Keynote Message

Historically, both bacterial cholangitis and cholecystitis have been reported infrequently in the dog; however, our recent work suggests that these conditions occur more frequently than has been previously recognised, having significant implications for patient management. In a multi-centre, retrospective study, we identified twenty-seven confirmed cases of bacterial cholangitis or cholecystitis against a background of approximately 460 cases of hepatitis diagnosed in the same institutions over the equivalent time period, far in excess of what would have generally been suggested by the paucity of publications.

Evaluation of the clinical characteristics of bacterial cholangitis and cholecystitis in this large case series identified important information about the presentation of the condition in this species. It highlighted that both bacterial cholangitis and cholecystitis should be considered as differential diagnoses in dogs presenting with jaundice and fever, abdominal pain or an inflammatory leucogram or with ultrasonographic evidence of gallbladder abnormalities. In addition, as bacteriological culture results documented both aerobic and anaerobic isolates, frequent antimicrobial resistance in aerobic isolates (approaching two thirds of E. coli isolates resistant to three or more antimicrobial classes) along with changes in resistance patterns and persistence of positive cultures in some patients despite antimicrobial therapy, the bacteriological culture of bile with sensitivity testing is recommended over empirical treatment.

In this session, the important features of bacterial cholangitis and cholecystitis in the dog will be reviewed along with more recent work, using fluorescence in situ hybridization (FISH) with oligonucleotide probes directed against bacterial ribosomal RNA, aimed at further investigating the aetiopathogenesis of these conditions and their potential inter-relationship.

Key References

1.  O'Neill EJ, Day MJ, Hall MJ, et al. Bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis in four dogs. Journal of Small Animal Practice. 2006;47:325–335. DOI: 10.1111/j.1748-5827.2006.00012.x.

2.  Tamborini A, Jahns H, McAllister H, et al. Bacterial cholangitis, cholecystitis, or both in dogs. Journal of Veterinary Internal Medicine. 2016;30:1046–1055. DOI: 10.1111/jvim.13974.

3.  Twedt DC, Cullen J, McCord K, et al. Evaluation of fluorescence in situ hybridization for the detection of bacteria in feline inflammatory liver disease. Journal of Feline Medicine and Surgery. 2014;16:109–117. DOI: 10.1177/1098612X13498249.

4.  Wagner KA, Hartmann FA, Trepanier LA. Bacterial culture results from liver, gallbladder, or bile in 248 dogs and cats evaluated for hepatobiliary disease: 1998–2003. Journal of Veterinary Internal Medicine. 2007;21:417–424. DOI: 10.1892/0891-6640(2007)21[417:BCRFLG]2.0.CO;2.