Saunders Harvey, Thornton Laura A, Burchell Richard
Massey University Veterinary Teaching Hospital, Private Bag 11-222, Palmerston North 4442, New Zealand.
Institute of Veterinary, Animal & Biomedical Sciences, Massey University, Tennent Drive, Palmerston North 4474, New Zealand.
Int J Vet Sci Med. 2017 Apr 20;5(1):75-80. doi: 10.1016/j.ijvsm.2017.01.002. eCollection 2017 Jun.
The factors enhancing mucocoele development in dogs remain poorly understood. A 7-year-old female spayed Miniature Schnauzer was presented to the Massey University Veterinary Teaching Hospital for progressive lethargy, inappetance and abdominal discomfort. Initial physical examination findings revealed a moderate degree of cranial abdominal pain, with subsequent diagnostic tests confirming the patient as having diabetes mellitus, with a concurrent marked hypertriglyceridaemia. In an attempt to localise the source of pain, an ultrasound examination of the abdomen was performed, revealing a marked degree of gallbladder sludge. With appropriate medical management including ursodeoxycholic acid and insulin therapy, the patient stabilised and was discharged. With persistence of clinical signs three months later, progression of the gallbladder sludge towards mucocoele development was suspected. Exploratory laparotomy was instigated, and an emergency cholecystectomy was performed. This case report therefore entails a suspected gallbladder mucocoele that developed in a diabetic patient with previously diagnosed biliary sludge. A unique feature of this case report is the presence of diabetes mellitus, which has been suggested to be a causative factor in the development of gallbladder mucocoeles. It is also hypothesised that gallbladder sludge and mucocoeles are associated, however it is yet to be ascertained whether this association is causal or contributory. The authors examined the possible relationship between this endocrinopathy and biliary sludge, and their possible effects on mucocoele development. Specific associated factors to sludge formation are also examined. The medical and surgical management of gallbladder mucocoeles is discussed.
犬黏液囊肿形成的促进因素仍未完全明确。一只7岁已绝育的雌性迷你雪纳瑞犬因进行性嗜睡、食欲不振和腹部不适被送至梅西大学兽医教学医院。初步体格检查发现有中度的上腹部疼痛，后续诊断测试证实该患者患有糖尿病，同时伴有明显的高甘油三酯血症。为了确定疼痛来源，对腹部进行了超声检查，发现胆囊内有大量胆汁淤积。经过包括熊去氧胆酸和胰岛素治疗在内的适当药物治疗，患者病情稳定并出院。三个月后临床症状持续存在，怀疑胆囊胆汁淤积进展为黏液囊肿。于是进行了剖腹探查，并实施了急诊胆囊切除术。因此，本病例报告涉及一例疑似胆囊黏液囊肿，该囊肿发生在一名先前诊断为胆汁淤积的糖尿病患者身上。本病例报告的一个独特之处是存在糖尿病，糖尿病被认为是胆囊黏液囊肿形成的一个致病因素。也有人推测胆囊胆汁淤积与黏液囊肿有关，但这种关联是因果关系还是促成关系尚待确定。作者研究了这种内分泌病与胆汁淤积之间的可能关系，以及它们对黏液囊肿形成的可能影响。还研究了与胆汁淤积形成相关的具体因素。并讨论了胆囊黏液囊肿的药物和手术治疗。
