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. 2022 Mar;36(2):565-575.
doi: 10.1111/jvim.16384. Epub 2022 Feb 15.

Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele

Jared A Jaffey  1 , Rachael Kreisler  2 , Kate Shumway  3 , Yan-Jane Lee  4   5 , Chung-Hui Lin  4   5 , Lawren L Durocher-Babek  6 , Kyoung-Won Seo  7   8 , Hojung Choi  7 , Ko Nakashima  9 , Hiromi Harada  9 , Hideyuki Kanemoto  10 , Lee-Shuan Lin  11
Affiliations

Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele

Jared A Jaffey et al. J Vet Intern Med. 2022 Mar.

Abstract

Background: Gallbladder mucocele (GBM) is a common biliary disorder in dogs that can be categorized into 6 types, but the value of this classification scheme remains unknown. Cholecystectomy is associated with high death rates and warrants additional interrogation.

Objectives: Investigate the clinical value of ultrasonographic diagnosis of type of GBM and identify prognostic factors in dogs with GBM undergoing cholecystectomy.

Animals: Two hundred sixteen dogs.

Methods: Retrospective cohort study. Dogs with GBM diagnosed from 2014 to 2019 at 6 veterinary referral hospitals in Asia. Ultrasonogram images were reviewed and a GBM type (ie, types I-VI) assigned.

Results: Dogs with GBM type V as compared to I (OR, 8.6; 95% CI, 2.6-27.8; P < .001) and III (OR, 10.0; 95% CI, 2.5-40.8; P = .001), and dogs with type VI compared to I (OR, 10.5; 95% CI, 1.8-61.2; P = .009) and III (OR, 12.3; 95% CI, 1.8-83.9; P = .01) were more likely to exhibit signs of biliary tract disease. Independent predictors of death after cholecystectomy included age (OR, 2.81; 95% CI, 1.41-5.59; P = .003) and intraoperative systolic blood pressure (SBP) nadir. There was an interaction between SBP nadir and gallbladder rupture; SBP nadir in dogs with (OR, 0.92; 95% CI, 0.89-0.94; P < .001) and without (OR, 0.88; 95% CI, 0.82-0.93; P < .001) gallbladder rupture.

Conclusion and clinical importance: Increasing developmental stage of GBM could be associated with an increased likelihood of biliary tract related clinical signs. Nadir SBP deserves further investigation as a prognostic or potentially modifiable variable, particularly in the presence of gallbladder rupture.

Keywords: biliary; blood pressure; canine; cholecystectomy; hypotension; survival.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Representative ultrasonogram images of 6 gallbladder mucocele types: (I) organized echogenic debris occupying >30% of lumen, (II) combination of organized echogenic debris with partial stellate strands adhered to the gallbladder wall, (III) stellate pattern, (IV) combination of stellate and kiwi pattern, (V) kiwi pattern with echogenic debris, and (VI) kiwi pattern
FIGURE 2
FIGURE 2
Flow diagram. A total of 216 dogs from 6 veterinary referral hospitals in Asia with gallbladder mucoceles were included in the study
FIGURE 3
FIGURE 3
Box plot illustrating associations between ultrasonographic gallbladder mucocele type and clinical status
FIGURE 4
FIGURE 4
Comparison of intraoperative systolic blood pressure (SBP) nadir in dogs with gallbladder mucocele that underwent cholecystectomy without gallbladder rupture that survived (n = 53) and died (n = 3; A) and in dogs with gallbladder rupture that survived (n = 17) and died (n = 5; B). Enclosed circles represent the mean. Error bars represent SD above and below the mean
See this image and copyright information in PMC

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