Choleliths in Dogs

Often seen incidentally on an ultrasound or after death, choleliths, commonly known as gallstones, are solid particles of differing compositions. It is typical for the choleliths to be made up of bile, cholesterol, bacteria, proteins and calcium salts. Their size can range from that of a tiny particle to stones of a size that can result in a blockage in the gallbladder, which is the organ that stores, concentrates and releases bile, and is located between the lobes of the liver.

Bile is responsible for killing substances like fungus and bacteria, neutralizing stomach acids that may be toxic to your dog, and stimulating food to move down the small intestine. Due to the importance of bile to the health of your dog, should he experience a blockage or perforation in his gall bladder, you will want to seek immediate medical attention to avoid complications.

Also known as gallstones, choleliths are solid particles of different compositions that can lead to a blockage or rupture of the gallbladder.

Choleliths may be present despite there being no symptoms. When a cholelith is large enough to cause a blockage in your dog’s gallbladder or result in a perforation of the organ, the condition may be life threatening. The following symptoms may be seen should your dog be experiencing a problem with his gallbladder:

• Vomiting
• Abdominal tenderness when touched
• Pain in the abdomen
• Jaundice 
• Fever
• Lethargy
• Lack of appetite

Types 

Three types of choleliths are found in dogs to include: pure cholesterol choleliths, mixed choleliths (cholesterol along with bile acids, pigment, calcium and protein) and pigment choleliths (calcium bilirubinate).

Choleliths are the result of bile hardening and forming into stone like fragments of different sizes. In most cases, choleliths are secondary to an underlying condition like:

• Nutrient deficiencies like taurine 
• Environmental toxins
• Significant concentration of bile
• A decrease in bile flow
• Changes to the gallbladder’s lining that result in complications like bile becoming thick

Should your dog appear to be having any of the symptoms of gallbladder complications, he should be taken to the veterinarian right away. As the gallbladder can rupture and that or a blockage can be life threatening, it is important that the choleliths be found quickly. Your veterinarian will ask you for information about the symptoms you have observed in your dog, as well as any changes in his behavior you have seen. He will conduct a physical examination where he will check your dog’s abdomen to see if he is experiencing any pain or tenderness and look for the presence of jaundice.

Depending upon what is seen during the physical examination, your veterinarian may request blood work to see if the liver enzymes in your pet are elevated. An x-ray and abdominal ultrasound may also be utilized to confirm the diagnosis. As there is often no obvious symptoms with choleliths, a diagnosis is frequently not made until a blockage or rupture has occurred.

Upon the diagnosis of choleliths in your dog, your veterinarian will recommend appropriate treatment. Should the choleliths be small enough, he may seek to use medication to dissolve them. If evidence is present of a blockage or that one appears imminent, surgery will be required. A cholecystectomy, which is the removal of the gallbladder, will be done so that a life threatening situation does not develop. In the case of surgery your dog may have to stay at the clinic for several days.

Before surgery is conducted, your dog will have blood work taken to be sure that there are no underlying conditions that need to be addressed or that could cause him issues during surgery. Your veterinarian will monitor your dog during his surgery to ensure that his heart rate and pulse remain stable. Throughout the procedure, intensive care will be provided to watch for bile entering your dog’s abdominal cavity and to keep bleeding controlled. A less invasive laparoscopic cholecystectomy has been developed and found to be successful for many dogs.

Should the choleliths be small and your veterinarian decide to treat them with medication, antibiotics will also be given to help your dog avoid developing an infection. Your veterinarian will also recommend a high protein diet along with vitamins. After experiencing choleliths, it is likely that your veterinarian will recommend that your dog remain on a prescription diet so as to help him avoid a recurrence of the condition.

Should your dog undergo regular gallbladder surgery, he will have to remain inactive for at least two weeks so that he does not tear his incision. When brought outside during this time, he will need to remain on a leash and an Elizabethan collar is recommended so that he will not lick the incision. Your veterinarian will prescribe a medication for pain relief along with one to help your dog avoid developing an infection. If your dog’s condition was at an advanced stage where organ damage occurred, treatment and recovery will be more complicated.