Natural History of Biliary Sludge in Dogs
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Background: Biliary sludge is associated with gallbladder (GB) dysmotility and mucus hypersecretion suggesting that these factors could lead to GB mucoceles. If biliary sludge does progress to GB mucoceles, treatments to reduce the production and progression of sludge are warranted. Objectives: The aim of this study was to determine the natural history of biliary sludge in dogs. Animals: Healthy, client-owned dogs (n=74) screened for biliary sludge; 42 affected dogs identified Methods: Prospective, observational design. Serial ultrasound examinations and biochemistries were evaluated over 1 year. The following were determined: percentage of the GB filled with sludge (mild (0.01%-24.4%), moderate (24.5%-49.4%), moderate to severe (49.5%-74.4%), severe (74.5%-100%)), gravity dependency of sludge, GB dimensions, and biochemical indices (ALT, GGT, ALP, total bilirubin, albumin, total calcium, triglycerides, and cholesterol). Mixed model ANOVA, Friedman chi-square, Mantel-Haenzsel chi-square tests, and Kruskal-Wallis test were performed to detect significant changes in these parameters. Significance at P <0.05. Results: After 1 year of follow-up, the percentage of the GB filled by sludge was mild (34%), moderate (47%), moderate to severe (13%), severe (3%), or absent (3%) with no significant difference in the median degree of biliary sludge within 1 year (P=0.36). There was no significant change in the gravity dependency of sludge over 1 year. Dogs had resolved (2%), decreased (19%), static (40%), increased (29%), or recurrent (10%) sludge at the conclusion of the study. Biochemical indices or GB volume were not significantly different over time or among groups. Conclusion: Biliary sludge is prevalent, affected dogs remain asymptomatic, and it rarely resolves in healthy dogs over a period of 1 year. Some dogs developed non-gravity dependent sludge within 1 year, which may indicate changes in consistency.
- Masters Theses