Presumptive migrating gall bladder mucocoele in two dogs with gall bladder rupture

A 10‐year‐old neutered female soft‐coated wheaten terrier and a 10‐year‐old, entire female Pomeranian were presented for vomiting and anorexia. Using ultrasound, an oval structure with a stellate, kiwifruit‐like appearance typical of a gall bladder mucocoele was observed in the caudal abdomen of the soft‐coated wheaten terrier and adjacent to the liver in the Pomeranian. There was also a moderate volume of abdominal effusion in both dogs. Cytology of the peritoneal fluid indicated a sterile exudative process but varied between the two dogs, with an absence of bile pigment in the soft‐coated wheaten terrier and marked bile peritonitis in the Pomeranian. An entire free‐floating ectopic mucocoele was confirmed via exploratory laparotomy with concomitant gall bladder rupture and common bile duct obstruction. Both dogs recovered completely after surgery. This is the first report of cases of gall bladder rupture with entire free‐floating gall bladder mucocoeles in dogs.     

Duplex gall bladder associated with choledocholithiasis, cholecystitis, gall bladder rupture and septic peritonitis in a cat

A 10-year-old cat was presented with a history of inappetence, pyrexia and weight loss. Clinical investigations showed anaemia, hyperbilirubinaemia, septic peritonitis and a double gall bladder with choleliths in an extrahepatic duct. Initial medical stabilisation was performed. At laparotomy, a duplex gall bladder with two separate cystic ducts was identified. The left gall bladder was thickened and had ruptured at the apex. Multiple choleliths were identified in the left cystic duct. The right gall bladder and cystic duct were grossly normal. The ruptured gall bladder was repaired, the gallstones were removed via a choledochotomy of the left cystic duct and a choledochoduodenostomy was created from the dilated left cystic duct. The cat remained depressed and anorexic, and it was euthanased 72 hours postoperatively at the owners' request. This is the first ante-mortem investigation of extrahepatic biliary disease associated with gall bladder duplication in the cat.     

Gastrointestinal small-cell lymphoma with gall bladder involvement in a cat

A 13-year-old female spayed domestic shorthair cat presented for investigation of decreased appetite and increased serum liver enzyme concentrations. An abdominal ultrasound revealed multiple sessile hyperechoic structures along the luminal aspect of the gall bladder wall and a mildly enlarged liver with hyperechoic nodules. Cholecystectomy was performed and biopsies were obtained by laparotomy. Histopathologic examination with immunohistochemistry was consistent with a diagnosis of small-cell lymphoma of T cells within the gall bladder, liver and small intestine. Clonality testing confirmed the diagnosis. The cat remains clinically stable 23 months after institution of treatment with prednisolone, chlorambucil and ursodeoxycholic acid. This is the first report of small-cell lymphoma in the gall bladder of a cat.     

Gall bladder rupture associated with cholecystitis in a domestic ferret (Mustela putorius)

A six‐year‐old neutered female albino ferret was presented with an acute episode of lethargy and anorexia. Clinical examination revealed marked cranial abdominal pain. A severe neutrophilic leukocytosis was present. Abdominal ultrasound was consistent with a diffuse peritonitis and severe bile duct inflammation. Cytology of the abdominal effusion revealed bile peritonitis. An exploratory laparotomy was performed and the gall bladder appeared inflamed with multiple perforations. A cholecystectomy was performed. The ferret recovered without complication. Bacteriological culture of the bile and gall bladder yielded a pure growth of Pseudomonas aeruginosa. Histopathological analysis of the gall bladder and liver was consistent with a marked cholecystitis and cholangiohepatitis. On the basis of sensitivity testing, the ferret was treated with marbofloxacin for one month. No complications or reoccurrence were seen up to 1 year after the diagnosis. To the author's knowledge, this is the first report of bile peritonitis secondary to gall bladder rupture in a ferret.     

Laparoscopic Cholecystectomy for Management of Uncomplicated Gall Bladder Mucocele in Six Dogs

Objectives— To describe a technique for, and outcome after, laparoscopic cholecystectomy (LC) for management of uncomplicated gall bladder mucocele (GBM) in dogs. Study Design— Case series. Animals— Dogs (n=6) with uncomplicated GBM. Methods— Dogs with ultrasonographic evidence of GBM but without imaging or laboratory signs of gall bladder rupture, peritonitis, or extra‐hepatic biliary tract rupture that had LC were included. A 4 portal technique was used. A fan retractor was used to retract the gall bladder to allow dissection around the cystic duct with 5 or 10 mm right‐angle dissecting forceps. The cystic duct was ligated using extracorporeally tied ligatures supplemented sometimes with hemostatic clips. A harmonic scalpel was used to dissect the gall bladder from its fossa. The gall bladder was placed into a specimen retrieval bag and after bile aspiration the bag was withdrawn through the 11 mm portal incision. Results— Five dogs had mild intermittent clinical signs including vomiting, inappetence, and lethargy. All dogs had successful LC without conversion to an open approach. All dogs with clinical signs had improvement or resolution of signs postoperatively. No important perioperative complications occurred and all dogs were alive at a median of 8 months postoperatively (range, 3–14 months). Conclusions— LC can be accomplished safely and effectively in dogs with uncomplicated GBM. Clinical Relevance— A minimally invasive approach for cholecystectomy can be used for the treatment of GBM in dogs.     

Gall bladder torsion and rupture in a dog

A 6-year-old desexed female German Shepherd dog was referred to the Murdoch University Veterinary Hospital for assessment and management of acute onset vomiting, diarrhoea, polydipsia and lethargy of 2 days duration. Surgical, microbiological and histological findings were consistent with necrotising cholecystitis secondary to gall bladder torsion, resulting in gall bladder rupture and secondary non-septic bile peritonitis. A chronic peritoneopleural perforation resulting from an abdominal cavity foreign body and congenital peritoneopericardial hernia were also present. The dog made a full recovery following cholecystectomy, foreign body removal, repair of the peritoneopleural perforation and peritoneopericardial herniorrhaphy. This is the first recorded case of gall bladder torsion in the dog.     

Fibrosing cholehepatitis in broiler chickens induced by bile duct ligations or inoculation of Clostridium perfringens.

The pathogenesis of fibrosing hepatitis causing condemnations in broiler chickens was investigated. Three to four week old broilers were inoculated via the hepatoenteric bile duct with saline washed suspensions of Clostridium perfringens (10(7) and 10(8) organisms). In another group of broilers, both bile ducts were ligated. The sequential development of liver and gall bladder lesions was studied at intervals ranging from 1-28 days postsurgery. The lesions were similar in both experiments in that the liver became mottled and swollen by five to seven days. Fibrinoid necrosis, heterophil and lymphocyte infiltration, bile duct hyperplasia and fibrosis with reticulin fiber proliferation occurred. By 14-17 days, the liver was enlarged, tan colored and firm with red and white foci. By 28 days, bile duct proliferation and fibrosis were massive with only a few hepatocytes remaining. The liver capsule was not involved. Jaundice was not present but the birds with ligated bile ducts excreted intensely yellow stained droppings after six to seven days. The gall bladder in inoculated birds was edematous and distended with flocculent or inspissated material. Clostridium perfringens was reisolated from gall bladder and/or liver of inoculated birds up to 28 days postsurgery. It is suggested that this organism plays a role in the pathogenesis of fibrosing cholehepatitis by inducing septic intrahepatic cholestasis.     

Innervation of Extrahepatic Biliary Tract,With Special Reference to the Direct Bidirectional Neural Connections of the Gall Bladder,Sphincter of Oddi and Duodenum in Suncus murinus,in Whole‐Mount Immunohistochemical Study

Sphincter of Oddi dysfunction is one of the most important symptoms in post‐cholecystectomy syndrome. Using either electrical or mechanical stimulation and retrogradely transported neuronal dyes, it has been demonstrated that there are direct neural pathways connecting gall bladder and the sphincter of Oddi in the Australian opossum and the golden hamster. In the present study, we employed whole‐mount immunohistochemistry staining to observe and verify that there are two different plexuses of the extrahepatic biliary tract in Suncus murinus. One, named Pathway One, showed a fine, irregular but dense network plexus that ran adhesively and resided on/in the extrahepatic biliary tract wall, and the plexus extended into the intrahepatic area. On the other hand, named Pathway Two, exhibiting simple, thicker and straight neural bundles, ran parallel to the surface of the extrahepatic biliary tract and passed between the gall bladder and duodenum, but did not give off any branches to the liver. Pathway Two was considered to involve direct bidirectional neural connections between the duodenum and the biliary tract system. For the first time, morphologically, we demonstrated direct neural connections between gall bladder and duodenum in S. murinus. Malfunction of the sphincter of Oddi may be caused by injury of the direct neural pathways between gall bladder and duodenum by cholecystectomy. From the viewpoint of preserving the function of the major duodenal papilla and common bile duct, we emphasize the importance of avoiding kocherization of the common bile duct so as to preserve the direct neural connections between gall bladder and sphincter of Oddi.     

Intraoperative hypertensive crisis in a dog with functional paraganglioma of the gall bladder

A 15-year-old spayed female mongrel presented with anorexia and an abdominal mass. The mass originated from the gall bladder and was surgically resected along with divisionectomy of the central hepatic division. Paroxysmal hypertension and tachycardia were noted during manipulation of the mass. Following resection, arterial blood pressure decreased significantly. Histopathological analysis confirmed a diagnosis of neuroendocrine neoplasm. Immunohistochemical staining for synaptophysin and chromogranin A yielded diffuse and strong positive results, while gastrin was positive in only 10% of the cells. The preoperative elevated concentrations of catecholamine in the urinalysis showed a marked decrease after surgery. Based on these findings, the tumour was diagnosed as a functional paraganglioma of the gall bladder. The patient has undergone regular thoracic radiographs and ultrasound examinations and, until 431 days after surgery, has shown no signs of metastases or recurrences. Based on our literature search, we report the first case of functional paraganglioma of the gall bladder in a dog.     

Canine bile duct carcinoma

Twenty-four adenocarcinomas of the hepatobiliary system were found among 110 primary hepatic neoplasms: 22 of these were intrahepatic, one involved the extrahepatic bile duct and one the gall bladder. Histologically, 10 intrahepatic neoplasms were classified as cholangiocarcinoma, and 12 as bile duct cystadenocarcinoma. The former were characterized by tubular structures lined by anaplastic cuboidal or columnar cells with diffuse fibrous stroma, and the latter by multiple cystic structures with papillary and solid areas. Half the bile duct cystadenocarcinomas showed benign cysts and transition to adenocarcinomas. This was seen in only one case of cholangiocarcinoma. The extrahepatic bile duct carcinoma was characterized by tubular structures lined with flattened cuboidal cells with scant stroma. The gall bladder adenocarcinoma contained many acinar structures lined with columnar or cuboidal cells and separated by thin stroma. Distant metastasis was found in 87.5% (21 of 24) sites of metastasis.     

Renal Cystic Adenocarcinoma in a Flowerhorn Cichlid with Metastatic Involvement of the Spleen

Abstract

A 480-g flowerhorn cichlid (an ornamental hybrid) with severe bilateral abdominal swelling, bulla-like structures on the skin, bilateral exophthalmia, and a prolapsed intestine was presented. Radiographs showed compression of the posterior part of the swim bladder and abdominal distention. Ultrasonography of visceral organs revealed a heterogeneous mass with hypoechoic to anechoic polycystic parenchyma and free fluid in the abdominal cavity. At necropsy, free fluid in the abdominal cavity and a large polycystic mass originating from the posterior kidney were observed. Histologically, the mass was composed of more cystic growth of tubules. The renal architecture was replaced by tubules, often irregular in shape, lined by simple to lightly stratified layers of neoplastic and pleomorphic cuboidal to columnar epithelial cells and the absence of glomeruli. Birefringent crystals were observed with polarized light within the lumen of some tubules. The apical border of the neoplastic cells was periodic acid–Schiff positive. Immunohistochemically, the neoplastic cells were positive for cytokeratin AE1/AE3 and proliferating cell nuclear antigen and were negative for p53 (tumor suppressor protein). Microscopic metastasis was seen in the spleen. The metastatic tumor was classified as a cystic adenocarcinoma of the kidney, originating from the proximal tubules.

Received October 7, 2016; accepted June 18, 2017 Published online July 31, 2017     

Treatment and long-term follow-up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a Somali cat with pyruvate kinase deficiency

A 2-year-old female neutered Somali cat was presented with vomiting and acute onset jaundice 1 year after diagnosis of pyruvate kinase (PK) deficiency. Diagnostic investigations revealed a moderate regenerative haemolytic anaemia, severe hyperbilirubinaemia and elevated liver enzymes. Ultrasonography revealed marked distension of the gall bladder and common bile duct (CBD), consistent with extrahepatic biliary obstruction (EHBO). At cholecystotomy, the gall bladder contained purulent material, and two obstructive choleliths were removed from the CBD by choledochotomy. The cat recovered from surgery uneventfully, and serum liver enzymes and bilirubin normalised within 10 days. Postoperative treatment consisted of cephalexin, metronidazole and ursodeoxycholic acid (UDCA). Bacterial culture of the gall bladder contents yielded a pure growth of an Actinomyces species. Cholelith analysis revealed that they consisted of 100% bilirubin. Antibiotic treatment was stopped 4 weeks after surgery but UDCA was continued indefinitely. The cat remains clinically well with no recurrence of cholelithiasis 20 months after initial presentation. This is the first report of successful treatment and long-term follow-up of a cat with EHBO due to bilirubin cholelithiasis in association with PK deficiency-induced chronic haemolysis.     

Extrahepatic Biliary Tract in Chinchilla (Chinchilla laniger,Molina)

The aim of the study was the macromorphological analysis of extrahepatic biliary tract in chinchilla (Chinchilla laniger Molina). Bile ducts, the gall bladder and portal vein were injected with coloured latex. Using the technique of dissection, bile ducts were isolated from the liver lobes. It was found that the cystic duct in this species is rarely single. Hepatic ducts form a system of multiple anastomosing structures running in the hepatoduodenal ligament. Many bile duct openings were observed in the duodenal papilla. The results confirm wide variations of the biliary tract in mammals and may be important for comparative analysis of the morphological differentiation of these structures in small mammals.     

朗德鹅疑似白血病的病理组织学观察

对某种鹅场疑似白血病的朗德鹅进行了病理组织学观察。剖检可见病鹅极度消瘦，肝、肾、脾、胆囊和卵巢等组织器官呈不同程度肿瘤样病理变化。其中肝病变尤为明显，稍肿胀，表面有颗粒状弥漫性结节，切面有斑驳状异变；肾苍白，质硬，正常结构消失，形成肿瘤结节；胆囊变硬，胆囊壁增厚。组织切片观察可见肝细胞大量坏死，结缔组织增生，淋巴细胞浸润，肿瘤细胞增生；肾小管上皮脱落，肾间质与肾小球有不同程度的坏死，血管球结构模糊；脾淋巴细胞显著减少，异嗜性粒细胞增多，有多量肿瘤细胞浸润；胰腺、卵巢、胆囊等则有纤维化、淋巴细胞浸润和凝固性坏死等病理变化。     

Struvite urethral calculus in a three-month-old thoroughbred colt.

A 3-month-old Thoroughbred colt was presented with signs of colic. Findings from physical examination, abdominal paracentesis, abdominal radiographs and clinical pathology revealed uroperitoneum secondary to a calculus obstructing the urethra and causing subsequent urinary bladder rupture. Analysis of the calculus demonstrated a tissue center with outer concretions composed primarily of struvite.     

Assessing the Illegal Bear Trade in Myanmar Through Conversations With Poachers: Topology,Perceptions, and Trade Links to China

Myanmar is home to Asiatic black bears and sun bears. We gained insight into illegal hunting and trade of these species in and out of Myanmar through conversations with 40 self-declared bear poachers. All respondents were males who typically killed or caught one to three bears a year, mostly by setting snares. There was a preference for Asiatic black bear. Perceptions were that bears were less abundant now than 5 years ago, but it was not more arduous to obtain one. Most poachers (75%) consumed less valuable parts and sold the remainder, whereas others trapped only to sell. Preferred tradable parts were gall bladder, meat, and paws. Chinese nationals or Burmese of Chinese descent were mentioned as playing key roles (ordering, buying, selling) in trade. Instead of focusing on poachers, we recommend that authorities focus on disrupting trade networks and markets. Cooperation with neighboring countries, especially China, is needed to stem the flow of bear parts.     

Surgical management of umbilical masses with associated umbilical cord remnant infections in calves

Intra-abdominal umbilical cord remnant infections were diagnosed in 21 calves during a 5-year period. The urachal remnant alone was involved in 15 calves, umbilical artery remnant alone in 1 calf, and the umbilical vein remnant alone in 4 calves. Both urachus and umbilical vein were involved in 1 calf. All cases were managed surgically by ventral celiotomy. Infected urachal remnants not extending to the bladder, infected umbilical artery remnant, and infected umbilical vein remnants not extending to the liver were dissected free of surrounding adhered structures, ligated proximal to the infected segment, transected, and removed. Infected urachal remnants extending to the bladder were similarly isolated and removed after resection of the attached bladder apex. Infected umbilical vein remnants extending to the liver were marsupialized. Of 19 calves available for follow-up from 1 to 32 months after surgery, 15 recovered without any postoperative complications, 3 had short-term complications, and 1 calf developed an incisional hernia.     

Bilothorax following cholecystectomy in a dog

A 10-year-old, entire female Pyrenean shepherd dog was presented for acute onset of gastroenteritis. An abdominal ultrasound examination showed the presence of a suspected gall bladder mucocele. After surgery for cholecystectomy, the dog showed signs of an acute onset of respiratory distress due to bilothorax. The bilothorax responded well to medical treatment that comprised of thoracocentesis and oral steroids.     

An outbreak of subacute fasciolosis in Soay sheep: ultrasonographic biochemical and histological studies

A naturally occurring outbreak of subacute fasciolosis in a group of 17 seven-month-old Soay ram lambs was studied following the sudden death of two sheep. In addition to standard biochemical investigations, ultrasound examination of the liver and cranial abdominal cavity was undertaken. There was a significant positive linear correlation between liver weight and ultrasonographic determination of liver size (R=0.72, P<0.05). Ultrasonographic examination of the liver revealed multiple hyperechoic dots in the parenchyma giving a granular appearance to the hepatic texture in three sheep corresponding to the most advanced histopathological changes as determined by the size of the abscesses and their relatively mature fibrous capsules, and areas of hepatic necrosis. No distension of the bile duct system was noted nor was the gall bladder imaged. While serum concentrations of albumin, globulin and certain liver enzymes assisted in the diagnosis of subacute fasciolosis in sheep, only glutamate dehydrogenase, and gammaglutamyl transferase remained elevated four weeks after triclabendazole treatment.     

Obstructive cholelithiasis and cholecystitis in a keeshond

A 10-year-old, neutered male, keeshond was presented for vomiting, lethargy, icterus, and anorexia. Obstructive cholelithiasis was diagnosed based on analysis of a serum biochemical profile, abdominal radiographs, and ultrasonography. Choleliths were removed from the gall bladder and common bile duct via a cholecystotomy.