What are Gallstones?
The gallbladder is an organ situated between the lobes of the liver, with a primary function of storing, concentrating and releasing of bile. Bile has many functions. It is important to your pet’s immune system, killing substances such as fungus and bacteria. It also serves to neutralize potentially toxic stomach acids and has the important work of stimulating food to move down the small intestine for processing. Due to the necessary functions of bile, a blockage caused by gallstones can lead to serious complications for the health of your pet.Gallstones, also known as choleliths, are solid particles which vary in composition. They usually contain bile, cholesterol, bacteria, proteins and calcium salts. The gallstones can range in size from a tiny particle to stones large enough to cause a blockage in the gall bladder. Immediate veterinary care is necessary with a gall bladder blockage or perforation.
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Symptoms of Gallstones in Dogs
While gallstones can be present with no symptoms, a large gallstone that causes a blockage in the gallbladder or leads to a perforation of the organ, which allows for spillage of the bile into the abdomen, can be life threatening. Symptoms of a problem with the gallbladder include:
- Abdominal tenderness to touch
- Abdominal pain
- Jaundice (yellowing of skin or eyes)
- Loss of appetite.
Causes of Gallstones in Dogs
Gallstones are primarily caused by the hardening and formation of bile into large and small stone like fragments. It has been noted that gallstones are most often secondary to other underlying issues as listed below:
- Nutrient deficiencies such as taurine
- Environmental toxins
- High concentration of gallbladder bile
- Decreased bile flow
- Changes to the lining of the gallbladder which can lead to complications such as bile forming a sludge and becoming thick.
Diagnosis of Gallstones in Dogs
If your dog is experiencing any of the symptoms normally seen with gallbladder complications, it is crucial to take your pet to the veterinarian immediately. Diagnosing gallstones in the earliest stage possible is important due to the risk of a rupture of the gallbladder, and the development of a life threatening obstruction or permanent organ damage.
At the start of the examination, your veterinarian will ask you to describe the symptoms and behaviors you are seeing in your pet. Physical observations will also be made by checking the abdomen for tenderness or pain, and by looking for signs of jaundice. Further diagnosis will involve ordering blood work to check the elevation of liver enzymes in the blood. An x-ray does not always provide a definitive diagnosis; additional investigation may include an abdominal ultrasound.
Unfortunately, due to lack of obvious symptoms in the early stages of gallstones, the diagnosis is not often made until there has been a blockage or rupture.
Treatment of Gallstones in Dogs
Some gallstones are small enough that your veterinarian may choose to dissolve them with a medication proven to give results. This conservative treatment is followed when the veterinarian feels a resolution of the gallstones is possible, along with an improvement in the flow of the bile.
If there is evidence that a blockage is present, or if a blockage appears to be imminent, surgery will be necessary in order to prevent serious health issues for your dog. Cholecystectomy, or removal of the gallbladder is done to avoid the likelihood of a life threatening situation. Gallbladder surgery may involve a stay of a few days at the clinic for your pet. Prior to surgery day, blood work will be done to rule out any underlying illnesses or problems with your pet’s health.
As with any surgery, risks associated with anesthesia are present. Your dog will be well monitored during the surgery, assuring a stable heart rate and pulse at all times. A cholecystectomy involves intensive care support throughout the procedure due to the possibility of bile entering the abdominal cavity. Bleeding must be controlled as well.
Recently, the veterinary surgical field has evolved to use the procedure of a laparoscopic cholecystectomy which has shown to be successful in many patients, with the bonus being that the procedure is less invasive and recovery is excellent.
Recovery of Gallstones in Dogs
If your veterinarian chooses to use medication to dissolve the gallstones, antibiotics will also be administered to avoid infection. Vitamins and a high protein diet will be prescribed. Chances are that your pet will remain on a veterinary prescribed diet from now on, in order to prevent the recurrence of gallstones by ensuring the diet is conducive to good health.
Recovery and management after surgery will be more involved. With regular gallbladder surgery (as opposed to the laparoscopic method) there is a need to keep your dog quiet for a minimum of two weeks in order to avoid a tear in the incision. Your dog must be kept on leash when outside. It is recommended to use an Elizabethan collar to minimize licking the incision. Medication to aid in pain relief will be prescribed, along with a prescription to avoid infection.
Resolution of gallstones is possible; the result depends on whether the gallstones have advanced to a stage where further organ damage was done. If you suspect your dog is unwell for any reason, consult your veterinarian without delay.
Gallstones Questions and Advice from Veterinary Professionals
My dog has passed three dime seize gallstones she has had them in the past and bounced back fine. Today she is lethargic and doesn't want to eat. Will she recover without a trip to the vet?
Lethargy may be a symptom of many different conditions, just because she had problems with gallstones in the past doesn’t mean the same problem is recurring especially in a geriatric dog. I would keep an eye on her until tomorrow, if she still doesn’t want to eat I would visit your Veterinarian for a check to determine the cause of the symptoms and if it is gallstones, are they small enough for her to pass comfortably. Regards Dr Callum Turner DVM
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I have a 16 year old American Eskimo with gallstone. He was initially diagnosed with biliary sludge last yeat and was started on Ursodiol. This seemed to do the trick and his liver enzymes started going down and had almost returned to normal and he was doing well. He had some vomiting last week and we did some bloodwork, His AST, ALT and gt were all elevated GT was 19 and AST and ALT were both in 900's I think. I do now have results with me now but I do remember that both were elevated and and at least one was in 900's, this is the highest his values have ever been. His pancreatic enzymes were also elevated. we did an untrasound initial results revealed small gallstones although not mucocele as of yet. His adrenals are also slightly enlarged. We did extensive testing last year to rule our diabetes, cushings diseases and other causes. We did not come up with a definitive diagnosis for why they were enlarged. We are currently waiting on review results of a specialist. in addition to the above finding his right kidney is slightly smaller than normal and his BUN was elevated. He is showing some signs of kidney decline but they are very mild given his age. He is also on Denamarin and Azodyl. The vet intitial diagnosis was that he might need his gallbladder removed. Given his age and other conditions we are very concerned about surgery in him. I have been doing some research into other treatment methods and I am not finding much. I bascially have two questions what other options can I try I am concerned because he developed gallstones while on ursodiol. We just changed his diet to i/d soft and nuggets mixed together. He was previously on Fromms whitefish and potato or salmon a la veg mixed with brown rice and canned pumpkin. He is currently on a short term course of famotidine due to his vomiting which has been resolved. Is there anything else we can do nonsurgically? I founf that they sometimes so lithotripsy in humans that are not candidates for surgery but I could not find anything about its use in canines. Can this be done in canines with any success? I am also curious as to how likely he is to progress to mucolele and eventually rupture. He is a happy dog and actually in pretty good shape especially given his age.
I understand your concerns regarding anaesthesia given his age, liver and kidney function. Lithotripsy is used in dogs to treat urinary stones but I’ve not read about its use for gallstones in animals; also lithotripsy isn’t something that you would find at your local Veterinary Clinic, specialist centers and universities would be where you would typically find the equipment. Looking at Baxter’s case, it looks like dietary management and supportive care is the way forward unless the Specialist is able to determine something. Regards Dr Callum Turner DVM
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My 9 year old min pin is peeing blood. He's not in any pain and is eating fine and active. There are no charges in his day to day life just that he is peeing blood. I took him to the vet and they said he looks to be in good health then they took some pee to test and gave me antibiotics to start. They called me with the results and said there is nothing growing in his pee. The antibiotics I don't think are helping cus he is still peeing blood. What should I do next?
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