Gallbladder aspirate from a dog

Abstract

A 7-year-old, male, castrated, Labrador Retriever with a history of pancreatitis and inflammatory bowel disease presented for vomiting and anorexia. Serum biochemistry findings were indicative of cholestasis, hepatocellular insult, and decreased hepatic function. Ultrasound examination showed sediment and gas within the gallbladder, and a diagnosis of emphysematous cholecystitis was made. Emergency gallbladder resection was performed. Cytologic examination of bile fluid collected at surgery showed a mixed population of bacteria (bactibilia) together with fungal organisms consistent with Cyniclomyces guttulatus (previously known as Saccharomycopsis guttulatus). Similar fungal organisms were seen on a fecal smear. Bacteria cultured were normal gastrointestinal flora, supporting ascending infection; the fungal organisms were interpreted as incidental. Histopathology of the gallbladder indicated active (suppurative) and chronic (lymphocytic) cholecystitis and sections of liver tissue had evidence of chronic liver disease. A positive liver culture indicated concurrent bacterial hepatitis or cholangiohepatitis. Despite supportive care, the dog continued to decline and was euthanized 30 days later. Necropsy results confirmed end stage liver disease, but an initiating cause was not found. This case highlights the role of bactibilia in the development of acute cholecystitis and the unique cytologic appearance of C guttulatus as an incidental finding in bile fluid.

Bacterial Cholangitis, Cholecystitis, or both in Dogs

“…The main clinical pathology abnormalities noted in the present case series were liver enzyme elevation, hyperbilirubinemia, hypercholesterolemia, an inflammatory leukogram, and in a few cases, hyperglobulinemia, findings consistent with cholestasis and an inflammatory process . These findings are broadly similar to those reported in previous cases; however, 10/10 cases in previous reports had been jaundiced and 8/8 had an inflammatory leukogram (2 others not reported) at some point in their history . When the cases in this study are considered based on their presentation, 15/18 of the acute cases presented with hyperbilirubinemia (one additional acutely presenting case had no serum biochemistry performed) and 17/19 had at least one of neutrophilia, monocytosis, or hyperglobulinemia.…”

“…Bacterial cholangitis is reported rarely in the dog, with previous reports comprising a few case reports and one small case series . Reports of bacterial cholecystitis in dogs are also not common, but this disease has been described more frequently than cholangitis .…”

Cytological Findings of 140 Bile Samples from Dogs and Cats and Associated Clinical Pathological Data

“…The majority of dogs with bactibilia in our study lacked cytological evidence of concurrent inflammation, raising the possibility of transient colonization rather than true infection. Transient, self‐limiting bactibilia can occur in clinically healthy dogs,5 but lack of concurrent inflammation in the bile or gallbladder wall despite bactibilia also occurs in clinically sick dogs 2, 7, 9. Although most of the animals had clinical signs of hepatobiliary disease, these could not be clearly attributed to gallbladder disease in cases from Group 2, as comorbidities were present in most cases.…”

Hepatic fungal infection in a young beagle with unrecognised hereditary cobalamin deficiency (Imerslund‐Gräsbeck syndrome)

“…The dog was treated with crystalloid infusions supplemented with glucose, a transfusion of two units of fresh frozen plasma, antibiotics [5 mg/kg doxycycline administration of corticosteroids, cytotoxic drugs and antibiotics, diabetes mellitus and breed-associated immune defects (German shepherd dogs). In addition, a single case of fungibilia with Cyniclomyces guttulatus has been reported (Neel et al 2006). Hepatic fungal infection without generalised disseminated disease has not been previously described to the authors' knowledge.…”

“…In addition, a single case of fungibilia with Cyniclomyces guttulatus has been reported (Neel et al . ). Hepatic fungal infection without generalised disseminated disease has not been previously described to the authors’ knowledge.…”