Bile peritonitis associated with gastric dilation-volvulus in a dog

This report describes a case of septic peritonitis and gall bladder rupture in German shepherd dog that developed 7 d after surgical treatment for gastric dilation-volvulus. Histological examination confirmed gall bladder necrosis, secondary to an acute ischemic event. Postoperative acute necrotizing cholecystitis has not been a previously reported complication in dogs.     

Estimation of the volume of the gall bladder of 32 dogs from linear ultrasonographic measurements

The maximum length and depth of the longitudinal section, and the maximum width and depth of the transverse section of the gall bladders of 32 dog cadavers were measured ultrasonographically; the contents of the gall bladder were then aspirated and its actual volume measured. The volume of the gall bladder was estimated from the ultrasonographic measurements by using formulae suggested for assessment of the volumes of the urinary bladder in human beings and the gall bladder of dogs, and these formulae were compared with a formula derived from the measurements made in this study. In 21 of the dogs, the measurements were repeated twice so that their reproducibility could be evaluated. All the formulae gave good estimations of the volume of the dogs' gall bladders, but the formula for the human urinary bladder volume was better than the other two. The actual volume of the gall bladder was related to the dogs' bodyweight. There were no significant differences between the repeated measurements of the maximum length and depth of the longitudinal section or the width of the transverse section of the gall bladder, but there were significant variations in the depth of the transverse section.     

Pneumopericardium after peritoneopericardial diaphragmatic hernia repair in a dog

A one-year-old neutered, Goldendoodle presented for evaluation. One week prior to presentation, the surgical closure of a peritoneopericardial diaphragmatic hernia was performed via ventral midline celiotomy. Since the procedure, the dog had been lethargic and anorexic at home. Thoracic radiographs revealed a pneumopericardium. Pericardiocentesis was performed which evacuated approximately 100 mL of air from the pericardial sac. The dog recovered well and began eating in the hospital and resumed normal activity. This is the first reported case of a pneumopericardium post-peritoneopericardial diaphragmatic hernia repair requiring pericardiocentesis. Clinicians should be aware of this rare complication in patients with post-operative peritoneopericardial diaphragmatic hernia.     

Obstructive cholelithiasis and gall bladder rupture in a dog

The literature on canine cholelithiasis is briefly reviewed. Details of a case of gall bladder rupture secondary to cholelithiasis in a six-year-old, neutered female, German shepherd dog are presented. The cholelith was found to be of amorphous composition and consisted of bilirubin and bile salts, with small amounts of calcium, phosphorus and cholesterol. These findings are compared with previous reports of canine choleliths.     

Gall bladder mucoceles and their association with endocrinopathies in dogs: a retrospective case‐control study

Objective : To investigate the relationship between endocrinopathies and diagnosis of gall bladder mucocele in dogs via a retrospective case‐control study. Methods : Records of 78 dogs with a surgical or ultrasonographic diagnosis of gall bladder mucocele were examined for the presence or absence of hyperadrenocorticism, hypothyroidism and diabetes mellitus. Two age‐ and breed‐matched controls for each gall bladder mucocele dog (156 total control dogs) were examined for the same concurrent diseases. A matched case‐control analysis was performed using conditional logistic regression. Results : The odds of mucocele in dogs with hyperadrenocorticism were 29 times that of dogs without hyperadrenocorticism (P=0·001; 95 per cent CI 3·8, 219·9). No difference was found between dogs with and without diabetes mellitus. Although a significant association was found between gall bladder mucocele and hypothyroidism, potential observation bias was also identifi ed. Clinical Significance : Hyperadrenocorticoid dogs that were presented for acute illness with laboratory evidence of hepatobiliary disease should undergo evaluation for the presence of a biliary mucocele. Dogs diagnosed with a gall bladder mucocele should be screened for concurrent hyperadrenocorticism if clinical suspicion exists.     

Gastrointestinal tract perforations caused by ingestion of multiple magnets in a dog

Objective – To describe a case of gastrointestinal tract perforation, septic peritonitis and coagulopathy caused by ingestion of multiple magnets in a dog. Case Summary – An 8‐month‐old castrated male Rottweiler, weighing 30.5 kg was presented for evaluation of vomiting and weakness. Abdominal radiography and abdominal ultrasonographic examination identified a metallic foreign object within the gastric lumen, presence of free peritoneal gas, and peritoneal effusion. Septic peritonitis was diagnosed by abdominal fluid analysis. Exploratory celiotomy revealed the presence of an omental abscess, and gastric and colonic perforations. Four magnetic foreign objects were found within the lumen of the perforated stomach. Surgical management including removal of the magnets, abscess debridement and excision, perforation repair, and abdominal drainage combined with intensive medical therapy resulted in complete recovery of this dog. New or Unique Information Provided – This report describes in detail the case management of a dog that developed both gastric and colonic perforations and severe morbidity secondary to ingesting multiple magnets.     

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.     

Post prandial and cholecystokinin-induced emptying of the gall bladder in dogs

In fasting dogs between 29 and 53 per cent (median 42 per cent) of newly produced bile was stored in the gall bladder, with the remainder being released directly into the duodenum. Pretreatment with methadone and atropine resulted in the complete closure of the sphincter of Oddi for three hours, and the complete retention of bile in the gall bladder. This effect could be abolished with nalorphine. The minimum dose of methadone to prevent bile from entering the intestines was 0.25 mg/kg, in combination with 0.1 mg/kg atropine. A meal of canned dog food resulted in the release of between 5 and 65 per cent of gall bladder bile (median 31 per cent) into the duodenum. Infusion with cholecystokinin octapeptide emptied the gall bladder more effectively and predictably and a median of 80 per cent (range 62 to 93 per cent) of the bile had been emptied into the duodenum after one hour. It was concluded that the induction of bile storage in the gall bladder with methadone and the subsequent stimulation of its release into the duodenum by the infusion of cholecystokinin produced an endogenous bile acid load that was three to four times larger than that induced by a meal after a period of fasting.     

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.     

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.     

Choledochotomy and primary repair of extrahepatic biliary duct rupture in seven dogs and two cats

Objective : To report clinical findings and outcome in dogs and cats undergoing choledochotomy or primary repair of extrahepatic biliary duct rupture. Methods : Retrospective study of dogs (n=7) and cats (n=2) that had choledochotomy or primary bile duct repair. Results : Extrahepatic biliary obstruction was confirmed at surgery in all cases. The underlying cause in four dogs and both cats was choledocholithiasis, two dogs had gall bladder mucocoeles with associated bile duct rupture, and one dog had inspissated bile obstructing the bile duct secondary to gall bladder carcinoid tumour. Three dogs and both cats had choledochotomies performed to relieve extrahepatic biliary obstruction, and four dogs with bile duct rupture underwent primary repair of the defect. One dog with a bile duct rupture was re‐explored four days postoperatively and had suffered dehiscence of the repair; this rupture was re‐repaired. All animals were discharged from the hospital, and did not have clinical recurrence of extrahepatic biliary obstruction. Clinical Significance : Choledochotomy and primary repair of extrahepatic biliary duct rupture were associated with low perioperative morbidity and no mortality in this small cohort of cases. These techniques are reasonable options either alone or in conjunction with other procedures when bile duct patency cannot be re‐established by catheterisation or bile duct discontinuity exists.     

Hypertrophic osteopathy associated with a bronchial foreign body and lobar pneumonia in a dog

Hypertrophic osteopathy was diagnosed in a dog with a bronchial foreign body and lobar pneumonia. Hypertrophic osteopathy is generally associated with primary or secondary neoplasms of the lungs and rarely associated with nonneoplastic thoracic lesions. The foreign body and affected lung lobe were removed by pneumonectomy, resulting in recovery of the dog and resolution of the hypertrophic osteopathy lesions.     

Surgical repair of a peritoneopericardial diaphragmatic hernia in a pregnant dog

Objective: To describe the surgical repair and pre‐ and postoperative management of a peritoneopericardial diaphragmatic hernia (PPDH) in a pregnant dog. Case summary: A pregnant dog was presented for vomiting, lethargy, and pale mucous membranes. Pulsus paradoxus was noted on physical examination. The dog was diagnosed with a PPDH via thoracic radiographs, abdominal ultrasound, and an echocardiogram. The hernia was surgically repaired and the dog received supportive medical care until the puppies were old enough to be delivered via cesarean section. The mother and all puppies survived. New or unique information provided: This is the first report that describes the surgical repair and postoperative management of a PPDH in a pregnant dog.     

Peritracheal abscess associated with tracheal collapse and bilateral laryngeal paralysis in a dog

Tracheal collapse and bilateral laryngeal paralysis were diagnosed in an 8-month-old Cocker Spaniel that had acute onset of dyspnea and cyanosis. Surgical exploration of the mediastinum revealed an abscess involving the ventral wall of the trachea immediately caudal to the thoracic inlet. Both recurrent laryngeal nerves were entrapped in fibrous tissue surrounding the abscess. The dog recovered after tracheal resection and anastomosis and freeing of the entrapped nerves. The peritracheal abscess was suspected to have been the result of esophageal perforation secondary to foreign body penetration.     

Concurrent gall bladder,liver lobe torsion,and bile peritonitis in a German shepherd dog 2 months after gastric dilatation/volvulus gastropexy and splenectomy

Postmortem examination of a 7-year-old German shepherd dog which had gastric dilatation/volvulus and splenectomy 2 months earlier revealed that the right middle and quadrate liver lobes were diffusely congested and torsed. The gall bladder was grossly distended and torsed along its long axis and there was evidence of bile peritonitis.     

Candida peritonitis in dogs: report of 5 cases

Candida peritonitis is reported in people and is associated with significant morbidity and mortality compared with sterile or bacterial peritonitis. Recognized predisposing risk factors include peritoneal dialysis, hollow viscous organ perforation, abdominal surgery, inflamed intestinal mucosa, antimicrobial administration, and immunosuppression. In this report, we describe 5 cases of dogs with peritonitis complicated by Candida spp; 3 dogs with C albicans, one dog with C albicans and C glabrata, and one dog with C glabrata only. The 3 dogs with C albicans peritonitis presented with duodenal perforation due to NSAID therapy, intestinal resection and anastomosis following postspay‐surgery dehiscence, and intestinal foreign body removal. The 2 dogs with C glabrata peritonitis had undergone cholecystectomy due to gall bladder rupture and dehiscence of intestinal biopsy removal sites following exploratory laparatomy. In all cases, initial diagnosis of fungal peritonitis was made via cytologic examination of peritoneal effusions, which revealed marked pyogranulomatous inflammation with numerous 3–8 μm oval, deeply basophilic yeast organisms with thin clear capsules noted within phagocytes and extracellularly. In addition, germ tube formation, hyphae, and pseudohyphae were rarely seen in some of the cases with pure C albicans. Identity of the organisms was determined by culture in all cases and confirmed by PCR in 3 cases. Candida spp. are commensals normally inhabiting the alimentary, the upper respiratory, and the lower urogenital tracts of mammals. They are opportunistic pathogens that can invade and colonize tissue when a patient is immune‐compromised or there is disruption of the mucosal barrier. Candida peritonitis should be considered in patients with peritoneal contamination with gastrointestinal or biliary contents.     

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.     

Benign masses in the pericardium of two dogs

Two miniature Schnauzer dogs were treated for pericardial masses. In one dog the mass consisted of necrotic fat that was attached to the apex of the pericardium by a pedicle. No obvious communication with the abdomen was present. The second dog had a peritoneopericardial hernia associated with a chronic cystic haematoma. In each case the mass was presumed to have arisen following congenital displacement of the omentum into the pericardium. The pericardial mass was removed and subtotal pericardectomy performed in both dogs. Recovery was complete in each case.     

Cecal perforation and adrenocortical adenoma in a dog

Cecal perforation was diagnosed in a dog with a history of acute vomiting. The dog also had an adrenocortical adenoma. Intestinal perforation can be a serious complication of cortico-steroid treatment in the dog, but has not been attributable to hyperadrenocorticism. Fever and an inflammatory CBC were not observed, which could have been secondary to adrenal-dependent hyperadrenocorticism. The acute abdominal crisis associated with peritonitis required quick resolution in an attempt to save the dog, but also precluded any further diagnostic procedures for possible hyperadrenocorticism. The signs that suggested hyper-adrenocorticism in this dog included alopecia, lymphopenia, eosinopenia, high liver enzyme activities, hypercholesterolemia, and one large and one small adrenal gland. This latter finding presumably indicated negative feedback suppression and atrophy attributable to a functional adrenocortical adenoma.     

Primary bronchotomy for removal of an intrabronchial foreign body in a dog.

An 8-year-old, spayed female toy poodle presented with wounds sustained from a dog fight. The multiple orthopedic injuries present were managed surgically. Months later, a chronic cough developed secondary to an aspirated canine tooth in the mainstem bronchus of the right cranial lung that was nonresponsive to medical management. A thoracotomy and primary bronchotomy were performed to remove the aspirated tooth, resulting in complete resolution of clinical signs. Bronchial foreign bodies are rarely diagnosed in companion animals. Primary bronchotomy is an alternative to bronchoscopy or lung lobectomy in cases that do not respond to medical management.