What is Bile Duct Cancer?
Bile serves an important function in your dog’s digestive health, as it breaks down fats into fatty acids, aids in the digestion of lipids, acts as a bactericide, and excretes bilirubin, which is a byproduct of red blood cells. The cancerous mass in the bile duct impairs the ability of the duct to pass bile from the liver to the gallbladder. When the transmission of bile through the bile ducts is impaired, the digestive function is halted, and bile will begin to build up within the liver, fats accumulate, and bilirubin levels rise.
Bile duct cancer is not found to be more common in any specific breed; however, it is more commonly found in female dogs and in dogs over ten years of age. Of liver cancers affecting dogs, bile duct cancer is the second most common, following hepatocellular carcinoma.
Cholangiocarcinoma is aggressive, with a metastasis rate of 67-88%, commonly metastasizing to the abdominal lining, liver’s lymph nodes, diaphragm, intestines, pancreas, spleen, kidneys, bladder, bone and/or lungs. Additionally, due to their location near, or more likely, within the liver, they are difficult to safely remove through surgery, even if they can be diagnosed before metastasizing.Cholangiocarcinoma is a malignant bile duct cancer. Dogs have intrahepatic bile ducts, or bile ducts within the liver, and extrahepatic bile ducts, or bile ducts outside of the liver. Bile duct carcinoma occurs more often in the intrahepatic bile ducts within the liver’s left lobe.
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Symptoms of Bile Duct Cancer in Dogs
- Lack of appetite
- Weight loss
- Excessive urination
- Excessive thirst
- Jaundice, or the yellowing of skin, eyes, and mucous membranes
- Ascites, or fluid accumulation leading to a swollen abdomen
Causes of Bile Duct Cancer in Dogs
As with any cancer, such as human, the cause of bile duct cancer is largely unknown, although there is suspected to be a connection to environmental exposure to carcinogens.
Diagnosis of Bile Duct Cancer in Dogs
At the start of the visit, the veterinarian will conduct a thorough physical examination of your dog, palpating for ascites, or fluid accumulation. Reporting of the onset of your dog’s symptoms and health history will aid the veterinarian in diagnosis. Be sure to report any exposure your dog has had to unusual or excessive toxins.
A complete blood count to test for abnormal red or white blood cell and platelet counts will be conducted, and in most cases, the veterinarian or vet technician will complete a chemical blood profile that will measure liver enzymes, albumin, bilirubin, and cholesterol level. A urinalysis will be conducted in order to measure electrolyte levels, elevated liver enzymes, and α-Fetoprotein concentration. Your dog’s blood clotting ability will be tested through a coagulation profile, which consists of a small sample of blood being placed in a vial with diatomaceous earth while the technician measures the time it takes for the clotting factors to activate.
If initial testing points to cancer, x-rays and ultrasounds will be taken in order to locate and identify the mass, as well as surrounding organs in order to detect metastasis. The symptoms of bile duct cancer are similar to those of other liver cancers; therefore, the only way to positively diagnose the origin of the cancer is through these imaging tests. Confirmation of the cancer will depend upon a liver biopsy, which will be conducted by fine needle aspiration or a larger tissue sample through a laparoscope, which requires a small surgical incision in the abdominal cavity. If your dog has ascites, or fluid accumulation, samples of the fluid will be drawn and sent to the lab along with the tissue sample for analysis.
Treatment of Bile Duct Cancer in Dogs
Bile duct cancer is difficult to treat, as chemotherapy has proven to be effective only as a palliative tool. You may consider, along with the veterinarian or veterinary oncologist, chemotherapy treatment in order to slow the spread of the cancer and decrease your dog’s discomfort, but this treatment has not been found to cure the cancer. Due to the high rate of metastasis, the prognosis is poor. Surgical removal of the bile duct tumor requires removal of the affected section of the liver; up to 75% of the liver may be removed if the remaining percent of the liver tissue is healthy. You will need to consult directly with the veterinarian or veterinary oncologist about your dog’s individual prognosis and if she is a capable and possible candidate for surgery; prognosis will depend upon if or how severely the cancer has metastasized, and how much of the liver is affected.
Recovery of Bile Duct Cancer in Dogs
If your dog is determined to be a candidate for surgery, you will need to monitor your dog’s recovery and return to the veterinarian for regular follow-ups, during which your dog’s liver enzyme levels will be tested, and x-ray and ultrasonic imaging will be utilized in order to check for metastasis. Additionally, as with any surgery, you will need to regularly clean and monitor the incision site to ensure proper healing.
In other cases, you will focus on management: keeping your dog as comfortable as possible, whether it is through chemotherapy or simple pain management.
Bile Duct Cancer Questions and Advice from Veterinary Professionals
My dog Bubas always had a huge appetite, so the day she skipped a meal, we knew something serious was going on and immediately took her to the vet. We found out she also had a fever, and after a lot of blood screens she was sent to a hospital, as her hepatic levels were very abnormal, and an ultrasound showed her gallbladder and liver weren't good. She had surgery to remove her gallbladder, and in that surgery a sample of her liver was sent to biopsy. Her liver was very damaged and they couldn't safely remove whatever she had safely, as it was very spread. She never recovered from the surgery. She stayed very lethargic and without eating for 7 days after that, until she finally collapsed and died. The biopsy results arrived the next day and we found she had cholangiocarcinoma. It was all so sudden we were in shock. She never showed any symptoms until she stopped eating, we didn't even had time to prepare ourselves. Now reading about this I see that the cause for this cancer can be due to exposure to toxins, and this got me worried as we have another dog. Bubas had a disgusting habit of eating that other dog's poo - if we weren't fast enough she would run for it and eat it! Could this cause the carcinoma? Or maybe something she ate? Mushrooms in the wild or something, since we have a big garden where she would freely spent her days at?
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The other day( dec 28) my dog went downhill very quickly and by the time we got her to the emergency clinic, she was in shock, her abdomen was filled with fluid and she had a 103 degree temp. The only thing that showed on her tests was low white blood cells and a few other low CBC numbers. She was to weak for surgery so we don’t know what she had or what caused the leak. Before she went downhill, she had increased urintion and drinking that the vets wanted to do blood tests for but she was being treated for a fungal infection so they held off on the test. I guess I’m just wondering the chance that she could of had this cancer that went unnoticed until it was to late because of her other health issues. We unfortunately had to put her to sleep, we didn’t really have another option but every symptom I’ve read has described what she went through
She had increased urination and drinking for a week or so prior to getting so sick.
She stopped eating the day before but would still be hungry and try to eat table scraps or something besides dog food.
The afternoon of she vomited up the only thing she was able to eat and continued to vomit for a little off and on. Then she was rushed in shock at the vet clinic and had fluid in her abdomen that wasn’t urine or blood but almost a pink clear watery fluid that did show sign of infection or sepsis
We knew she wasn’t feeling well but because of her fungal infection and being on medication we thought it may of been from that and at the time didn’t want to put her through more at the vets office so we held off on the blood tests until she felt a bit better. I regret that decision but more so I regret that we may never know why it happened to her, what caused it
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My ex-wife's Boston terrier is about 5 years. He began vomiting blood and initially it was thought to be infectious with quite elevated liver enzymes. It resolved for some weeks and had just recurred. A vet internist found sludge in the gallbladder and performed surgery. There was sludge in the common bile duct which passed plus a mass in the gallbladder. The mass was biopsied and she just called to tell me it was "hemorrhagic cancer." His liver enzymes are currently quite elevated but he has responded well to surgery and appears healthy. Nevertheless, from what I've read of GB cholangiocarcinoma in a dog, the prognosis looks grim. Doubly so because the lesion was hemorrhagic and clearly has been present for over one month.
Do you think there is any prospect for recovery in this case? Chemotherapy appears to be purely palliative.
I know it's going to be painful if she has to put him down but I can't see waiting for local recurrence or metastatic disease Sx to arise and make the dog's life miserable if there are essentially zero prospects for survival.
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