Gallbladder and Bile Duct Inflammation in Dogs
Cholecystitis and Choledochitis in Dogs
The gallbladder rests in the abdomen, firmly affixed to the liver and serving as a storage receptacle for bile, a fluid that is essential for digesting food in the stomach and intestines. The bile duct transports bile from the liver into the gallbladder and into the small intestine, and the liver functions in the secretion of the bile. All of the components of this digestive system work in together, and if one fails to function properly, the result is that most of the body will suffer ill effects. Inflammation of the gallbladder is sometimes associated with gallstones, and is often associated with obstruction and/or inflammation of the common bile duct and/or the liver/bile system. Severe cases can result in rupture of the gallbladder and subsequent severe inflammation of the bile duct, resulting in combined surgical and medical treatments.
Malignant gallbladder disease in dogs usually occurs at middle-aged or older. Dogs with enlarged livers are more likely to get disease of the gallbladder, which will interfere with the flow of bile, and which, in turn causes inflammation in the gallbladder.
Symptoms and Types
Some of the symptoms of an inflamed gallbladder or bile duct are a sudden loss of appetite, lethargy, vomiting and abdominal pain. Mild to moderate jaundice with fever is common with conditions of the bile duct. Look for yellow eyes and yellowing of the gums. Shock can occur due to infection with symptoms of shallow breathing, abnormally low body temperature (normal for a dog is 101-102.5 degrees F), gray gums and a weak but rapid pulse.
The causes for an inflamed gallbladder or bile duct can be from one or more conditions that will lead up to it. Muscles in the gallbladder may be malfunctioning, which can lead to impaired bile flow in the cystic duct or gallbladder, irritating the wall of the gallbladder. Or the blood supply to the gallbladder wall is being restricted, in which case the cause for the restriction must be isolated and treated to improve the blood flow. Irritants in the bile can cause the bile duct to be overly sensitive and reactive. Previous abdominal surgery or trauma to the abdomen, can directly lead to internal sensitivity, affecting one or many of the internal organs, including the liver and gallbladder.
Some of the more common intestinal disorders that your veterinarian will look for to confirm or disregard are bacterial infections (this includes E. coli) originating in the intestine or bloodstream and invading the gall bladder. Acute gall bladder inflammation characterized by the presence of gas in the gallbladder wall is associated with diabetes mellitus and causes a traumatic restriction of blood flow to the gallbladder. Acute gallbladder inflammation with or without stones can also occur in these cases. Rare causes that may need to be ruled out by your veterinarian are abnormal gall bladder development and parasites of the bile duct (biliary coccidiosis).
Your veterinarian will rule out the following possible causes for the gall bladder disease:
- Focal or diffuse peritonitis which is when a dog’s abdominal cavity becomes infected or inflamed due to an increase of fluid in the serous membrane lining the cavity of the abdomen and covering the abdominal organs, called the peritoneum
- Gastroenteritis with inflammation of the intestines spreading into the bile duct
- Stones in the gall bladder
- Cholangiohepatitis which is inflammation of the system that carries bile and the surrounding liver tissue
- Cell destruction in the liver
- Abscess in the liver
- Blood poisoning
- Metastatic cancer (growing or spreading, cancer)
- Accumulation of thickened bile in the gall bladder
Your veterinarian will order blood and urinalysis tests. X-rays and/or ultrasound images of the abdomen may also be one of the diagnostic tools used pretreatment.
If the condition of your dog is not life threatening or severe, outpatient care may include antibiotics or medication to dissolve gallstones. For the more serious, critical complications, inpatient care may be indicated. During diagnostic and presurgical evaluations, restoring fluid and electrolyte balances and monitoring electrolytes frequently are essential in the early phase of treatment for stabilizing the dog. Other treatments that may be indicated are intravenous fluids, plasma (if indicated) or whole blood transfusion for dogs with bleeding tendencies or dogs that have lost blood. Surgery to remove the gallbladder may be indicated.
Living and Management
Physical examinations and pertinent diagnostic testing will be prescribed by your veterinarian, repeating every 2-4 weeks until normal results are regular. Be prepared for possible complication or recurrences and be vigilant of your pet during the healing stages. A ruptured biliary tract (bile system) and/or peritonitis may prolong the dog’s recovery.
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