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Jaffey JA, Pavlick M, Webster CR, Moore GE, McDaniel KA, Blois SL, Brand EM, Reich CF, Motschenbacher L, Hostnik ET, Su D, Lidbury JA, Raab O, Carr SV, Mabry KE, Fox-Alvarez W, Townsend S, Palermo S, Nakazono Y, Ohno K, VanEerde E, Fieten H, Hulsman AH, Cooley-Lock K, Dunning M, Kisielewicz C, Zoia A, Caldin M, Conti-Patara A, Ross L, Mansfield C, Lynn O, Claus MA, Watson PJ, Swallow A, Yool DA, Gommeren K, Knops M, Ceplecha V, de Rooster H, Lobetti R, Dossin O, Jolivet F, Papazoglou LG, Pappalardo MCF, Manczur F, Dudás-Györki Z, O'Neill EJ, Martinez C, Gal A, Owen RL, Gunn E, Brown K, Harder LK, Griebsch C, Anfinsen KP, Gron TK, Marchetti V, Heilmann RM, Pazzi P, DeClue AE. Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele. Vet J 2019; 251:105350. [PMID: 31492387 DOI: 10.1016/j.tvjl.2019.105350] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 07/27/2019] [Accepted: 07/28/2019] [Indexed: 12/21/2022]
Abstract
Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14-8.23; P<0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19-3.77; P=0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08-3.47; P=0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10-5.50; P=0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30-0.72; P=0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01-1.04; P<0.001) and age (OR, 1.17; 95% CI, 1.08-1.26; P<0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54-0.69) and a specificity of 0.63 (95% CI, 0.59-0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study.
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Affiliation(s)
- J A Jaffey
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA.
| | - M Pavlick
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA
| | - C R Webster
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA
| | - G E Moore
- Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47907, USA
| | - K A McDaniel
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA
| | - S L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - E M Brand
- Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - C F Reich
- Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - L Motschenbacher
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1352 Boyd Avenue, C-325, St Paul, MN, USA
| | - E T Hostnik
- Department of Veterinary Clinical Sciences, Veterinary Medical Center, Ohio State University, 601 Vernon L Tharp Street Columbus, OH, 43210, USA
| | - D Su
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, 37996, USA
| | - J A Lidbury
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843, USA
| | - O Raab
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3, Canada
| | - S V Carr
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 215 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - K E Mabry
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 215 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - W Fox-Alvarez
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32608, USA
| | - S Townsend
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32608, USA
| | - S Palermo
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Nakazono
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - K Ohno
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - E VanEerde
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010, USA
| | - H Fieten
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - A H Hulsman
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - K Cooley-Lock
- Department of Clinical Sciences, College of Veterinary Medicine, P.O. Box 6100, Mississippi State University, Mississippi State, MS, 39762-6100, USA
| | - M Dunning
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
| | - C Kisielewicz
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
| | - A Zoia
- San Marco Veterinary Clinic, via Sorio 114c, 35141, Padua, Italy
| | - M Caldin
- San Marco Veterinary Clinic, via Sorio 114c, 35141, Padua, Italy
| | - A Conti-Patara
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, 99164, USA
| | - L Ross
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, 36849, USA
| | - C Mansfield
- Faculty of Veterinary Science, The University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - O Lynn
- Faculty of Veterinary Science, The University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - M A Claus
- Comparative Health Research Group, College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - P J Watson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, United Kingdom
| | - A Swallow
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, United Kingdom
| | - D A Yool
- Division of Veterinary Clinical Sciences, Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Midlothian, EH25 9RG, United Kingdom
| | - K Gommeren
- Department of Clinical Sciences, Small Animal Medicine, Faculty of Veterinary Medicine, University of Liege, Liege, Belgium
| | - M Knops
- Department of Clinical Sciences, Small Animal Medicine, Faculty of Veterinary Medicine, University of Liege, Liege, Belgium
| | - V Ceplecha
- Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackeho 1/3, 612 42, Brno, Czech Republic
| | - H de Rooster
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - R Lobetti
- Bryanston Veterinary Hospital, P.O. Box 67092, Bryanston, South Africa
| | - O Dossin
- Department of Small Animal Clinical Sciences, ENVT and IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France
| | - F Jolivet
- Department of Small Animal Clinical Sciences, ENVT and IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France
| | - L G Papazoglou
- Department of Clinical Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M C F Pappalardo
- Vet Support, Small Animal Intensive Care Medicine, Sao Paulo, 04082-002, Brazil
| | - F Manczur
- Department and Clinic of Internal Medicine, University of Veterinary Medicine, H-1400, P.O. Box 2, Hungary
| | - Z Dudás-Györki
- Department and Clinic of Internal Medicine, University of Veterinary Medicine, H-1400, P.O. Box 2, Hungary
| | - E J O'Neill
- Department of Veterinary Clinical Studies, School of Veterinary Medicine, University of Dublin, Belfield, Dublin 4, Ireland
| | - C Martinez
- Department of Veterinary Clinical Studies, School of Veterinary Medicine, University of Dublin, Belfield, Dublin 4, Ireland
| | - A Gal
- School of Veterinary Science, Massey University, Palmerston North, 4410, New Zealand
| | - R L Owen
- School of Veterinary Science, Massey University, Palmerston North, 4410, New Zealand
| | - E Gunn
- University of Glasgow Small Animal Hospital, Bearsden Road, Glasgow, G61 1QH, United Kingdom
| | - K Brown
- University of Glasgow Small Animal Hospital, Bearsden Road, Glasgow, G61 1QH, United Kingdom
| | - L K Harder
- Small Animal Hospital, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany
| | - C Griebsch
- University Veterinary Teaching Hospital Sydney, The University of Sydney, 65 Parramatta Road, 2050, Camperdown, New South Wales, Australia
| | - K P Anfinsen
- Department of Companion Animal Clinical Sciences, NMBU School of Veterinary Science, N-0033, Oslo, Norway
| | - T K Gron
- Department of Companion Animal Clinical Sciences, NMBU School of Veterinary Science, N-0033, Oslo, Norway
| | - V Marchetti
- Department of Veterinary Science, University of Pisa, Via Livornese lato monte, 56122, San Piero a Grado, Pisa, Italy
| | - R M Heilmann
- Small Animal Clinic, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Leipzig, An den Tierkliniken 23, DE-04103, Leipzig, Saxony, Germany
| | - P Pazzi
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Old Soutpan Road, Onderstepoort, 0110, South Africa
| | - A E DeClue
- Pride Veterinary Centre, Riverside Road, Pride Park, Derby, UK
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