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Mitsui I, Uchida K. Canine Gallbladder Erosion/Ulcer and Hemocholecyst: Clinicopathological Characteristics of 14 Cases. Animals (Basel) 2023; 13:3335. [PMID: 37958090 PMCID: PMC10649012 DOI: 10.3390/ani13213335] [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: 07/21/2023] [Revised: 10/08/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
(1) Background: Gallbladder mucosal erosion and/or ulceration are illnesses associated with unexpected gallbladder intra-cystic bleeding (hemocholecyst), an under-reported problem in dogs. (2) Methods: Clinicopathological characteristics of 14 dogs with gallbladder erosion/ulcer were investigated in this single-center retrospective study using clinical data and archived gallbladder tissues of client-owned dogs. (3) Results: Canine gallbladder erosion/ulcer tends to occur in older, neutered dogs of various breeds. Vomiting, lethargy, and anorexia are common. Concurrent gallbladder rupture occurred in 5/14 cases (35.7%), while rupture was absent in 6/14 cases (42.8%) and undetermined in 3/14 (21.4%) cases. Histologically, the gallbladder wall was markedly thickened due to mucosal hyperplasia, inflammatory infiltrates, fibrosis, edema, hemorrhage, and smooth muscle hyperplasia/hypertrophy. Twelve out of fourteen cases (85.7%) had concurrent cholecystitis of varying severity. Bacteria were detected by Giemsa or Warthin-Starry stain in 8/14 (57.1%) cases. Bacterial rods immunoreactive to the anti-Helicobacter antibody were present in one case. Mucosal epithelial cells of the gallbladder erosion/ulcer cohort were immunopositive for the cyclooxygenases COX-1 or COX-2 in only 5/14 (35.7%) cases. In contrast, COX-1 and COX-2 were more frequently expressed in a reference pool of cases of gallbladder mucocele (n = 5) and chronic cholecystitis (n = 5). COX-1 was expressed in 9/10 cases (90.0%) of gallbladder mucocele and chronic cholecystitis and in 10/10 cases (100%) for COX-2. (4) Conclusions: Canine gallbladder erosion/ulcer is an under-reported condition which requires active clinical intervention. Based on the clinicopathological information reported in this study in addition to the COX-1 and COX-2 IHC results, we suggest that canine gallbladder erosion/ulcer may be related to decreased cytoprotection physiologically provided by arachidonic acid, but which is decreased or absent due to reduced COX expression because of yet undetermined etiologies.
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Affiliation(s)
- Ikki Mitsui
- Laboratory of Veterinary Anatomy, Faculty of Veterinary Medicine, Okayama University of Science, Imabari 794-8555, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Bunkyo-ku, Tokyo 113-8657, Japan;
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2
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Gookin JL, Hartley AN, Aicher KM, Mathews KG, Cullen R, Cullen JM, Callahan BJ, Stowe DM, Seiler GS, Jacob ME, Arnold JW, Azcarate-Peril MA, Stauffer SH. Gallbladder microbiota in healthy dogs and dogs with mucocele formation. PLoS One 2023; 18:e0281432. [PMID: 36763596 PMCID: PMC9916591 DOI: 10.1371/journal.pone.0281432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
To date studies have not investigated the culture-independent microbiome of bile from dogs, a species where aseptic collection of bile under ultrasound guidance is somewhat routine. Despite frequent collection of bile for culture-based diagnosis of bacterial cholecystitis, it is unknown whether bile from healthy dogs harbors uncultivable bacteria or a core microbiota. The answer to this question is critical to understanding the pathogenesis of biliary infection and as a baseline to exploration of other biliary diseases in dogs where uncultivable bacteria could play a pathogenic role. A pressing example of such a disease would be gallbladder mucocele formation in dogs. This prevalent and deadly condition is characterized by excessive secretion of abnormal mucus by the gallbladder epithelium that can eventually lead to rupture of the gallbladder or obstruction of bile flow. The cause of mucocele formation is unknown as is whether uncultivable, and therefore unrecognized, bacteria play any systematic role in pathogenesis. In this study we applied next-generation 16S rRNA gene sequencing to identify the culture-negative bacterial community of gallbladder bile from healthy dogs and gallbladder mucus from dogs with mucocele formation. Integral to our study was the use of 2 separate DNA isolations on each sample using different extraction methods and sequencing of negative control samples enabling recognition and curation of contaminating sequences. Microbiota findings were validated by simultaneous culture-based identification, cytological examination of bile, and fluorescence in-situ hybridization (FISH) performed on gallbladder mucosa. Using culture-dependent, cytological, FISH, and 16S rRNA sequencing approaches, results of our study do not support existence of a core microbiome in the bile of healthy dogs or gallbladder mucus from dogs with mucocele formation. Our findings further document how contaminating sequences can significantly contribute to the results of sequencing analysis when performed on samples with low bacterial biomass.
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Affiliation(s)
- Jody L. Gookin
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| | - Ashley N. Hartley
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kathleen M. Aicher
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kyle G. Mathews
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Rachel Cullen
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - John M. Cullen
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Benjamin J. Callahan
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Devorah M. Stowe
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Megan E. Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Jason W. Arnold
- Department of Medicine, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Andrea Azcarate-Peril
- Department of Medicine, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Stephen H. Stauffer
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
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Biedrzycki AH, Roe HA. Septic cholecystitis in a goat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Adam H. Biedrzycki
- Department of Large Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
| | - Heather A. Roe
- Department of Large Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville Florida USA
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4
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Jaffey JA. Canine extrahepatic biliary disease: what have we learned? J Small Anim Pract 2021; 63:247-264. [PMID: 34935155 DOI: 10.1111/jsap.13468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/01/2021] [Accepted: 12/02/2021] [Indexed: 12/07/2022]
Abstract
Extrahepatic biliary disease in dogs is commonly encountered in clinical practice worldwide. Diseases in this segment of the biliary tract are diverse and can manifest with mild clinical signs or can be life-threatening. In the last decade there have been advances in diagnostic tests, imaging modalities and therapeutic interventions as well as the identification of novel prognostic variables that could improve outcomes in dogs with extrahepatic biliary disease. Therefore, the objective of this review was to summarise clinically relevant updates of extrahepatic biliary disease in dogs.
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Affiliation(s)
- J A Jaffey
- Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, 85308, USA
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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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Verwey E, Gal A, Kettner F, Botha WJ, Pazzi P. Prevalence of subclinical bactibilia in apparently healthy shelter dogs. J Small Anim Pract 2021; 62:948-958. [PMID: 34264529 DOI: 10.1111/jsap.13398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 06/04/2021] [Accepted: 06/19/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine the prevalence of subclinical bactibilia in apparently healthy shelter dogs and characterise serum liver enzymes activities, hepatobiliary histopathology and bile cytology in apparently healthy dogs with and without bactibilia. MATERIALS AND METHODS Healthy, abandoned dogs euthanased for non-medical reasons were prospectively recruited for this cross-sectional study. Whole blood, collected immediately before euthanasia, was submitted for serum liver enzyme activity (alkaline phosphatase, alanine aminotransferase and gamma-glutamyl transferase) analyses. Bile, gall bladder and liver samples were collected aseptically from dogs within 25 minutes of euthanasia. Bile was submitted for bacterial culture and cytology in all dogs. Gall bladder and liver samples were submitted for histopathological examination in bactibilic dogs and nine randomly selected non-bactibilic dogs. RESULTS Sixty-five healthy dogs were included in this study. Bactibilia was diagnosed in 10.8% (7/65) of dogs, with 9.2% (6/65) of dogs diagnosed on cytological examination and 4.6% (3/65) on culture. Elevated alanine aminotransferase activities were present in one bactibilic and five non-bactibilic dogs; and elevated gamma-glutamyl transferase activities in one bactibilic and two non-bactibilic dogs. No dogs had elevated alkaline phosphatase activities. Histopathological changes in bactibilic and non-bactibilic dogs included lymphoplasmocellular cholecystitis (7/7 and 9/9), gall bladder oedema (7/7 and 9/9), hepatic vacuolar degeneration (6/7 and 8/9), cholangitis (5/7 and 7/9), hepatic nodular hyperplasia (3/7 and 5/9) and hepatic cholestasis (2/7 and 4/9). CLINICAL SIGNIFICANCE This study confirms that subclinical bactibilia occurs in a small number of apparently healthy shelter dogs and that subclinical hepatobiliary histopathological abnormalities can occur in apparently healthy bactibilic and non-bactibilic dogs.
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Affiliation(s)
- E Verwey
- Internal Medicine Clinic, Tygerberg Animal Hospital, Cape Town, South Africa
| | - A Gal
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - F Kettner
- Internal Medicine Clinic, Tygerberg Animal Hospital, Cape Town, South Africa
| | - W J Botha
- Medicine Clinic, Panorama Veterinary Clinic and Specialist Centre, Cape Town, South Africa
| | - P Pazzi
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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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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8
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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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Hinson WD, Rogovskyy AS, Lawhon SD, Thieman Mankin KM. Influence of a cell salvage washing system and leukocyte reduction filtration on bacterial contamination of canine whole blood ex vivo. Vet Surg 2020; 49:989-996. [PMID: 32166777 DOI: 10.1111/vsu.13410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/12/2019] [Accepted: 02/24/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine the ability of cell salvage washing and leukoreduction filtration to remove bacterial contamination from canine whole blood. STUDY DESIGN Ex vivo nested cohort study. SAMPLE POPULATION Commercially purchased fresh canine whole blood (n = 33 units). METHODS Commercially obtained canine whole blood was inoculated with known concentrations of one of three species of bacteria, Escherichia coli (ATCC 25922), Staphylococcus pseudintermedius (quality control strain; Texas A&M University), or Pseudomonas aeruginosa (ATCC 27853). Negative controls were inoculated with sterile saline. The inoculated blood was processed through a cell salvage system and filtered through a series of two leukocyte reduction filters. Samples were aseptically collected at five points during processing (inoculum, prewash, postwash, post-first filtration, and post-second filtration) for bacterial enumeration. RESULTS Bacterial concentrations were reduced by 85.2%, 91.5%, and 93.9% for E coli, S pseudintermedius, and P aeruginosa, respectively, after washing (P < .0001), and bacterial concentrations were reduced by 99.9%, 100%, and 100%, respectively, after the first filtration (P < .0001). After the second filtration, none of the three species of bacteria could be isolated (100% reduction). No bacterial growth was obtained from negative controls throughout the study. The type of bacteria (P = .29) did not allow prediction of bacterial reduction. CONCLUSION Cell salvage washing combined with leukoreduction filtration eliminated bacterial contamination of whole dog blood (P < .0001). CLINICAL SIGNIFICANCE Cell salvage washing and leukoreduction filtration could be applied to intraoperative autotransfusion in clinical animals, especially those treated for trauma or hemorrhage with concurrent bacterial contamination.
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Affiliation(s)
- Whitney D Hinson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Artem S Rogovskyy
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
| | - Kelley M Thieman Mankin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M College of Veterinary Medicine, College Station, Texas
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Whittemore JC, Moyers TD, Price JM. Randomized, controlled, crossover trial of prevention of antibiotic-induced gastrointestinal signs using a synbiotic mixture in healthy research dogs. J Vet Intern Med 2019; 33:1619-1626. [PMID: 31268578 PMCID: PMC6639531 DOI: 10.1111/jvim.15553] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 06/21/2019] [Indexed: 12/11/2022] Open
Abstract
Background Synbiotics decrease antibiotic‐associated gastrointestinal signs (AAGS) in cats, but data supporting synbiotic use to ameliorate AAGS in dogs are lacking. Objectives To determine if administration of synbiotics mitigates AAGS in dogs. Animals Twenty‐two healthy research dogs. Methods Randomized, double‐blinded, placebo‐controlled, 2‐way, 2‐period, crossover study with an 8‐week washout period. Each period included a 1‐week baseline and 3‐week treatment phase. Dogs received enrofloxacin (10 mg/kg PO q24h) and metronidazole (12.5 mg/kg PO q12h), followed 1 hour later by a bacterial/yeast synbiotic combination or placebo. Food intake, vomiting, and fecal score were compared using repeated‐measures crossover analyses, with P < .05 considered significant. Results Hyporexia, vomiting, and diarrhea occurred in 41% (95% confidence interval [CI], 21‐64), 77% (95% CI, 55‐92), and 100% (95% CI, 85‐100) of dogs, respectively, during the first treatment period. Derangements in food intake were smaller in both periods for dogs receiving synbiotics (F‐value, 5.1; P = .04) with treatment‐by‐period interactions (F‐value, 6.0; P = .02). Days of vomiting differed over time (F‐value, 4.7; P = .006). Fecal scores increased over time (F‐value, 33.5; P < .001), were lower during period 2 (F‐value, 14.5; P = .001), and had treatment‐by‐period effects (F‐value, 4.8; P = .04). Conclusions and Clinical Importance Enrofloxacin/metronidazole administration is associated with a high frequency of AAGS. Synbiotic administration decreases food intake derangements. The presence of milder AAGS in period 2 suggests that clinical effects of synbiotics persist >9 weeks after discontinuation, mitigating AAGS in dogs being treated with antibiotics followed by placebo.
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Affiliation(s)
- Jacqueline C Whittemore
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Tamberlyn D Moyers
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Joshua M Price
- Office of Information Technology, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
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11
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Harrison JL, Turek BJ, Brown DC, Bradley C, Callahan Clark J. Cholangitis and Cholangiohepatitis in Dogs: A Descriptive Study of 54 Cases Based on Histopathologic Diagnosis (2004-2014). J Vet Intern Med 2017; 32:172-180. [PMID: 29131399 PMCID: PMC5787197 DOI: 10.1111/jvim.14866] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 08/10/2017] [Accepted: 10/11/2017] [Indexed: 12/15/2022] Open
Abstract
Background Cholangitis in dogs appears to be more common than previously thought, but understanding of the disease remains incomplete. Objective To describe a population of dogs with cholangitis or cholangiohepatitis. Animals Fifty‐four client‐owned dogs with cholangitis or cholangiohepatitis. Methods Medical records of dogs with cholangitis or cholangiohepatitis confirmed by histopathology between January 2004 and December 2014 were identified using a computer‐based search and retrospectively reviewed. Results Clinical signs included vomiting (72.2%), lethargy (70.4%), and inappetence (64.8%). Most dogs (49/50) had increased liver enzyme activities, hyperbilirubinemia (32/50), and hypercholesterolemia (24/43). Ultrasonographic abnormalities of the hepatobiliary system were seen in 84% of cases. On histopathology, 53 of 54 affected dogs had neutrophilic cholangitis (NC) or cholangiohepatitis, whereas 1 dog had lymphocytic cholangitis. Most cases (42/54) were chronic. Evidence of concurrent biliary disease (46.2%) and biliary tract obstruction (42.6%) was common. Seventeen of 36 biliary and 11 of 25 liver cultures were positive for bacterial growth; Escherichia coli and Enterococcus spp. were most common. Median patient survival was 671 days (95% confidence interval [CI]: 114–1,426). On Cox regression, dogs that did not have a cholecystectomy performed had a 2.1 greater hazard for death (P = 0.037; 95% CI: 1.0–4.3) compared to cholecystectomized dogs. Dogs >13 years old had a 5.0 greater hazard for death (P = 0.001; 95% CI: 1.9–13.2) compared to younger dogs. Conclusions and Clinical Significance Chronic NC or cholangiohepatitis was most common. Cholecystitis and biliary tract obstruction often occurred in conjunction with cholangitis. Cholecystectomized dogs had decreased risk of death; thus, cholecystectomy may improve patient outcome.
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Affiliation(s)
- J L Harrison
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - B J Turek
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - D C Brown
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - C Bradley
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - J Callahan Clark
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
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12
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Policelli Smith R, Gookin JL, Smolski W, Di Cicco MF, Correa M, Seiler GS. Association between Gallbladder Ultrasound Findings and Bacterial Culture of Bile in 70 Cats and 202 Dogs. J Vet Intern Med 2017; 31:1451-1458. [PMID: 28755468 PMCID: PMC5598895 DOI: 10.1111/jvim.14792] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/05/2017] [Accepted: 06/22/2017] [Indexed: 12/03/2022] Open
Abstract
Background Bacterial cholecystitis often is diagnosed by combination of gallbladder ultrasound (US) findings and positive results of bile culture. The value of gallbladder US in determining the likelihood of bile bacterial infection in cats and dogs with suspected biliary disease is unknown. Hypothesis/Objectives To determine the value of gallbladder US in predicting bile bacterial culture results, identify most common bacterial isolates from bile, and describe complications after cholecystocentesis in cats and dogs with suspected hepatobiliary disease. Animals Cats (70) and dogs (202) that underwent an abdominal US and submission of bile for culture were included in the study. Methods A cross‐sectional study design was used to determine the association of gallbladder US abnormalities and the results of bile cultures, and complications of cholecystocentesis. Results Abnormal gallbladder US had high sensitivity (96%) but low specificity (49%) in cats with positive and negative results of bile bacterial culture, respectively. Cats with normal gallbladder US findings were unlikely to have positive bile bacterial culture (negative predictive value of 96%). Gallbladder US had lower sensitivity (81%), specificity (31%), positive predictive value (20%), and negative predictive value (88%) in dogs. The most common bacterial isolates were of enteric origin, the prevalence being higher in cats. Incidence of complications after cholecystocentesis was 3.4%. Conclusions and clinical importance Gallbladder US has a high negative predictive value for bile culture results in cats. This modality is less predictive of infection in dogs. Percutaneous US‐guided cholecystocentesis has a low complication rate.
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Affiliation(s)
- R Policelli Smith
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - J L Gookin
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - W Smolski
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - M F Di Cicco
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - M Correa
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - G S Seiler
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
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Affiliation(s)
| | - Vera Geisen
- Ludwig Maximilian University, Munich, Germany
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14
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Pashmakova MB, Piccione J, Bishop MA, Nelson WR, Lawhon SD. Agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia in dogs and cats with hepatobiliary disease. J Am Vet Med Assoc 2017; 250:1007-1013. [DOI: 10.2460/javma.250.9.1007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Mizutani S, Torisu S, Kaneko Y, Yamamoto S, Fujimoto S, Ong BHE, Naganobu K. Retrospective analysis of canine gallbladder contents in biliary sludge and gallbladder mucoceles. J Vet Med Sci 2016; 79:366-374. [PMID: 27990011 PMCID: PMC5326943 DOI: 10.1292/jvms.16-0562] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The pathophysiology of canine gallbladder diseases, including biliary sludge, gallbladder
mucoceles and gallstones, is poorly understood. This study aimed to evaluate the component
of gallbladder contents and bacterial infection of the gallbladder in order to elucidate
the pathophysiology of biliary sludge and gallbladder mucoceles. A total of 43 samples of
canine gallbladder contents (biliary sludge, 21 and gallbladder mucoceles, 22) were
subjected to component analysis by infrared spectroscopy, and the resultant infrared
spectra were compared with that of swine mucin. Of the 43 samples, 41 were also evaluated
by aerobic and anaerobic bacterial culture. The contents of 20 (95.2%) biliary sludge and
22 (100%) gallbladder mucocele samples exhibited similar infrared spectra as swine mucin.
Although biliary sludge and gallbladder mucocele contents exhibited similar infrared
spectra, one sample of biliary sludge (4.8%) was determined to be composed of proteins.
The rate of bacterial infection of the gallbladder was 10.0% for biliary sludge and 14.3%
for gallbladder mucoceles. Almost all of the identified bacterial species were intestinal
flora. These results indicate that the principal components of gallbladder contents in
both gallbladder mucoceles and biliary sludge are mucins and that both pathophysiologies
exhibit low rates of bacterial infection of the gallbladder. Therefore, it is possible
that gallbladder mucoceles and biliary sludge have the same pathophysiology, and, rather
than being independent diseases, they could possibly represent a continuous disease. Thus,
biliary sludge could be considered as the stage preceding the appearance of gallbladder
mucoceles.
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Affiliation(s)
- Shinya Mizutani
- University of Miyazaki Veterinary Teaching Hospital, 1-1 Gakuen Kibana-dai Nishi, Miyazaki City, Miyazaki 889-2192, Japan
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16
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Bargellini P, Orlandi R, Paloni C, Rubini G, Fonti P, Peterson ME, Rishniw M, Boiti C. EVALUATION OF CONTRAST-ENHANCED ULTRASONOGRAPHY AS A METHOD FOR DETECTING GALLBLADDER NECROSIS OR RUPTURE IN DOGS. Vet Radiol Ultrasound 2016; 57:611-620. [DOI: 10.1111/vru.12404] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 01/29/2023] Open
Affiliation(s)
| | | | - Chiara Paloni
- Tyrus Clinica Veterinaria; Via Bartocci 1G 05100 Terni Italy
| | - Giuseppe Rubini
- Ultravet Diagnostic; Via E. Fermi 59 40017 S. Giovanni in Persiceto Bologna Italy
| | - Paolo Fonti
- Centro Veterinario Specialistico; Via S. Giovannini 51 00137 Roma Italy
| | | | - Mark Rishniw
- Veterinary Information Network; 777 W Covell Blvd Davis CA
| | - Cristiano Boiti
- Dipartimento di Medicina Veterinaria; Università di Perugia; Via S. Costanzo 4 06126 Perugia Italy
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Tamborini A, Jahns H, McAllister H, Kent A, Harris B, Procoli F, Allenspach K, Hall EJ, Day MJ, Watson PJ, O'Neill EJ. Bacterial Cholangitis, Cholecystitis, or both in Dogs. J Vet Intern Med 2016; 30:1046-55. [PMID: 27203848 PMCID: PMC5084764 DOI: 10.1111/jvim.13974] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/12/2016] [Accepted: 04/27/2016] [Indexed: 12/18/2022] Open
Abstract
Background Bacterial cholangitis and cholecystitis are rarely reported, poorly characterized diseases in the dog. Objectives To characterize the clinical features of these conditions. Animals Twenty‐seven client‐owned dogs with bacterial cholangitis, cholecystitis, or both. Methods Multicenter, retrospective cases series of dogs with bacterial cholangitis, cholecystitis, or both, presenting January 2000 to June 2011 to 4 Veterinary Schools in Ireland/United Kingdom. Interrogation of hospital databases identified all cases with the inclusion criteria; histopathologically confirmed cholangitis or cholecystitis and bile culture/cytology results supporting a bacterial etiology. Results Twenty‐seven dogs met the inclusion criteria with approximately 460 hepatitis cases documented over the same study period. Typical clinical pathology findings were increases in liver enzyme activities (25/26), hyperbilirubinemia (20/26), and an inflammatory leukogram (21/24). Ultrasound findings, although nonspecific, aided decision‐making in 25/26 cases. The most frequent hepatobiliary bacterial isolates were Escherichia coli (n = 17; 16 cases), Enterococcus spp. (n = 8; 6 cases), and Clostridium spp. (n = 5; 5 cases). Antimicrobial resistance was an important feature of aerobic isolates; 10/16 E. coli isolates resistant to 3 or more antimicrobial classes. Biliary tract rupture complicated nearly one third of cases, associated with significant mortality (4/8). Discharged dogs had a guarded to fair prognosis; 17/18 alive at 2 months, although 5/10 re‐evaluated had persistent liver enzyme elevation 2–12 months later. Conclusion and Clinical Significance Bacterial cholangitis and cholecystitis occur more frequently than suggested by current literature and should be considered in dogs presenting with jaundice and fever, abdominal pain, or an inflammatory leukogram or with ultrasonographic evidence of gallbladder abnormalities.
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Affiliation(s)
- A Tamborini
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - H Jahns
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - H McAllister
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - A Kent
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - B Harris
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - F Procoli
- Department of Veterinary Clinical Sciences, Royal Veterinary College, London, UK
| | - K Allenspach
- Department of Veterinary Clinical Sciences, Royal Veterinary College, London, UK
| | - E J Hall
- School of Veterinary Sciences, University of Bristol, Bristol, UK
| | - M J Day
- School of Veterinary Sciences, University of Bristol, Bristol, UK
| | - P J Watson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - E J O'Neill
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
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Peters LM, Glanemann B, Garden OA, Szladovits B. Cytological Findings of 140 Bile Samples from Dogs and Cats and Associated Clinical Pathological Data. J Vet Intern Med 2015; 30:123-31. [PMID: 26566964 PMCID: PMC4913648 DOI: 10.1111/jvim.13645] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/17/2015] [Accepted: 09/16/2015] [Indexed: 11/30/2022] Open
Abstract
Background Cholecystocentesis can be part of the diagnostic workup of hepatobiliary disease in small animals, but literature on cytological evaluation of bile is scant. Objectives To determine the diagnostic utility of cytological assessment of bile aspirates. Animals Fifty‐six and 78 client‐owned dogs and cats, respectively, with bile collected by cholecystocentesis and submitted to our diagnostic laboratory between 1999 and 2014. Methods Retrospective study describing cytological findings of bile, concurrent bacterial culture results, hematological and serum biochemical data, gallbladder biopsy results, as well as final diagnosis and complications after cholecystocentesis. Results Infectious agents were found in 30% of canine and 22% of feline bile aspirates, and inflammation in 5% and 19% respectively. Presence of microorganisms was more often detected on cytological examination (24%) than by culture (21%). The most common bacterial isolates were Escherichia coli and Enterococcus spp., isolated from 14.8% and 6.7% of cultured samples respectively. Only increased canine pancreatic lipase immunoreactivity concentration (cPLI) was significantly associated with the presence of microorganisms, inflammatory cells, or both in bile. Clinically relevant complications of cholecystocentesis occurred in 2 dogs. The majority of the animals undergoing cholecystocentesis suffered from hepatic, pancreatic, gastrointestinal disease, or a combination thereof. Conclusions and Clinical Importance Cytological examination of bile is inexpensive and straightforward, and yields diagnostically relevant information that precedes and complements bacterial culture.
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Affiliation(s)
- L M Peters
- Departments of Pathology and Pathogen Biology, The Royal Veterinary College, Hertfordshire, UK
| | - B Glanemann
- Clinical Sciences and Services, The Royal Veterinary College, Hertfordshire, UK
| | - O A Garden
- Clinical Sciences and Services, The Royal Veterinary College, Hertfordshire, UK
| | - B Szladovits
- Departments of Pathology and Pathogen Biology, The Royal Veterinary College, Hertfordshire, UK
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