BackgroundGallbladder mucocele (GBM) is an increasingly recognized extrahepatic biliary disease in dogs.ObjectivesTo investigate cases of GBM and identify variables associated with survival and the sensitivity and specificity of ultrasonography to identify gallbladder rupture.AnimalsTwo hundred and nineteen client‐owned dogs with GBM.MethodsMulticenter, retrospective study of dogs with GBM, presented from January 2007 to November 2016 to 6 academic veterinary hospitals in the United States. Interrogation of hospital databases identified all cases with the inclusion criteria of a gross and histopathologic diagnosis of GBM after cholecystectomy and intraoperative bacteriologic cultures of at least 1 of the following: gallbladder wall, gallbladder contents, or abdominal effusion.ResultsTwo hundred and nineteen dogs fulfilled the inclusion criteria. Dogs with GBM and gallbladder rupture with bile peritonitis at the time of surgery were 2.7 times more likely to die than dogs without gallbladder rupture and bile peritonitis (P = 0.001; 95% confidence interval [CI], 1.50–4.68; n = 41). No significant associations were identified between survival and positive bacteriologic cultures, antibiotic administration, or time (days) from ultrasonographic identification of GBM to the time of surgery. The sensitivity, specificity, positive, and negative likelihood ratios for ultrasonographic identification of gallbladder rupture were 56.1% (95% CI, 39.9–71.2), 91.7% (95% CI, 85.3–95.6), 6.74, and 0.44, respectively.Conclusion and Clinical ImportanceDogs in our study with GBM and intraoperative evidence of gallbladder rupture and bile peritonitis had a significantly higher risk of death. Additionally, abdominal ultrasonography had low sensitivity for identification of gallbladder rupture.

A 12-year-old castrated male, domestic long-haired cat weighing 4.93 kg was evaluated for weight loss and an abdominal mass. The cat had a 3-month history of diabetes mellitus treated with 2 units of ultralente insulin a twice daily. Hypokalemia, mild azotemia, mild hyperglycemia, and glucosuria were noted on recent laboratory evaluations.Physical examination findings included a thin, greasy haircoat, dermal and epidermal atrophy, cutaneous fragility, a III/VI left peristernal systolic heart murmur, and a cranial abdominal mass. Clinicopathologic abnormalities included hyperglycemia (460 mg/dL, reference range 52-153 mg/ dL), azotemia (blood urea nitrogen 76 mg/dL, reference range 17-35 mg/dL; creatinine 3.1 mg/dL, reference range 0.50-2.20 mg/dL), hypokalemia (2.5 mmol/L, reference range 3.0-4.0 mmol/L), hypochloremia (110 mmol/L, reference range 114-122 mmol/L), hyperphosphatemia (6.1 mmol/L, reference range 2.0-5.3 mmol/L), increased total CO 2 (27 mmol/L, reference range 11-22 mmol/L), and glucosuria. Venous blood gas analysis was consistent with a metabolic alkalosis (pH 7.38, HCO 3 ϭ 28.2 mmol/L) with respiratory compensation (partial pressure of carbon dioxide [PCO 2 ] ϭ 48.7). Serum total thyroxine (T 4 ) concentration, magnesium concentration, creatine phosphokinase activity, and CBC were within reference ranges. A mass cranial to the right kidney (Fig 1) and mild cardiomegaly were noted on abdominal and thoracic radiographs, respectively. The mass, measuring 2 ϫ 2.5 cm by ultrasound, was identified as the right adrenal gland (Fig 2). Echocardiography was unremarkable. Mild hypertension was identified on an initial reading (blood pressure 170 mm Hg, systolic). However, considering the fractious nature of this cat during blood pressure measurement and a lack of ocular manifestations of hypertension, therapy was deemed unnecessary at the time.Endocrinologic testing was performed to investigate functionality of the adrenal tumor. Surgical exploration and tumor removal was planned. Potassium gluconate e supplementation was initiated (2 mEq q24h PO) and insulin therapy continued pending surgery. Serum potassium concentrations did not normalize before surgery despite supplementation. At surgery, the right adrenal gland contained a 1.5 ϫ 2.0-cm mass that appeared encapsulated but closely associated with the vena cava. Extension of tumor thrombi was evident into the phenicoabdominal vein but not into the vena cava. The phenicoabdominal vein was ligated at the level of the vena cava and tumor excision was accomplished with a combination of blunt dissection and the use of hemoclips. The left adrenal gland was grossly normal, and no evidence was found of gross metastasis to any abdominal organ. Histopathology of the right adrenal gland (Fig 3) was consistent with a cortical adrenal gland carcinoma.Initial postoperative treatment included insulin, dexamethasone f (0.25 mg/kg q24h IV), and a balanced electrolyte solution g with potassium supplementation (20 mEq/L IV). Insulin administration was discontinued after ...

Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7-45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14-8.23; P<0.001). The multivariable model indicated that categorical variables including owner recognition of

Multiple organ dysfunction syndrome (MODS), defined as the presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention, is a cause of high morbidity and mortality in humans and animals. Many advances have been made in understanding the pathophysiology and treatment of this syndrome in human medicine, but much still is unknown. This comparative review will provide information regarding the history and pathophysiology of MODS in humans and discuss how MODS affects each major organ system in animals.