thickened by epithelial proliferation, fibrosis and mononuclear cell infiltration. Large numbers of globule leucocytes were present in the epithelium of gallbladders and common hepatic ducts as well as in minute intrahepatic bile ducts. Very few mast cells were observed in these locations. Globule leucocytes in two goats were positive for argentaffin reaction with Gomori hexamine silver stain. The proliferative cholecystitis in experimental goats was similar to adenomatous cholecystitis in cattle naturally infected with fascioliasis. Globule leucocytes had no obvious deleterious effects on the parasites.