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Gall Bladder Mass vs Mucocele

Sonopath Forum

Gall Bladder Mass vs Mucocele

Hi everyone,

I might have my first ever case of gall bladder mass but because it is so rare i’m still doubting myself.

8 year old, male neutered Maltese. This was a classic hyperadrenocorticism dog; pendulous abdomen, polyuria, polydipsia and calcinosis cutis.

Ultrasound confirmed bilateral adrenomegaly. When scanning the gall bladder, I assumed mucocele at first due to the ‘stellate’ pattern on the periphery of the gall bladder wall. However, on colour doppler, I was surprised to see vascularisation. Does this confirm a gall bladder mass?

Hi everyone,

I might have my first ever case of gall bladder mass but because it is so rare i’m still doubting myself.

8 year old, male neutered Maltese. This was a classic hyperadrenocorticism dog; pendulous abdomen, polyuria, polydipsia and calcinosis cutis.

Ultrasound confirmed bilateral adrenomegaly. When scanning the gall bladder, I assumed mucocele at first due to the ‘stellate’ pattern on the periphery of the gall bladder wall. However, on colour doppler, I was surprised to see vascularisation. Does this confirm a gall bladder mass?

In addition, the common bile duct was unremarkable and measured 0.16cm.

 

Comments

randyhermandvm

To me this looks like a

To me this looks like a classic mucocele.

randyhermandvm

To me this looks like a

To me this looks like a classic mucocele.

EL

Very interesting… I believe

Very interesting… I believe this to be a mucocele and the major doppler + comes in the periphery and the minor signals are in the center which makes me thing the vascularity is in the adjacent tissue around and behind the mucocele and the center signals are dampened by the sludge… I could be wrong but this is a surgical Gb anyway and Gb mucoceles are much more common that gb masses especially when the material in question is maintained wihtin the GB and not deviating it with a mass effect. I would get a scalpel. Nice post.

EL

Very interesting… I believe

Very interesting… I believe this to be a mucocele and the major doppler + comes in the periphery and the minor signals are in the center which makes me thing the vascularity is in the adjacent tissue around and behind the mucocele and the center signals are dampened by the sludge… I could be wrong but this is a surgical Gb anyway and Gb mucoceles are much more common that gb masses especially when the material in question is maintained wihtin the GB and not deviating it with a mass effect. I would get a scalpel. Nice post.

rlobetti

Gall bladder mucocele most

Gall bladder mucocele most likely seconadry to the Cushing’s disease.

rlobetti

Gall bladder mucocele most

Gall bladder mucocele most likely seconadry to the Cushing’s disease.

lookpris

Very interesting….
Just got

Very interesting….

Just got an update : unfortunately the owner doesn’t want surgery. Will try and persuade her on post mortem when the time comes.

 

Thank you all for your opinions!

lookpris

Very interesting….
Just got

Very interesting….

Just got an update : unfortunately the owner doesn’t want surgery. Will try and persuade her on post mortem when the time comes.

 

Thank you all for your opinions!

randyhermandvm

I didn’t know mucoceles were

I didn’t know mucoceles were more common in Cushings dogs.

Why is that riobetti?

randyhermandvm

I didn’t know mucoceles were

I didn’t know mucoceles were more common in Cushings dogs.

Why is that riobetti?

EL

yes for sure they were

yes for sure they were overrepresented in our surgical biliary abstract as well. I know there are a couple of articles that overrepresent cushings and other endocrine dogs and I’m sure Remo has them handy.

EL

yes for sure they were

yes for sure they were overrepresented in our surgical biliary abstract as well. I know there are a couple of articles that overrepresent cushings and other endocrine dogs and I’m sure Remo has them handy.

rlobetti

Two abstracts on this

Two abstracts on this subject:

 

Mesich ML et Gall bladder mucoceles and their association with endocrinopathies in dogs: a retrospective case-control study. J Small Anim Pract. 2009;50:630-635

OBJECTIVE:

To investigate the relationship between endocrinopathies and diagnosis of gall bladder mucocele in dogs via a retrospective case-control study.

METHODS:

Records of 78 dogs with a surgical or ultrasonographic diagnosis of gall bladder mucocele were examined for the presence or absence of hyperadrenocorticism, hypothyroidism and diabetes mellitus. Two age- and breed-matched controls for each gall bladder mucocele dog (156 total control dogs) were examined for the same concurrent diseases. A matched case-control analysis was performed using conditional logistic regression.

RESULTS:

The odds of mucocele in dogs with hyperadrenocorticism were 29 times that of dogs without hyperadrenocorticism (P=0.001; 95 per cent CI 3.8, 219.9). No difference was found between dogs with and without diabetes mellitus. Although a significant association was found between gall bladder mucocele and hypothyroidism, potential observation bias was also identified.

CLINICAL SIGNIFICANCE:

Hyperadrenocorticoid dogs that were presented for acute illness with laboratory evidence of hepatobiliary disease should undergo evaluation for the presence of a biliary mucocele. Dogs diagnosed with a gall bladder mucocele should be screened for concurrent hyperadrenocorticism if clinical suspicion exists.

Kutsunai M et al The association between gall bladder mucoceles and hyperlipidaemia in dogs: a retrospective case control study. Vet J. 2014;199:76-79. 

The diagnosis of gall bladder mucoceles (GM) in dogs has become increasingly frequent in veterinary medicine. Primary breed-specific hyperlipidaemia is reported in Shetland Sheepdogs and Miniature Schnauzers, breeds in which GM are known to occur more frequently than in other breeds. The objective of this study was to evaluate the association between GM and hyperlipidaemia in dogs. The study design was a retrospective case control study. Medical records of dogs diagnosed with GM at the Veterinary Medical Centre of The University of Tokyo between 1 April 2007 and 31 March 2012, were reviewed. Fifty-eight dogs with GM and a record of either serum cholesterol, triglyceride, or glucose concentrations were included in the study. Hypercholesterolaemia (15/37 cases; odds ratio [OR]: 2.92; 95% confidence interval [CI]: 1.02-8.36) and hypertriglyceridaemia (13/24 cases; OR: 3.55; 95% CI:1.12-15.91) showed significant association with GM. Pomeranians (OR: 10.69), American Cocker Spaniels (OR: 8.94), Shetland Sheepdogs (OR: 6.21), Miniature Schnauzers (OR: 5.23), and Chihuahuas (OR: 3.06) were significantly predisposed to GM. Thirty-nine out of 58 cases had at least one concurrent disease, including pancreatitis (five cases), hyperadrenocorticism (two cases), and hypothyroidism (two cases). A significant association between GM and hyperlipidaemia was confirmed, suggesting that hyperlipidaemia may play a role in the pathogenesis of GM.

rlobetti

Two abstracts on this

Two abstracts on this subject:

 

Mesich ML et Gall bladder mucoceles and their association with endocrinopathies in dogs: a retrospective case-control study. J Small Anim Pract. 2009;50:630-635

OBJECTIVE:

To investigate the relationship between endocrinopathies and diagnosis of gall bladder mucocele in dogs via a retrospective case-control study.

METHODS:

Records of 78 dogs with a surgical or ultrasonographic diagnosis of gall bladder mucocele were examined for the presence or absence of hyperadrenocorticism, hypothyroidism and diabetes mellitus. Two age- and breed-matched controls for each gall bladder mucocele dog (156 total control dogs) were examined for the same concurrent diseases. A matched case-control analysis was performed using conditional logistic regression.

RESULTS:

The odds of mucocele in dogs with hyperadrenocorticism were 29 times that of dogs without hyperadrenocorticism (P=0.001; 95 per cent CI 3.8, 219.9). No difference was found between dogs with and without diabetes mellitus. Although a significant association was found between gall bladder mucocele and hypothyroidism, potential observation bias was also identified.

CLINICAL SIGNIFICANCE:

Hyperadrenocorticoid dogs that were presented for acute illness with laboratory evidence of hepatobiliary disease should undergo evaluation for the presence of a biliary mucocele. Dogs diagnosed with a gall bladder mucocele should be screened for concurrent hyperadrenocorticism if clinical suspicion exists.

Kutsunai M et al The association between gall bladder mucoceles and hyperlipidaemia in dogs: a retrospective case control study. Vet J. 2014;199:76-79. 

The diagnosis of gall bladder mucoceles (GM) in dogs has become increasingly frequent in veterinary medicine. Primary breed-specific hyperlipidaemia is reported in Shetland Sheepdogs and Miniature Schnauzers, breeds in which GM are known to occur more frequently than in other breeds. The objective of this study was to evaluate the association between GM and hyperlipidaemia in dogs. The study design was a retrospective case control study. Medical records of dogs diagnosed with GM at the Veterinary Medical Centre of The University of Tokyo between 1 April 2007 and 31 March 2012, were reviewed. Fifty-eight dogs with GM and a record of either serum cholesterol, triglyceride, or glucose concentrations were included in the study. Hypercholesterolaemia (15/37 cases; odds ratio [OR]: 2.92; 95% confidence interval [CI]: 1.02-8.36) and hypertriglyceridaemia (13/24 cases; OR: 3.55; 95% CI:1.12-15.91) showed significant association with GM. Pomeranians (OR: 10.69), American Cocker Spaniels (OR: 8.94), Shetland Sheepdogs (OR: 6.21), Miniature Schnauzers (OR: 5.23), and Chihuahuas (OR: 3.06) were significantly predisposed to GM. Thirty-nine out of 58 cases had at least one concurrent disease, including pancreatitis (five cases), hyperadrenocorticism (two cases), and hypothyroidism (two cases). A significant association between GM and hyperlipidaemia was confirmed, suggesting that hyperlipidaemia may play a role in the pathogenesis of GM.