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Cholecystectomy is a surgical procedure to remove the gallbladder of a dog, as a result of gallbladder disease. It is an uncommon procedure, and in most cases undertaken at a specialist center or referral practice.
Certain dog breeds, such as the Shetland sheepdog, miniature Schnauzer, and Cocker spaniels are at higher risk of gallbladder disease than other dogs. They have a tendency to form a sludgy, mucoid bile which doesn't flow well through the bile duct. This causes distension of the gallbladder with associated pain and a risk of rupture. In addition, the stagnant bile can become infected, causing an abscess-like condition in the gallbladder. Remove of the gallbladder is the most appropriate treatment.
It's crucial to accurately diagnose the GBM so that surgery can be flagged up as an appropriate treatment. This uncommon condition is usually detected by a couple of ultrasound scans that look at the size of the gallbladder before and after a meal. A gallbladder that doesn't empty in response to food in the stomach, and has a congested appearance, is highly likely to have a GBM.
A course of antibiotics may be given prior to surgery as a high percentage of GBM are infected. Pre-emptive antibiosis can help reduce the risk of complications due to infection.
The dog is prepared for a full general anesthetic and a laparotomy (surgically opening into the abdomen.) The surgeon then visualizes the liver to locate the gallbladder and dissects the latter free, resecting it in its entirety.
The abdomen is then closed and the sutures removed 10 to 14 days later.
Cholecystectomy is the treatment of choice in those patients with a GBM. Simply opening the gallbladder and removing the sludge or stones is not likely to bring about a long-term resolution, as the condition tends to recur.
If cholecystectomy is not undertaken there is a risk of the ball bladder eventually rupturing and causing a serious, often fatal condition called bile peritonitis.
In addition to cholecystectomy the clinician will wish to treat any underlying problems which contributed to the development of the GBM. For example, starting a diabetic patient on insulin, or a dog with Cushing's disease onto trilostane.
Cholecystectomy is invasive surgery. The dog will need rest, antibiotics, and pain relief in the immediate days following the operation. The skin incision must not be licked or interfered with and so the dog may need to wear a cone.
A low fat diet may be indicated post surgery, as many dogs that develop a GBM are prone to high lipid levels in the blood.
The skin sutures are removed 10 to 14 days post surgery. It is advisable not to over exert the dog for 4 weeks after surgery, to allow adequate healing of the body wall.
Cholecystectomy is a costly procedure and surgery is liable to be a minimum of $1,000. In addition, there are costs leading up to diagnosis such as repeated ultrasound scans (around $200) and diagnostic blood tests (ranging from $50 to hundreds of dollars).
Culture of bile to decide on the best antibiotics could cost around $80. Depending on the class of antibiotic needed and size of dog, the cost of antibiosis could be $20 to $200.
Cholecystitis is an extremely painful condition that can cause vomiting and diarrhea. Without surgery, the problem can only be managed (rather than cured) with pain relief and antibiotics. Unfortunately, repeated episodes weaken the gallbladder and ultimately rupture is a very real possibility. The latter is extremely serious and will eventually lead to septicaemia and death.
Thus, in cases that need a cholecystectomy, it is important to go ahead with the procedure. The risk of complications from not acting far outweighs the anesthetic risk and that of the surgical procedure.
It may be wise to feed a dog from a breed known to be predisposed to high blood cholesterol levels and GBM on a low fat diet. This will not eliminate the risk ,but it could decrease it.
Also, it's important for an owner to be vigilant and get their dog checked by a vet when the pet is unwell. The correction of underlying problems, such as underactive thyroid or diabetes, could prevent complications that then require treatment by cholecystectomy.
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