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Multicenter Study
. 2016 Jul;30(4):1046-55.
doi: 10.1111/jvim.13974. Epub 2016 May 20.

Bacterial Cholangitis, Cholecystitis, or Both in Dogs

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Free PMC article
Multicenter Study

Bacterial Cholangitis, Cholecystitis, or Both in Dogs

A Tamborini et al. J Vet Intern Med. .
Free PMC article

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.

Keywords: Canine; Cholangiohepatitis; Hepatitis; Liver disease.

Figures

Figure 1
Figure 1
Ultrasound of gall bladder. This picture shows a thickened gall bladder wall, defined as ≥3 mm13–15. This was a common finding (9/26) in the study.
Figure 2
Figure 2
Cytology of the bile. This picture shows rod‐shaped bacteria, as identified in 2 cases. Bar 10 μm.
Figure 3
Figure 3
Liver, portal triad histopathology. Chronic active cholangitis; The portal area including bile duct epithelium (centre) are infiltrated by mainly neutrophils with some plasma cells, lymphocytes and macrophages. There is marked fibroplasia of the portal tract. Haematoxylin and Eosin (H&E) stain; Bar, 100μm
Figure 4
Figure 4
Gall bladder wall histopathology. There is marked epithelial hyperplasia with multifocal ulceration and necrosis. The lumen contains a thick exudate consisting of neutrophils, fibrin, and erythrocytes. The submucosa is edematous and markedly infiltrated by neutrophils, few plasma cells, and lymphocytes. Hematoxylin and eosin (H&E) stain; bar 100 μm.

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