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Martinez C, Davies D, Hoey S, Shiel RE, O'Neill EJ. Ultrasonographic measurement of gallbladder wall thickness in fasted dogs without signs of hepatobiliary disease. J Vet Intern Med 2023; 37:1766-1771. [PMID: 37469251 PMCID: PMC10473047 DOI: 10.1111/jvim.16810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 07/03/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Ultrasound-determined gallbladder wall thickness is widely used to aid in the diagnosis of gallbladder disease, but no reference values supported by published measurement data are available in dogs. HYPOTHESIS/OBJECTIVE Establish normal thickness of the gallbladder wall in dogs. ANIMALS Fifty-three dogs presented to a referral hospital and required abdominal ultrasound examination for reasons unrelated to primary hepatobiliary disease. METHODS Cross-sectional observational study recruiting dogs requiring abdominal ultrasound examination. A standard sequence of gallbladder wall images was recorded for later review. Inclusion criteria were normal ultrasonographic hepatobiliary, pancreatic, and small intestinal findings. Exclusion was determined by 2 European College of Veterinary Internal Medicine (ECVIM)-certified veterinary internists blinded to gallbladder wall thickness data. Dogs were excluded if they had inadequate medical records, a previous history of hepatobiliary, gastrointestinal, or pancreatic disease likely to impact the biliary system (eg, chronic vomiting, nausea, jaundice, diarrhea), unexplained increases in liver enzyme activities, hypoalbuminemia, or ascites. Gallbladder wall thickness was determined by 2 European College of Veterinary Diagnostic Imaging (ECVDI)-certified veterinary radiologists working together to generate a consensus for each dog. The final output was the maximum normal wall thickness for this population of dogs. RESULTS The upper limit for gallbladder wall thickness in 53 fasted (8 hours) dogs <40 kg was 1.30 mm (90% confidence interval, 1.19-1.41). CONCLUSIONS AND CLINICAL IMPORTANCE Normal gallbladder wall thickness in dogs is lower than previously reported. Additional studies are required to determine potential effects of body weight and the optimal cut-off to distinguish between healthy and diseased gallbladders.
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Affiliation(s)
- Carlos Martinez
- Department of Internal MedicineAÚNA Especialidades Veterinarias ‐ IVC EvidensiaValenciaSpain
| | | | - Séamus Hoey
- School of Veterinary MedicineUniversity College Dublin, Belfield Co.DublinIreland
| | - Robert E. Shiel
- School of Veterinary MedicineMurdoch UniversityPerthWestern AustraliaAustralia
| | - Emma J. O'Neill
- School of Veterinary MedicineUniversity College Dublin, Belfield Co.DublinIreland
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2
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Butler T, Bexfield N, Dor C, Fantaconi N, Heinsoo I, Kelly D, Kent A, Pack M, Spence SJ, Ward PM, Watson P, McCallum KE. A multicenter retrospective study assessing progression of biliary sludge in dogs using ultrasonography. J Vet Intern Med 2022; 36:976-985. [PMID: 35426163 PMCID: PMC9151485 DOI: 10.1111/jvim.16423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Objectives Animals Methods Results Conclusions and Clinical Importance
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Affiliation(s)
- Thomas Butler
- Queen's Veterinary School Hospital Cambridge United Kingdom
| | - Nick Bexfield
- Queen's Veterinary School Hospital Cambridge United Kingdom
| | - Cecile Dor
- Pride Veterinary Centre and University of Nottingham Nottingham United Kingdom
| | | | - Iris Heinsoo
- Anderson Moores Veterinary Specialists Winchester United Kingdom
| | - Darren Kelly
- Southern Counties Veterinary Specialists Ringwood United Kingdom
| | - Andrew Kent
- Willows Veterinary Centre and Referral Service Solihull United Kingdom
| | - Matthew Pack
- Langford Small Animal Referral Hospital Bristol United Kingdom
| | | | - Patricia M. Ward
- University of Glasgow Small Animal Hospital Glasgow United Kingdom
| | - Penny Watson
- Queen's Veterinary School Hospital Cambridge United Kingdom
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3
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Villm J, DeMonaco S, Larson M. Prevalence of gallbladder sludge and associated abnormalities in cats undergoing abdominal ultrasound. Vet Radiol Ultrasound 2022; 63:601-608. [PMID: 35415932 DOI: 10.1111/vru.13091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/06/2022] [Accepted: 01/16/2022] [Indexed: 11/30/2022] Open
Abstract
The significance of gallbladder sludge in cats remains largely unknown and has been speculated to be a pathologic finding in cats. The objectives of this retrospective, observational study were to determine the prevalence of gallbladder sludge in the population of cats presenting for abdominal ultrasound; to describe clinical signs, laboratory findings and certain abdominal ultrasound abnormalities; and to compare these findings to cats without gallbladder sludge. One hundred and ninety-two cats were included. Medical records were searched for cats with an abdominal ultrasound performed between October 2014-2015. Signalment, clinical signs, complete blood count, biochemical findings, presence or absence of gallbladder sludge, and hepatobiliary and pancreatic ultrasound findings were recorded. Gallbladder sludge was present in 44% of cats that underwent an abdominal ultrasound. There was no significant difference in age, sex, presenting clinical signs or clinicopathologic variables between the two groups. Gallbladder wall thickening significantly increased the odds of detecting gallbladder sludge (OR-3.7 95% CI 1.4 - 10.0). Gallbladder sludge was not associated with other ultrasonographic abnormalities of the liver, gallbladder, bile duct or pancreas. Gallbladder sludge is common in cats undergoing abdominal ultrasound and appears to be a non-specific finding. The clinical significance of concurrent gallbladder sludge and gallbladder wall thickening present on ultrasound in cats remains to be determined.
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Affiliation(s)
- Jessica Villm
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, 215 Duck Pond Drive, Blacksburg, Virginia, 24060, US
| | - Stefanie DeMonaco
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, 215 Duck Pond Drive, Blacksburg, Virginia, 24060, US
| | - Martha Larson
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, 215 Duck Pond Drive, Blacksburg, Virginia, 24060, US
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Wallace ML. Updates in Hepatobiliary Surgery. Vet Clin North Am Small Anim Pract 2022; 52:369-385. [DOI: 10.1016/j.cvsm.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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5
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Chronic Cholecystitis of Dogs: Clinicopathologic Features and Relationship with Liver. Animals (Basel) 2021; 11:ani11113324. [PMID: 34828055 PMCID: PMC8614729 DOI: 10.3390/ani11113324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This study on the gallbladders and livers of 219 client-owned dogs provides a benchmark for future studies on chronic canine cholecystitis. The statistical evaluation of clinical data; histopathology; histochemistry; and immunohistochemistry in this report provides insight into the etiology of chronic cholecystitis in dogs Abstract (1) Background: Chronic cholecystitis of dogs has not been vigorously investigated histopathologically. In addition, the relationship between gallbladder and liver diseases is not known. (2) Methods: We aimed to provide a hallmark for canine chronic cholecystitis using clinical data, histopathology, histochemistry, immunohistochemistry, and statistical analysis. (3) Results: Our investigation of 219 ultrasonographically abnormal surgically resected canine gallbladders revealed 189 cases (86.3%) of mucosal lymphoplasmacytic infiltration (chronic cholecystitis). Sludge, a gravity-dependent or nondependent fine granular hyperechoic material, was more prevalent (105/219, 47.9%) than mucocele (51/219, 23.2%) in this cohort. Mucosal lymphoid follicles were detected in 68/219 cases (31%), suggesting the influence of long-standing antigenic stimulation. Bacteria were histochemically detected in 41/60 (68.3%) of heavily inflamed gallbladders, 18/129 (14%) of lightly inflamed, and 3/18 (16.7%) of uninflamed gallbladders, suggesting a possible relationship between bacteria and chronic cholecystitis. Simultaneous liver biopsies revealed mild or no inflammation, changes consistent with primary portal vein hypoplasia, and mild hepatocellular degeneration. (4) Conclusions: Based on the results of our statistical analysis, we conclude that canine chronic cholecystitis is a long-standing inflammatory process of unknown (but possibly bacterial) etiology and that liver pathology is unlikely the cause of chronic cholecystitis in dogs.
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Viljoen AD, Tamborini A, Bexfield NH. Gall bladder ejection fractions in dogs investigated for chronic altered appetite: 14 cases (2015-2017). J Small Anim Pract 2021; 62:1101-1107. [PMID: 34431090 DOI: 10.1111/jsap.13408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/13/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine if gall bladder dysmotility occurs in dogs investigated for chronic altered appetite and to determine if gall bladder dysmotility warrants further investigation as a contributing factor to altered appetite. MATERIALS AND METHODS Case series of dogs investigated for chronic gastrointestinal disease. Gastrointestinal clinical signs were assessed before and after a 6-week hydrolysed protein diet. Gall bladder ejection fractions were determined at the end of the 6-week hydrolysed protein diet as part of an investigation that included a full blood cell count, biochemistry, abdominal X-rays and ultrasound. The gall bladder ejections fraction results of dogs with normal appetite were compared to dogs with general inappetence and dogs with diurnal inappetence in the morning. RESULTS In this retrospective case series of 14 dogs, altered appetite was the most frequent and persistent clinical sign associated with chronic gastrointestinal disease. Nine dogs had suboptimal gall bladder function and this occurred in dogs with, and without, gravity-dependent biliary sludge. Gall bladder function and volumes of dogs in this study were comparable to those of dogs with nongravity-dependent gall bladder sludge or gall bladder mucoceles in other studies. There was an observable difference in gall bladder ejection fractions between groups defined by appetite but no statistically significant difference was present. Small sample sizes meant the effect size was large. CLINICAL SIGNIFICANCE Gall bladder dysmotility and distension can occur in the absence of gall bladder sludge and mucocoeles in younger dogs. Gall bladder dysmotility requires further investigation as a potential contributing factor to altered appetite in dogs.
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Affiliation(s)
- A D Viljoen
- Vets4Pets Torquay, Bridge Retail Park, Hele Road, Torquay, TQ2 7AP, UK
| | - A Tamborini
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, CB8 0U, UK
| | - N H Bexfield
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
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7
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Viljoen AD, Tamborini A, Watson PJ, Bexfield NH. Clinical characteristics and histology of cholecystectomised dogs with nongravity-dependent biliary sludge: 16 cases (2014-2019). J Small Anim Pract 2021; 62:478-488. [PMID: 33629392 DOI: 10.1111/jsap.13302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/17/2020] [Accepted: 12/29/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To report the available histology, biochemistry and clinical progression of dogs without classic overt biliary tract signs that underwent cholecystectomy for nongravity-dependent biliary sludge. MATERIALS AND METHODS Case series of client-owned dogs for which a cholecystectomy was performed for nongravity-dependent biliary sludge. In six dogs, for which nongravity-dependent biliary sludge filled less than half of gall bladder volume, gall bladder ejection fractions were measured. Available histology, biochemistry, presenting clinical signs and post-surgical clinical progression were reported. RESULTS Sixteen dogs were included in this retrospective case series. No dogs met the histological criteria for gall bladder mucocoeles or had histological evidence of primary hepatitis or cholangitis. Biochemistry was normal for 11 dogs. Hypercholesterolaemia was not noted in any dog. Twelve dogs had cholecystitis (11 lymphoplasmacytic, one neutrophilic) and nine dogs had biliary mucosal hyperplasia. Thirteen dogs had enteritis (12 lymphoplasmacytic, one eosinophilic) and nine dogs had reactive hepatitis (eight lymphoplasmacytic, one neutrophilic). All six dogs with nongravity-dependent biliary sludge that filled less than half of gall bladder volume had sub-optimal gall bladder function. Presenting clinical signs, including diurnal inappetence in the morning and exercise intolerance, resolved in 86% (12/14) of dogs after cholecystectomy and clinical improvement was noted in 81% (13/16) of dogs overall. CLINICAL SIGNIFICANCE Duodenal inflammation could potentially impact gall bladder dysmotility in dogs with nongravity-dependent biliary sludge. Furthermore, diurnal inappetence in the morning and exercise intolerance could indicate symptomatic gall bladder disease in dogs with NDBS and can potentially precede more obvious systemic clinical signs associated with gall bladder mucocoeles.
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Affiliation(s)
- A D Viljoen
- Vets4Pets Torquay, Bridge Retail Park, Hele Road, Torquay, TQ2 7AP, UK
| | - A Tamborini
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, CB8 0U, UK
| | - P J Watson
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - N H Bexfield
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
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Brand EM, Lim CK, Heng HG, Grosso FV, Hanlon J, Jones-Hall Y. Computed tomographic features of confirmed gallbladder pathology in 34 dogs. Vet Radiol Ultrasound 2020; 61:667-679. [PMID: 32918854 DOI: 10.1111/vru.12909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/03/2020] [Accepted: 07/04/2020] [Indexed: 11/30/2022] Open
Abstract
Gallbladder pathology is common in dogs, but published studies describing the computed tomographic (CT) appearance of many gallbladder pathologies are currently lacking. This retrospective, multicenter, cases series, descriptive study evaluated the CT features of confirmed gallbladder pathology in 34 dogs. In this subset of dogs, the most common pathologies included cystic mucosal hyperplasia (15/34, 44.1%), gallbladder wall edema (9/34, 26.5%), gallbladder mucocele (8/34, 23.5%), bactibilia (7/34, 20.6%), cholecystitis (6/34, 17.6%), white bile (6/34, 17.6%), and cholelithiasis (4/34, 11.8%). The presence of intraluminal nodules, gallbladder wall thickening, hyperattenuating material (35-100 HU), and mineral attenuating material (>100 HU) were the most common abnormalities detected. However, overlap of each of these findings with a variety of gallbladder pathologies showed that none of the findings were pathognomonic for any of these pathologies. The presence of any of these CT abnormalities should increase the suspicion of gallbladder pathology and prompt further evaluation of the gallbladder for definitive diagnosis.
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Affiliation(s)
- Emily M Brand
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Chee Kin Lim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Hock Gan Heng
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Federico Vilaplana Grosso
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Jessica Hanlon
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Yava Jones-Hall
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
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9
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Parkanzky M, Grimes J, Schmiedt C, Secrest S, Bugbee A. Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both. J Vet Intern Med 2019; 33:2057-2066. [PMID: 31490022 PMCID: PMC6766501 DOI: 10.1111/jvim.15611] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 08/20/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Gallbladder mucoceles (GBM) typically are treated by cholecystectomy. Medical management rarely has been reported and medical and surgical management have not been compared. HYPOTHESIS/OBJECTIVES To compare survival of dogs treated for GBM by medical management or cholecystectomy or both. ANIMALS Eighty-nine client-owned dogs diagnosed with GBM that received cholecystectomy or medical treatment or both from 2011 to 2017. METHODS Potential cases were identified by searching the medical records database. Data collected included signalment, clinicopathologic results, treatments, and ultrasonographic images and reports. Dogs were grouped according to the treatment received (medical management, surgical treatment, or both) that was chosen at the discretion of the attending veterinarian. Survival analysis was performed and prognostic variables identified and compared between treatment groups. RESULTS Of dogs surviving at least 14 days after diagnosis, median survival times were 1802 (95% confidence interval [CI], 855-not reached) days, 1340 (95% CI, 444-1340) days, and 203 (95% CI, 18-525) days, for the surgical, medical, and medical then surgical treatment groups, respectively, and differed significantly (P < .0001). Gallbladder mucocele type (P = .05), serum alkaline phosphatase activity (P = .0001), and serum creatinine (P = .002) and phosphorus (P = .04) concentrations were associated with decreased survival across groups. Suspicion of biliary rupture on abdominal ultrasound (AUS) examination was correlated with increased survival in the surgical group (P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE Cholecystectomy for the treatment of GBM results in the best long-term survival in dogs surviving the immediate postoperative period (14 days) compared to medical management. Although medical management is associated with shorter survival compared to surgical treatment, it is a reasonable alternative when surgery cannot be pursued.
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Affiliation(s)
- Max Parkanzky
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Janet Grimes
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Andrew Bugbee
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
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Allerton F, Swinbourne F, Barker L, Black V, Kathrani A, Tivers M, Henriques T, Kisielewicz C, Dunning M, Kent A. Gall bladder mucoceles in Border terriers. J Vet Intern Med 2018; 32:1618-1628. [PMID: 30079451 PMCID: PMC6189338 DOI: 10.1111/jvim.15249] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 04/30/2018] [Accepted: 05/24/2018] [Indexed: 12/27/2022] Open
Abstract
Background Gall bladder mucoceles (GBM) are a leading cause of biliary disease in dogs with several breeds, including the Shetland Sheepdog, American Cocker Spaniel, Chihuahua, Pomeranian, and Miniature Schnauzer apparently predisposed. Objective To determine risk factors, clinical features, and response to treatment of GBM in Border terriers (BT). Animals Medical records of 99 dogs (including 51 BT) with an ultrasonographic (±histopathologic) diagnosis of GBM from three referral centers in the United Kingdom were collected. A control group of 87 similar‐aged BT with no ultrasonographic evidence of gall bladder disease was selected for comparison. Method Retrospective case‐control study. Odds ratios were calculated to establish breed predisposition. Signalment, presence of endocrine disease, clinicopathologic results, and outcome were compared between the BT, other breeds, and control BTs. Results The odds of identifying a GBM in a BT in this hospital population was 85 times that of all other breeds (95% confidence interval 56.9‐126.8). BT had similar clinical signs and clinicopathologic changes to other breeds with GBM. There was no evidence that endocrinopathies were associated with GBM in BT. Clinical Significance A robust breed predisposition to GBM is established for the BT.
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Affiliation(s)
- F Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, The United Kingdom
| | - F Swinbourne
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, The United Kingdom
| | - L Barker
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - V Black
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - A Kathrani
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - M Tivers
- Bristol Veterinary School, University of Bristol, Langford, Bristol, BS40 5DU, The United Kingdom
| | - T Henriques
- Pride Veterinary Centre, Riverside Road, Derby, DE24 8HX, The United Kingdom
| | - C Kisielewicz
- Pride Veterinary Centre, Riverside Road, Derby, DE24 8HX, The United Kingdom
| | - M Dunning
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Leicestershire, The United Kingdom
| | - A Kent
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, The United Kingdom
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Bargellini P, Orlandi R, Paloni C, Rubini G, Fonti P, Righi C, Peterson ME, Rishniw M, Boiti C. Contrast-enhanced ultrasound complements two-dimensional ultrasonography in diagnosing gallbladder diseases in dogs. Vet Radiol Ultrasound 2018; 59:345-356. [DOI: 10.1111/vru.12601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 11/02/2017] [Accepted: 11/16/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
| | | | | | | | - Paolo Fonti
- Centro Veterinario Specialistico; 00137 Roma Italy
| | - Cecilia Righi
- Dipartimento di Diagnostica Generale e Benessere Animale; Istituto Zooprofilattico Sperimentale dell'Umbria e della Marche; 06126 Perugia Italy
| | - Mark E. Peterson
- Endocrinology & Nuclear Medicine; Animal Endocrine Clinic; New York NY 10025
| | | | - Cristiano Boiti
- Dipartimento di Medicina veterinaria; Università degli Studi di Perugia; 06126 Perugia Italy
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Schiborra F, McConnell JF, Maddox TW. Percutaneous ultrasound-guided cholecystocentesis: complications and association of ultrasonographic findings with bile culture results. J Small Anim Pract 2017; 58:389-394. [DOI: 10.1111/jsap.12697] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 03/06/2017] [Accepted: 04/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- F. Schiborra
- Small Animal Teaching Hospital; University of Liverpool; Neston Cheshire CH64 7TE UK
| | - J. F. McConnell
- Small Animal Teaching Hospital; University of Liverpool; Neston Cheshire CH64 7TE UK
| | - T. W. Maddox
- Small Animal Teaching Hospital; University of Liverpool; Neston Cheshire CH64 7TE UK
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