Bacterial Cholangitis, Cholecystitis, or both in Dogs

Abstract

BackgroundBacterial cholangitis and cholecystitis are rarely reported, poorly characterized diseases in the dog.ObjectivesTo characterize the clinical features of these conditions.AnimalsTwenty‐seven client‐owned dogs with bacterial cholangitis, cholecystitis, or both.MethodsMulticenter, 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.ResultsTwenty‐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 SignificanceBacterial 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.

Cholangitis and Cholangiohepatitis in Dogs: A Descriptive Study of 54 Cases Based on Histopathologic Diagnosis (2004–2014)

“…Cholangitis in dogs appears to largely affect middle‐aged, medium‐sized dogs with no clear breed predominance. Females may be slightly overrepresented compared to males, but statistical significance was not demonstrated in our study or in a prior study . Duration of clinical signs was variable, ranging from 0 to 56 days in our study, which likely reflects the various concurrent disease processes encountered in this population.…”

“…Duration of clinical signs was variable, ranging from 0 to 56 days in our study, which likely reflects the various concurrent disease processes encountered in this population. A more acute onset would be expected in a dog with a bacterial infection compared to a progressive inflammatory process such as formation of a mucocele, which may account for the greater frequency of acute cases in the prior report of dogs with bacterial cholangitis or cholecystitis . As previously reported, the most common presenting clinical signs included nonspecific gastrointestinal signs and lethargy, whereas fever, icterus, dull mentation, and abdominal pain were the most common physical examination abnormalities …”

“…More recently, larger studies investigating cholangitis, cholecystitis, and bactibilia in dogs have been published. A recent retrospective study evaluating 27 dogs with bacterial cholangitis and NC found that these diseases occur more frequently than has been thought . Both NC and cholecystitis were seen concurrently in the majority of cases suggesting a link between bacterial cholangitis and gallbladder disease.…”

“…Both medically and surgically managed cases had good outcomes . In both of these reports, resistant bacterial infections were identified . A third study of bile cytology and culture in cats and dogs with suspected hepatobiliary disease found that in 30% of canine cases, infectious agents were involved.…”

“…In this classification scheme, the term cholangitis is used in preference to cholangiohepatitis because involvement of the hepatic parenchyma is not a consistent feature, and if present, it is usually an extension of primary cholangitis. Neutrophilic cholecystitis also has been described, associated with bacterial infection, and may occur in combination with NC or as a solitary process . Recently, reports characterizing the treatment and outcome of neutrophilic cholecystitis have been published .…”