Mucocele is an accumulation of mucus in the gallbladder that could cause it to rupture and make the patient very ill

Surgery is the best treatment of choice

Long-term survival is very good after surgery, however, significant mortality is expected in the perioperative period

• By definition, a mucocele is an accumulation of thick mucus with the gallbladder
• The underlying cause of this condition is not known, however, mucus-producing cells are found in excessive numbers within the gallbladder wall
• Infection may or may not be associated with this condition
• Excessive distention of the gallbladder may cause it to rupture, thus bile will leak into the abdomen and result in severe illness

Anatomy

• The liver produces bile which ultimately drains into larger and larger ducts (collecting tubes) that terminate into about 5 ducts which deliver bile to the gallbladder
• The common bile duct delivers bile to the small intestine
• The gallbladder is located between two liver bones on the right side of the liver
• Cholecystokinin (a hormone) released when food is ingested, stimulates the gallbladder to contract and squeeze its contents into the small intestine via the bile duct

Signs

• Signalment: mild to older medium sized breeds of dogs are most commonly affected; Cocker Spaniels, Miniature Schnauzers and Shetland Sheepdogs
• Signs that a pet owner may note: vomiting, loss of appetite and lethargy
• Signs that a veterinarian may note on physical examination: abdominal pain, jaundice, elevated respiratory rate, fever and elevated heart rate.

Diagnosis

• Bloodwork - commonly shows elevation of liver enzymes
• With rupture of the gallbladder, liver enzymes are usually very elevated and the white blood cell counts are mild to markedly elevated
• Ultrasound commonly reveals a “kiwi” appearance of the gallbladder.

Treatment

• Medical therapy - recommended in select cases;, surgery is typically needed in most cases.
• Surgery - removal of the gallbladder (cholecystectomy) is the treatment of choice
• Following surgery -
  • pain-relieving medication
  • intravenous fluids
  • blood testing s

Homecare

• Incision - should be checked for signs of infection
• Diet - A low fat diet may be recommended in some patients; however, a regular diet may be tolerated.
• Antibiotics - prescribed after the surgery if bacterial infection is suspected or confirmed by culture results
• Exercise - restricted for about 3 weeks after surgery

Prognosis

• The perioperative mortality ranges from 22 to 32%
• Rupture of the gallbladder has been shown to worsen the prognosis when infection is present
• Long-term survival of patients that have undergone gallbladder removal is excellent
• Liver enzymes remain elevated in most patients, but these values usually are much lower than the preop state
  

References

1. Pike FS, Berg J, King NW, et al. Gallbladder mucocele in dogs: 30 cases (2000–2002). J Am Vet Med Assoc 224:1615–1622, 2004.

2. Neer TM. A Review of disorders of the gallbladder and extrahepatic biliary Tract in the dog and cat. Journal of Veterinary Internal Medicine 6:186-192,1992.

3. Aguire AL, Center SA, Randolph JF, et al. Gallbladder disease in Shetland Sheepdogs: 38 cases (1995–2005). J Am Vet Med Assoc 231:79–88, 2007.

4. Mehler SJ, Mayhew PD, Drobatz KJ and Holt DE. Variables associated with outcome in dogs undergoing extrahepatic biliary surgery: 60 Cases (1988–2002). Veterinary Surgery 33:644–649, 2004.

5. Worley, DR, Hottinger Lawrence HJ. Surgical management of gallbladder mucoceles in dogs: 22 cases (1999–2003). J Am Vet Med Assoc 225:1418–1422, 2004.

6. Amellem PM, Seim HB, MacPhail CM, et al. Long-term survival and risk factors associated with biliary surgery in dogs: 34 cases (1994–2004). J Am Vet Med Assoc 229:1451–1457, 2006.

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