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Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele

JA. Jaffey, M. Pavlick, CR. Webster, GE. Moore, KA. McDaniel, SL. Blois, EM. Brand, CF. Reich, L. Motschenbacher, ET. Hostnik, D. Su, JA. Lidbury, O. Raab, SV. Carr, KE. Mabry, W. Fox-Alvarez, S. Townsend, S. Palermo, Y. Nakazono, K. Ohno, E....

. 2019 ; 251 (-) : 105350. [pub] 20190731

Language English Country Great Britain

Document type Journal Article, Multicenter Study

Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14-8.23; P<0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19-3.77; P=0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08-3.47; P=0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10-5.50; P=0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30-0.72; P=0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01-1.04; P<0.001) and age (OR, 1.17; 95% CI, 1.08-1.26; P<0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54-0.69) and a specificity of 0.63 (95% CI, 0.59-0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study.

Bryanston Veterinary Hospital P O Box 67092 Bryanston South Africa

Comparative Health Research Group College of Veterinary Medicine School of Veterinary and Life Sciences Murdoch University Murdoch Western Australia 6150 Australia

Department and Clinic of Internal Medicine University of Veterinary Medicine H 1400 P O Box 2 Hungary

Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn AL 36849 USA

Department of Clinical Sciences College of Veterinary Medicine P O Box 6100 Mississippi State University Mississippi State MS 39762 6100 USA

Department of Clinical Sciences Cummings School of Veterinary Medicine at Tufts University 200 Westboro Road North Grafton MA 01536 USA

Department of Clinical Sciences of Companion Animals Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands

Department of Clinical Sciences School of Veterinary Medicine Aristotle University of Thessaloniki Thessaloniki Greece

Department of Clinical Sciences Small Animal Medicine Faculty of Veterinary Medicine University of Liege Liege Belgium

Department of Clinical Studies Ontario Veterinary College University of Guelph Guelph ON N1G 2W1 Canada

Department of Clinical Studies School of Veterinary Medicine University of Pennsylvania Philadelphia PA USA

Department of Companion Animal Clinical Sciences NMBU School of Veterinary Science N 0033 Oslo Norway

Department of Companion Animal Clinical Studies Faculty of Veterinary Science University of Pretoria Old Soutpan Road Onderstepoort 0110 South Africa

Department of Companion Animals Atlantic Veterinary College University of Prince Edward Island 550 University Avenue Charlottetown Prince Edward Island C1A 4P3 Canada

Department of Small Animal Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Texas A and M University 4474 TAMU College Station TX 77843 USA

Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Florida Gainesville FL 32608 USA

Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Tennessee Knoxville TN 37996 USA

Department of Small Animal Clinical Sciences ENVT and IRSD Université de Toulouse INSERM INRA ENVT UPS Toulouse France

Department of Small Animal Clinical Sciences Virginia Maryland College of Veterinary Medicine Virginia Tech 215 Duck Pond Drive Blacksburg VA 24061 USA

Department of Veterinary Administration College of Veterinary Medicine Purdue University West Lafayette IN 47907 USA

Department of Veterinary Clinical Sciences College of Veterinary Medicine Iowa State University Ames IA 50010 USA

Department of Veterinary Clinical Sciences College of Veterinary Medicine University of Minnesota 1352 Boyd Avenue C 325 St Paul MN USA

Department of Veterinary Clinical Sciences College of Veterinary Medicine Washington State University Pullman WA 99164 USA

Department of Veterinary Clinical Sciences Veterinary Medical Center Ohio State University 601 Vernon L Tharp Street Columbus OH 43210 USA

Department of Veterinary Clinical Studies School of Veterinary Medicine University of Dublin Belfield Dublin 4 Ireland

Department of Veterinary Internal Medicine Graduate School of Agricultural and Life Sciences The University of Tokyo Tokyo Japan

Department of Veterinary Medicine and Surgery Veterinary Health Center University of Missouri 900 East Campus Drive Columbia MO 65211 USA

Department of Veterinary Medicine University of Cambridge Cambridge CB3 0ES United Kingdom

Department of Veterinary Science University of Pisa Via Livornese lato monte 56122 San Piero a Grado Pisa Italy

Division of Veterinary Clinical Sciences Hospital for Small Animals Royal School of Veterinary Studies The University of Edinburgh Midlothian EH25 9RG United Kingdom

Faculty of Veterinary Science The University of Melbourne 250 Princes Highway Werribee Victoria 3030 Australia

Pride Veterinary Centre Riverside Road Pride Park Derby UK

San Marco Veterinary Clinic via Sorio 114c 35141 Padua Italy

School of Veterinary Medicine and Science University of Nottingham Sutton Bonington Campus Leicestershire LE12 5RD United Kingdom

School of Veterinary Science Massey University Palmerston North 4410 New Zealand

Small Animal Clinic Faculty of Veterinary Medicine University of Veterinary and Pharmaceutical Sciences Brno Palackeho 1 3 612 42 Brno Czech Republic

Small Animal Clinic Veterinary Teaching Hospital College of Veterinary Medicine University of Leipzig An den Tierkliniken 23 DE 04103 Leipzig Saxony Germany

Small Animal Department Faculty of Veterinary Medicine Ghent University Merelbeke Belgium

Small Animal Hospital University of Veterinary Medicine Hannover Foundation Bünteweg 9 D 30559 Hannover Germany

University of Glasgow Small Animal Hospital Bearsden Road Glasgow G61 1QH United Kingdom

University Veterinary Teaching Hospital Sydney The University of Sydney 65 Parramatta Road 2050 Camperdown New South Wales Australia

Vet Support Small Animal Intensive Care Medicine Sao Paulo 04082 002 Brazil

Veterinary Medical Center College of Veterinary Medicine Michigan State University East Lansing MI USA

References provided by Crossref.org

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$a Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele / $c JA. Jaffey, M. Pavlick, CR. Webster, GE. Moore, KA. McDaniel, SL. Blois, EM. Brand, CF. Reich, L. Motschenbacher, ET. Hostnik, D. Su, JA. Lidbury, O. Raab, SV. Carr, KE. Mabry, W. Fox-Alvarez, S. Townsend, S. Palermo, Y. Nakazono, K. Ohno, E. VanEerde, H. Fieten, AH. Hulsman, K. Cooley-Lock, M. Dunning, C. Kisielewicz, A. Zoia, M. Caldin, A. Conti-Patara, L. Ross, C. Mansfield, O. Lynn, MA. Claus, PJ. Watson, A. Swallow, DA. Yool, K. Gommeren, M. Knops, V. Ceplecha, H. de Rooster, R. Lobetti, O. Dossin, F. Jolivet, LG. Papazoglou, MCF. Pappalardo, F. Manczur, Z. Dudás-Györki, EJ. O'Neill, C. Martinez, A. Gal, RL. Owen, E. Gunn, K. Brown, LK. Harder, C. Griebsch, KP. Anfinsen, TK. Gron, V. Marchetti, RM. Heilmann, P. Pazzi, AE. DeClue,
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$a Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14-8.23; P<0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19-3.77; P=0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08-3.47; P=0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10-5.50; P=0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30-0.72; P=0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01-1.04; P<0.001) and age (OR, 1.17; 95% CI, 1.08-1.26; P<0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54-0.69) and a specificity of 0.63 (95% CI, 0.59-0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study.
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$a Pavlick, M $u Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA.
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