Dear Dr. Kaplan: Lilly is my nine-year-old female Shetland sheepdog that I have owned since a pup. Three weeks ago, she became lethargic and would not eat. We took her to the veterinarian who did some tests and discovered that her gall bladder contained an abnormal substance that was preventing it from properly draining. The result was that her gallbladder was very large and in danger of rupturing. Surgery was done and Lilly's gallbladder was removed.
It took Lilly a few days to recover from surgery, but she is doing well now and I am grateful for that. However, I was wondering if there was a way to avoid surgery as they are sometimes able to do with people that have gallbladder disease.
ANSWER: It sounds like Lilly acquired a condition known as gallbladder mucocele (GBM). This is a syndrome in which the gallbladder fills with mucus. This mucus accumulation can result in gallbladder distension, blockage of the gallbladder, and gallbladder rupture. Shetland sheepdogs, cocker spaniels, and miniature schnauzers appear predisposed. A genetic influence appears likely.
Loss of appetite, lethargy, abdominal pain, diarrhea and icterus (jaundice) are symptoms often seen with this condition. GBM is usually diagnosed by abdominal ultrasound and affected dogs sometimes have concurrent endocrine diseases such as diabetes mellitus or hypothyroidism. Pancreatitis also appears to increase the risk for GBM. Hyperlipidemia can be a contributing factor as well.
If the condition is caught before the onset of symptoms, medical management alone is sometimes effective in controlling GBM. The treatment often includes low fat diets if the patient is hyperlipidemic, as well as medications to thin out the bile to prevent or resolve biliary obstruction. Close monitoring via abdominal ultrasound is essential. Antibiotics are sometimes utilized as well.
However, in cases such as Lilly's, in which the patient is already clinically ill from GBM, surgery is the treatment of choice. Removing the gallbladder quickly resolves any obstruction and the pain associated with such an obstruction. Gallbladder rupture can be prevented as well. Since the mucus is produced in the gallbladder, removal of the gallbladder removes the source of the mucus and the possibility of future biliary obstructions. Obviously, if the gallbladder is already ruptured, surgery is not just the best option but the only option if the patient is to survive.
Eliot Kaplan is an Okanagan resident and holds a diploma from the American Board of Veterinary Practitioners. Questions can be directed to