Sato K, Sakai M, Hayakawa S, Sakamoto Y, Kagawa Y, Kutara K, Teshima K, Asano K, Watari T
Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Kanagawa, Japan.
North Lab, Sapporo, Hokkaido, Japan.
J Vet Intern Med. 2018 Jan;32(1):188-194. doi: 10.1111/jvim.15034.
Gallbladder agenesis (GBA) is extremely rare in dogs.
HYPOTHESIS/OBJECTIVES: To describe the history, clinical signs, diagnosis, treatment, and outcomes of dogs with GBA.
Seventeen client-owned dogs with GBA.
Medical records from 2006 through 2016 were retrospectively reviewed. Dogs were included when GBA was suspected on abdominal ultrasonography and confirmed by gross evaluation. Signalment, clinical signs, clinicopathological data, diagnostic imaging, histopathology, treatment, and outcome were recorded.
Dogs were of 6 different breeds, and Chihuahuas (10 of 17) were most common. Median age at presentation was 1.9 (range, 0.7-7.4) years. Clinical signs included vomiting (5 of 17), anorexia (2 of 17), ascites (2 of 17), diarrhea (1 of 17), lethargy (1 of 17), and seizures (1 of 17). All dogs had increased serum activity of at least 1 liver enzyme, most commonly alanine aminotransferase (15 of 17). Fifteen dogs underwent computed tomography (CT) cholangiography; common bile duct (CBD) dilatation was confirmed in 12, without evidence of bile duct obstruction. Gross evaluation confirmed malformation of the liver lobes in 14 of 17 dogs and acquired portosystemic collaterals in 5 of 17. Ductal plate malformation was confirmed histologically in 16 of 17 dogs. During follow-up (range, 4-3,379 days), 16 of 17 dogs remained alive.
Dogs with GBA exhibit clinicopathological signs of hepatobiliary injury and hepatic histopathological changes consistent with a ductal plate abnormality. Computed tomography cholangiography was superior to ultrasound examination in identifying accompanying nonobstructive CBD distention. Computed tomography cholangiography combined with laparoscopic liver biopsy is the preferable approach to characterize the full disease spectrum accompanying GBA in dogs.
胆囊缺如(GBA)在犬类中极为罕见。
假设/目的:描述患有GBA的犬只的病史、临床症状、诊断、治疗及预后情况。
17只客户拥有的患有GBA的犬只。
对2006年至2016年的病历进行回顾性研究。当腹部超声怀疑GBA并经大体评估证实时,将犬只纳入研究。记录其品种、临床症状、临床病理数据、诊断性影像学检查结果、组织病理学检查结果、治疗情况及预后。
犬只分属6个不同品种,其中吉娃娃犬最为常见(17只中有10只)。就诊时的中位年龄为1.9岁(范围0.7 - 7.4岁)。临床症状包括呕吐(17只中有5只)、厌食(17只中有2只)、腹水(17只中有2只)、腹泻(17只中有1只)、嗜睡(17只中有1只)和癫痫发作(17只中有1只)。所有犬只至少有一种肝酶的血清活性升高,最常见的是丙氨酸转氨酶(17只中有15只)。15只犬只接受了计算机断层扫描(CT)胆管造影;12只证实胆总管(CBD)扩张,无胆管梗阻证据。大体评估显示,17只犬中有14只存在肝叶畸形,17只中有5只存在后天性门体分流。17只犬中有十六只经组织学证实存在导管板畸形。在随访期间(范围4 - 3379天),17只犬中有16只存活。
患有GBA的犬只表现出肝胆损伤的临床病理体征及与导管板异常一致的肝脏组织病理学变化。CT胆管造影在识别伴随的非梗阻性CBD扩张方面优于超声检查。CT胆管造影结合腹腔镜肝脏活检是描述犬类GBA伴随的完整疾病谱的首选方法。