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CHOLECYSTITIS

Note for Pet Owners:

This information is provided by Provet for educational purposes only.

You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

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Description
Cholecystitis is inflammation of the bile ducts and gall bladder. The disorder occurs in both dogs and cats, but it  is an uncommon diagnosis in veterinary practice. This may reflect the difficulty of getting an accurate diagnosis because the clinical findings are similar to those found in other  liver and gastrointestinal disorders. 

Cause
The aetiopathogenesis of cholecystitis is not fully understood, but ascending infection or the movement of inflammatory contents from the intestinal lumen by reflux up the bile duct is considered to be a likely cause. Obstruction of the biliary tract (eg by a cholelith or neoplasia) or bacteraemia may also lead to bile duct infection. Any cause of bile stasis, or increased cholesterol or bilirubin concentration in bile is likely to predispose to stone formation, as well as the presence of infection.

Infections which may be associated with cholecystitis include :

  • E.coli
  • Salmonella spp (dogs)
  • Pasteurella spp (cats)
  • Campylobacter spp (dogs)
  • Helicobacter ? (dogs)

Breed Occurrence
Cholecystitis can affect any age or breed , but cholelithiasis is most common in older small breed dogs.

Signs

The clinical signs of cholecystitis may include :

  • Abdominal pain
  • Anaemia - non-regenerative (if the bile duct is totally blocked)
  • Anorexia
  • Coagulopathy - if vitamin K absorption is impaired
  • Gastrointestinal haemorrhage (due to ulcer formation)
  • Hepatomegaly
  • High temperature
  • Jaundice 
  • Pale (white) faeces
  • Vomiting

Complications
Complications of bilary tract infection and inflammation include cholelithiasis, which can further obstruct bile outflow. Also the biliary tract may rupture causing peritonitis which is very serious.

Diagnosis

Diagnosis is based upon clinical signs, and the following laboratory test results :

Radiography may reveal - hepatomegaly, radiodense choleliths, free fluid if peritonitis. In some situations (notably in patients with diabetes mellitus) gas may be produced within the biliary system, or it may leak into the peritoneal cavity causing a pneumoperitoneum.

Ultrasonography may reveal - thickening, distension, occlusion, increased tortuosity, or choleliths in biliary tract

Exploratory laparotomy may be needed to confirm the diagnosis.

Treatment

Antibiotics.

Surgery to perform cholecystotomy and divert bile flow may be needed if the tract is permanently obstructed. Removal of choleliths or localised neoplasia may also be possible. 

Emergency lavage is important for cases with peritonitis

 

Prognosis
Good if bile tract patency can be restored to normal and the primary infection can be treated successfully. 

Guarded if peritonitis is present, or if neoplasia is involved.

Long term problems
 Maldigestion and absorption of nutrients due to lack of bile salts reaching the intestine leading to deficiencies eg vitamin K.

 

Updated January 2016