Cholecystitis

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

StartingoverVet

Flight Instructor for hire
Lifetime Donor
10+ Year Member
Joined
Feb 17, 2010
Messages
24,118
Reaction score
8,861
First off, I am not looking for medical advice, I am not going to giving any details of my dog's condition or want any recommendations....

He has cholecystitis, but I can't really find much info on it, not even in the medical/surgery classes where the biliary system was covered. So anyone who has knowledge to share IN GENERAL about the condition, would love to hear your unverified, speculative thoughts.

Especially curious about various forms, how they were treated, and outcomes. When my dogs get sick, I like to use it as a learning experience, and this one seems a tough one to get general info on.

Members don't see this ad.
 
First off, I am not looking for medical advice, I am not going to giving any details of my dog's condition or want any recommendations....

He has cholecystitis, but I can't really find much info on it, not even in the medical/surgery classes where the biliary system was covered. So anyone who has knowledge to share IN GENERAL about the condition, would love to hear your unverified, speculative thoughts.

Especially curious about various forms, how they were treated, and outcomes. When my dogs get sick, I like to use it as a learning experience, and this one seems a tough one to get general info on.
My chihuahua was diagnosed with cholecystitis at 2 years old, and had to have a cholecystectomy. He has secondary liver disease as a result, but he is doing well at 7 years old. Surgery was ~$5000, and total bill when he left the hospital was ~$10,000. He is on Sam-E, milk thistle, vit E (all SID), and ursodiol BID. Meds are probably ~$1000/year. Drs think that it was a congenital problem, caused by an infarct. Surgeon described his gall bladder as "looking like hamburger meat" when he removed it. He gets sick like once/year, usually when my Dad feeds him something really fatty..like pistachios, and his liver values shoot up. Usually treat him with SQ fluids, baytril, metronidazole, and cerenia.
I hope your little guy is okay, SOV.
 
  • Like
Reactions: 1 user
I have seen it successfully treated with ursodiol.
 
Members don't see this ad :)
My dog is currently in a research study that is looking at biliary sludge (via ultrasound) and it's implications in healthy dogs. The internal med resident who is doing the study told me that it is considered an incidental finding in dogs, but that in people it is considered a risk factor for/is associated with gall stones and cholecystitis. Not super helpful to you SOV, but on topic anyways....
 
  • Like
Reactions: 1 user
Nothing on VIN either?

I can try to dig up my sys path notes but I'm sitting here studying equine liver problems. Not much use to you, but hope you get some good info :)
VIN is a thought. I just don't have the patience to use that frequently. I will probably browse on it tomorrow. Thanks for the idea.
 
thanks for the info.
My chihuahua was diagnosed with cholecystitis at 2 years old, and had to have a cholecystectomy. He has secondary liver disease as a result, but he is doing well at 7 years old. Surgery was ~$5000, and total bill when he left the hospital was ~$10,000. He is on Sam-E, milk thistle, vit E (all SID), and ursodiol BID. Meds are probably ~$1000/year. Drs think that it was a congenital problem, caused by an infarct. Surgeon described his gall bladder as "looking like hamburger meat" when he removed it. He gets sick like once/year, usually when my Dad feeds him something really fatty..like pistachios, and his liver values shoot up. Usually treat him with SQ fluids, baytril, metronidazole, and cerenia.
I hope your little guy is okay, SOV.
 
This article has a couple paragraphs on managing/treating it (you'll have to scroll past the mucocele first): http://veterinarycalendar.dvm360.com/avhc/article/articleDetail.jsp?id=738490&sk=&date=&pageID=4. Otherwise, VIN :)

Hope he feels better soon!
Thanks. That was useful. A bunch of what I have been getting bits of pieces of, all in one place, and a fair amount matching my particular case.
Pretty much hoping it is bacterial and mucocele, but we shall see.
 
I personally had it when I was 17 and it was the worst time of my life. I was hospitalized for 4 days, went on a super low-fat diet for 3 months, then had a cholecystectomy. Basically I can't eat a lot of fat at one time otherwise I get sick. I'm sure there are differences between cholecystitis in humans vs. dogs but I know a decent amount about it in humans :)
 
I personally had it when I was 17 and it was the worst time of my life. I was hospitalized for 4 days, went on a super low-fat diet for 3 months, then had a cholecystectomy. Basically I can't eat a lot of fat at one time otherwise I get sick. I'm sure there are differences between cholecystitis in humans vs. dogs but I know a decent amount about it in humans :)
I had cholestasis when I was like 19-20. I had a cholecystectomy then and I got lucky that I can still eat whatever I want.
 
Members don't see this ad :)
I personally had it when I was 17 and it was the worst time of my life. I was hospitalized for 4 days, went on a super low-fat diet for 3 months, then had a cholecystectomy. Basically I can't eat a lot of fat at one time otherwise I get sick. I'm sure there are differences between cholecystitis in humans vs. dogs but I know a decent amount about it in humans :)
Actually that is a little helpful. Antibiotics have taken down his temp, so I presume they are working but he still inappetant, dull mentation, and in pain.
Waiting to see how his blood work looks. Hoping to see some improvement.

Hoping he doesn't need surgery... although being unable to eat fat is hardly a problem as he is already on a hydrolyzed protein diet.
 
Actually that is a little helpful. Antibiotics have taken down his temp, so I presume they are working but he still inappetant, dull mentation, and in pain.
Waiting to see how his blood work looks. Hoping to see some improvement.

Hoping he doesn't need surgery... although being unable to eat fat is hardly a problem as he is already on a hydrolyzed protein diet.

My bile duct was completely blocked so when I was in the hospital I wasn't allowed to do anything that could potentially stimulate my gallbladder (i.e. eat or drink). I was on IV antibiotics, fluids, fat emulsion, a bright yellow formula (I think essential vitamins & minerals?), and morphine. I was told my gallbladder definitely needed to come out otherwise I would likely have more bouts of cholecystitis (my bigger stones were marble-sized). I'm fine with healthy fats like in fish, avocado, and olive oil but when it comes to fried food and dairy products I have to watch how much I eat.

The vet hospital that I work at offers homeopathy and acupuncture in addition to traditional western medicine. The company that supplies our supplements and "voodoo" products invited us to a seminar a couple months back that was human-based but could be applied to animal medicine. They talked some about the liver/gallbladder connection and have liver support supplements they recommend for humans/animals with gallbladder issues. In their opinion an unhealthy gallbladder is a result of an unhealthy liver (though I take everything they say with a grain of salt - I have never had an abnormal liver function test). I've been trying to research this more but there's not a whole lot out there, especially not from credible sources that I've been able to find.

Hopefully your little guy won't need surgery!
 
My little guy doesn't appear to have stones. His liver enzymes are more elevated today which is worrisome.
Not hard to believe unhealthy liver ==> unhealthy gall bladder. He is on phenobarb, so who knows if there is some link. All his GI issues started post seizures, but can't really leave him unmedicated.
 
Ursodiol is your friend.

Also, hope your pup makes a speedy recovery!
 
  • Like
Reactions: 1 user
For the sake of posterity I will update that my dog is doing much better. In fact, after giving antibiotics, I think the most important thing they did was take him off his pain meds (gotta check what he was on... bup?). He had zero desire to eat for 2 days, then when we stopped the pain meds, suddenly his appetite came back in spades! Coincidence? Maybe. Maybe the pain subsided and that led to appetite. No way to be sure.... but something to think about when you have a case like this.

Still waiting to see if liver values are improving. ALT and bilirubin came down, but alk phos was still rising (has a longer 1/2 life apparently).

His case seems like it was a good one for medical management. Luckily really just an infection, seems to be no cholestasis, no mucocele, and leakage from the gall bladder causing any systemic effects. Knock on wood.
 
  • Like
Reactions: 2 users
Decided to make this thread into the "SOV IG Case study thread".... (for educational purposes only).

So my older dog who has been healthy has the following history:

Day 1: Inappetant, lethargic. Borborygmi. Doesn't eat until end of day.

Day 2: Some Melena in stool but seems 100% ok. Eating, playing etc.

Day 3: Diarrhea late night/early morning. Wakes up, eats breakfast, shortly thereafter vomits a large quantity of blood (hematemesis).
Goes to ES. Suspected Rodenticide ingestion (though I insisted she couldn't get to it)....
Coag panel normal.
Blood work normal (very slight hyperglycemia, very slighty hypocalcemia, very slightly low proteins.)
Abdominal U/S slight inflammation of the liver, gall bladder, and urinary bladder. Ruled incidental/secondary. Sent home with no dx, treated with anti-emetics etc.
Goes home. Eats. Seems better.

Day 4: Numerous bouts of hematochezia. Lethargic. Inappetant.

Day 5: Wakes up some slight diarrhea and slight hematochezia. Mid morning has hives on face, chin and back. Give benadryl
Goes to ES. No blood in rectum. Administer more benadryl. She responds seems better. In evening active and eating.

Day 6: Wakes up as normalish poo. Active feeling good. In evening lethargic.

Day 7: Morning lethargic. More hematochezia. Inappetant. By evening feeling better.

Day 8: Feeling better all day. Poo is normal-ish

Day 9: Feeling 100% it seems. a little bit of blood in poo.

Day 10: Wakes up inappetant. More hematochezia. (mixed with mucous).
Goes to appointment...

Current Top diagnosis
1) Addison's. Ruled out by blood work.
2) platelet disorder: ruled out by blood count.
3) Parasite: Doing fecal culture and float. Results not back yet.
4) Mast Cell cancer. Can check with Endoscopy. Holding off.
5) Some type of Anaphylactic syndrome (apparently this has kind of situation been described where not just an acute event). We are treating with Benadryl right now to see if she is responding.
6) Some type of immune disease.

Anyway, I thought this is kind of an interesting case as frank blood out of both ends... some signs of inflammation (and a past history of allergic reaction to vaccines).

We will see.
My dogs love to get these unusual problems. Lucky me.
 
And I should update you that over 1 month on, Zephyr's cholecystitis seems to be completely better. Most recent blood work showed liver values all back to normal. He will be finishing up his 6 weeks of antibiotics in another week.
 
  • Like
Reactions: 1 users
Saw you going into VHUP the other day while I was studying by Green Line...was hoping it was just a recheck of some sorts. Hope you have an answer soon and that she is well again soon.
 
  • Like
Reactions: 1 user
For the record...this was a question on my NAVLE and the only reason I knew the treatment was because of this thread. So thank you SOV and I am glad the puppers is doing better!
 
  • Like
Reactions: 1 user
For the record...this was a question on my NAVLE and the only reason I knew the treatment was because of this thread. So thank you SOV and I am glad the puppers is doing better!
So if you pass by 1 question you owe me 10% of all your future income!
Happy to be of help.
I find interesting cases to make things much easier to remember. Happy Zephyr could help.
 
So if you pass by 1 question you owe me 10% of all your future income!
Happy to be of help.
I find interesting cases to make things much easier to remember. Happy Zephyr could help.

Hahahah 10%? sheesh. I really will be living out of a cardboard box.
 
eh... 10% x a really small number = a really really small number.

Yes...but my salary is also going to be a really really really small number...keep in mind the field I want to go into!
 
updating....

So she has been on Benadryl for a while..
She was still have diarrhea, but no more blood.

She seems to be back to normal, have stopped giving her meds, although I am keeping her on the elimination diet for now just in case.

Typical vet med case, in the end don't really know what was wrong, but she is better now. Did the meds help? Was it an allergic reaction? Was it IBD? Who knows?

Damn frustrating profession.
 
Thanks for the update! Glad she's feeling better; sorry you don't have a definitive solution (but such is the life of a vet pet :()
 
So my cholecystitis boy had another IBD flare up 2 months ago and ended up in emergency room a couple of times....
blah blah blah... lots of boring details.

2 weeks ago we started him on daily Dex injections, and IMMEDIATELY (the next day) he was feeling better.
For the last 2 weeks he has not had a single symptom of his IBD.
No diarrhea
No melena in stool
No frank blood in stool (or vomitus)
No vomiting.
No excessive borborygmi
No smelly gas
No inappetance.

The best he has done in a while.

Of course, he has the typical PU/PD, and his appetite which was huge already when he was healthy (Phenobarb) is now unbelievable. He wakes up every couple of hours during the night and cries until I feed him. But that is a small price to pay for his overall health.

So happy to have a reasonably healthy boy. Took him in today to check on his proteins (they are always low..) and if they are bouncing back maybe can even move to oral pred.

:):):):D:D:D:happy::happy::happy:
 
  • Like
Reactions: 4 users
That's fantastic SOV! Glad to hear he's doing so much better. Nice to see such a huge change.
 
  • Like
Reactions: 1 user
It seems like a small thing, switching from sub-q, to oral, but the poor guy started slinking away from me all the time... he is really not the stoic type (is any IG really stoic?).
 
Top