Ultrasonographic features of gallbladder wall thickening in dogs with hypoalbuminemia

Abstract

Hypoalbuminemia has been considered as a cause of gallbladder wall thickening in humans and dogs. Recent study revealed that gallbladder wall thickening in dogs with hypoalbuminemia may not be associated with serum albumin/plasma levels within 48 h of ultrasound study. However, gallbladder wall edema may change within 48 h, and the ultrasonographic features of gallbladder wall thickening in dogs with hypoalbuminemia have not been reported. The purpose of this study is to describe the relationship between serum albumin levels within 24 h of ultrasound and gallbladder wall thickening, and to describe the ultrasonographic features of thickened gallbladder walls in dogs with hypoalbuminemia. 37 hypoalbuminemic dogs with gallbladder ultrasound images were retrospectively included. Ultrasound studies were reviewed, and gallbladder wall thickness, layering appearance, echogenicity, echotexture, distribution, evidence of gallbladder mucocele, and presence of peritoneal effusion were recorded. Additionally, serum albumin levels within 24 h of ultrasound study and the administerd sedation were recorded. The prevalence of gallbladder wall thickening in dogs with hypoalbuminemia was 13.5%. The 3-layer appearance of the gallbladder wall was observed in 4 dogs, and a single-layer gallbladder wall thickening in one dog. Diffuse thickening was observed in all 5 dogs. The serum albumin level of dogs with gallbladder wall thickening was not different (p = 0.14) from dogs without thickening. Gallbladder wall thickening was not common, occurring only with mild hypoalbuminemia, and was commonly associated with a 3-layer appearance and considered as gallbladder wall subserosal edema. Causes other than hypoalbuminemia may be responsible for thickening of the gallbladder wall in dogs with hypoalbuminemia.

Keywords: Gallbladder wall edema; canine; hypoproteinemia; ultrasound.

Figure 1.

Gallbladder wall thickness in dogs with hypoalbuminemia. The serum albumin level of the dogs with normal gallbladder wall thickness (<2 mm; Group A) was shown in blue dots and with gallbladder wall thickening (Group B and C) was shown in orange dots. The serum albumin level of the dogs in Group A (1.82 ± 0.33 g/dl) and the dogs in Groups B and C (2.10 ± 0.17 g/dl) was not significantly different (p = 0.14). No correlation was present between the serum albumin level and the gallbladder wall thickness (p = 0.12).

Figure 2.

Ultrasound images of gallbladder wall thickening in dogs with hypoalbuminemia. (A) A mild and diffuse homogeneously hyperechoic gallbladder wall thickening is present. This dog was diagnosed with lymphoma. (B) A mild and diffuse gallbladder wall thickening with a 3-layer appearance. There are thin inner and outer hyperechoic layers and a central hypoechoic layer. This dog was diagnosed with hepatic metastatic carcinoma. (C) A mild and diffuse gallbladder wall thickening with a 3-layer appearance. Hyperechoic lacy striations are present within the central hypoechoic layer. This dog was diagnosed with the caudal vena cava obstruction due to neoplasia associated thrombosis with hepatic congestion and ascites.