Bile acid composition of gallbladder contents in dogs with gallbladder mucocele and biliary sludge

Kakimoto, Toshiaki; Kanemoto, Hideyuki; Fukushima, Kenjiro; Ohno, Koichi; Tsujimoto, Hajime

doi:10.2460/ajvr.78.2.223

Cited by 14 publications

(22 citation statements)

References 28 publications

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“…Abdominal ultrasonography is the imaging technique of choice for evaluating the gallbladder, but can have limited diagnostic accuracy . Ultrasonographically, biliary sludge appears as echogenic amorphous material without acoustic shadowing that collects on the dependent aspect of the gallbladder and is either gravitationally mobile or an immobile echogenic mass—a “sludge ball” . Although echoic patterns differ with the nature and type of gallbladder content, conventional ultrasonography generally identifies biliary sludge and/or sludge balls that move and/or change shape following changes in body position .…”

Section: Introductionmentioning

confidence: 99%

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Bargellini¹,

Orlandi²,

Paloni³

et al. 2018

Vet Radiology Ultrasound

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Gall-bladder diseases are common in dogs and two-dimensional ultrasonography is a current standard method for diagnosis and treatment planning. However, findings from this modality can be nonspecific. The aim of this retrospective, case series study was to describe conventional and contrast-enhanced ultrasound (using SonoVue ) findings in a group of dogs with histologically confirmed gall bladder disease. A total of 65 dogs were included. Branchlike, heterogeneous, and homogeneous contrast enhancement of echogenic intraluminal mass-forming lesions was a contrast-enhanced ultrasound characteristic of polypoid lesions due to cystic mucosal hyperplasia of the gallbladder and/or tumor, which had different wash-in and washout characteristics. In dogs with mobile or immobile biliary sludge or mucocele, the echogenic intraluminal masses remained unenhanced. A double rim mark or enhancement defect in the gallbladder wall was a characteristic of edema or necrosis/rupture of the wall, respectively. Conventional ultrasonography correctly identified biliary sludge or mucocele in 36/37 dogs, cholecystitis/edema in 44/47 dogs, necrosis/rupture in 19/25 dogs, and gallbladder neoplasia in three of three dogs with these pathologies. It falsely identified biliary sludge or mucocele in eight of 28 dogs, cholecystitis/edema in three of 15 dogs, necrosis/rupture in 13/37 dogs, and gall-bladder neoplasia in 20/59 dogs that did not have these pathologies. Contrast-enhanced ultrasound correctly identified cholecystitis/edema in 42/47 dogs, but falsely identified cholecystitis/edema in three of 18 dogs. It correctly identified necrosis/rupture, benign polypoid lesions, and gallbladder neoplasia in all dogs with no false-positive results. Findings supported contrast-enhanced ultrasound as a complement to conventional ultrasonography for dogs with suspected gallbladder pathologies such as edema, necrosis, and rupture.

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Section: Introductionmentioning

confidence: 99%

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Bargellini¹,

Orlandi²,

Paloni³

et al. 2018

Vet Radiology Ultrasound

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“…Research by Kaminski et al, using feline subjects, suggested the possible role of arachidonic acid metabolites on the development of cholecystitis, but it has yet to be proven that this applies to cholecystitis in other animal species [ 48 ]. Kakimoto and colleagues have attributed canine gallbladder diseases to altered bile acid composition [ 22 ]. Ultrastructural work by Gilloteaux et al suggested a possible involvement of altered lipid metabolism, which causes a subcellular accumulation of lipid deposits and a resultant sloughing of cholecystocytes (gallbladder mucosal epithelial cells), leading to the formation of bile sludge [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…As ultrasonographic evaluation of this organ becomes common in veterinary practice, it is necessary to determine the relationship between abnormal imaging findings and histological changes in order to clarify the underlying pathogenesis and to predict disease outcomes [ 19 ]. The need for such knowledge is reflected in the increasing number of studies and publications related to sludge and mucocele in canine gallbladders [ 4 , 6 , 12 , 16 , 17 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Previously, veterinary practitioners regarded ultrasonographic findings of gallbladder sludge, gravity-dependent or nondependent fine granular hyperechoic content, as inconsequential incidental findings [ 4 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Chronic Cholecystitis of Dogs: Clinicopathologic Features and Relationship with Liver

Mitsui

Ohtsuki

Uchida

2021

Animals

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(1) Background: Chronic cholecystitis of dogs has not been vigorously investigated histopathologically. In addition, the relationship between gallbladder and liver diseases is not known. (2) Methods: We aimed to provide a hallmark for canine chronic cholecystitis using clinical data, histopathology, histochemistry, immunohistochemistry, and statistical analysis. (3) Results: Our investigation of 219 ultrasonographically abnormal surgically resected canine gallbladders revealed 189 cases (86.3%) of mucosal lymphoplasmacytic infiltration (chronic cholecystitis). Sludge, a gravity-dependent or nondependent fine granular hyperechoic material, was more prevalent (105/219, 47.9%) than mucocele (51/219, 23.2%) in this cohort. Mucosal lymphoid follicles were detected in 68/219 cases (31%), suggesting the influence of long-standing antigenic stimulation. Bacteria were histochemically detected in 41/60 (68.3%) of heavily inflamed gallbladders, 18/129 (14%) of lightly inflamed, and 3/18 (16.7%) of uninflamed gallbladders, suggesting a possible relationship between bacteria and chronic cholecystitis. Simultaneous liver biopsies revealed mild or no inflammation, changes consistent with primary portal vein hypoplasia, and mild hepatocellular degeneration. (4) Conclusions: Based on the results of our statistical analysis, we conclude that canine chronic cholecystitis is a long-standing inflammatory process of unknown (but possibly bacterial) etiology and that liver pathology is unlikely the cause of chronic cholecystitis in dogs.

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“…With exception to dogs with cholestasis, dogs with mucocele formation had a similar quantity of bile acids in serum, but a lower quantity of some bile acids in hepatic duct bile compared to control dogs. Others have similarly shown decreased concentrations of bile acids in mucus collected from the gallbladder of dogs with mucocele formation[ 54 ]. Lower quantities of bile acids in hepatic duct bile of dogs with mucocele formation may reflect cholehepatic shunting of bile acids from the duct lumen back to the liver in an effort to augment bile salt dependent fluid secretion and prevent long exposures of the biliary epithelium to bile acids[ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Qualitative metabolomics profiling of serum and bile from dogs with gallbladder mucocele formation

et al. 2018

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Mucocele formation is characterized by secretion of abnormally thick mucus by the gallbladder epithelium of dogs that may cause obstruction of the bile duct or rupture of the gallbladder. The disease is increasingly recognized and is associated with a high morbidity and mortality. The cause of gallbladder mucocele formation in dogs is unknown. There is a strong breed predisposition and affected dogs have a high incidence of concurrent endocrinopathy or hyperlipidemia. These observations suggest a significant influence of both genetic and metabolic factors on disease pathogenesis. In this study, we investigated a theory that mucocele formation is associated with a syndrome of metabolic disruption. We surmised that a global, untargeted metabolomics approach could provide unique insight into the systemic pathogenesis of gallbladder mucocele formation and identify specific compounds as candidate biomarkers or treatment targets. Moreover, concurrent examination of the serum and hepatic duct bile metabolome would enable the construction of mechanism-based theories or identification of specific compounds responsible for altered function of the gallbladder epithelium. Abnormalities observed in dogs with gallbladder mucocele formation, including a 33-fold decrease in serum adenosine 5’-monophosphate (AMP), lower quantities of precursors required for synthesis of energy transporting nucleotides, and increases in citric acid cycle intermediates, suggest excess metabolic energy and a carbon surplus. Altered quantities of compounds involved in protein translation and RNA turnover, together with accumulation of gamma-glutamylated and N-acetylated amino acids in serum suggest abnormal regulation of protein and amino acid metabolism. Increases in lathosterol and 7α-hydroxycholesterol suggest a primary increase in cholesterol synthesis and diversion to bile acid formation. A number of specific biomarker compounds were identified for their ability to distinguish between control dogs and those that formed a gallbladder mucocele. Particularly noteworthy was a significant decrease in quantity of biologically active compounds that stimulate biliary ductal fluid secretion including adenosine, cAMP, taurolithocholic acid, and taurocholic acid. These findings support the presence of significant metabolic disruption in dogs with mucocele formation. A targeted, quantitative analysis of the identified serum biomarkers is warranted to determine their utility for diagnosis of this disease. Finally, repletion of compounds whose biological activity normally promotes biliary ductal secretion should be examined for any therapeutic impact for resolution or prevention of mucocele formation.

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Bile acid composition of gallbladder contents in dogs with gallbladder mucocele and biliary sludge

Cited by 14 publications

References 28 publications

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Chronic Cholecystitis of Dogs: Clinicopathologic Features and Relationship with Liver

Qualitative metabolomics profiling of serum and bile from dogs with gallbladder mucocele formation

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