Gallbladder problems are common in people, but many dog and cat owners may not know that gallbladder disease can affect our furry friends, too. Although not as prevalent, the incidence of gallbladder disease is on the rise in dogs and cats. As a pet owner, it’s important to learn about these diseases so that you can be proactive in prevention and understand how your veterinarian can help with diagnosis and treatment.
What is gallbladder disease in dogs and cats?
The gallbladder, in conjunction with the liver and pancreas, make up the biliary system of the animal. This system is integral in digestion and waste disposal. While the pancreas produces enzymes that help break down proteins, carbohydrates and fats, the gallbladder is a small, sac-like organ that collects, concentrates, and transports bile. Produced by the liver, bile is needed to help digest fats and vitamins, as well as to help excrete waste matter from the body. If the gallbladder is not able to function properly, bile may back up, causing gallbladder disease and possibly gallbladder rupture.
Bile and bile flow are important in the biliary and digestive system of your dog or cat. Bile, with its high pH, is essential in neutralizing stomach acid as food makes its way through the digestive tract. Bile has an important immune system function – it has antifungal and antibiotic properties, killing fungus and bacteria present in the small intestine. If the flow of bile slows down in the digestive system, bile thickening called “sludging” can occur. Bile sludging creates bile deficiency which in turn creates indigestion, acid reflux and ulcers because bile is not sufficient to pass into the small intestine.
Which dogs and cats are at higher risk for gallbladder disease?
Gallbladder disease can occur in almost every breed of dog, including mixed breeds. In general, however, older female dogs have an increased risk for gallbladder problems. High risk breeds include Shetland sheepdogs, Cocker spaniels, Miniature schnauzers, and Chihuahuas. Gallbladder inflammation can occur in cats of any breed or age and is equally likely to occur in males or females. Certain diseases such as Cushing’s Disease and hypothyroidism can increase the risk for gallbladder problems.
What are the symptoms of gallbladder disease in dogs and cats?
Dogs and cats with mild forms of gallbladder disease can be asymptomatic. Outward signs of gallbladder problems include gastro-intestinal (GI) upset, vomiting, abdominal pain and/or distension, lethargy, diarrhea, poor appetite, and jaundice (skin, mucous membranes, and the whites of the eyes turn yellow due to a build up of bilirubin in the body.)
What types of gallbladder disease are most prevalent in dogs and cats?
- Cholecystitis is an inflammation of the gallbladder. Gallbladder inflammation is usually caused by bacterial infections that start in the small intestine and travel up the bile duct or are spread through the blood. In the absence of outward symptoms, blood test results can reveal elevated liver enzymes (ALP and GGT). Abdominal ultrasound will reveal a thickened gallbladder wall, thickened common bile duct, and/or gallstones. Conventional management of cholecystitis includes fluid therapy, nutritional support, pain management and antibiotics. In severe cases, surgery is performed to remove the gallbladder. After surgery, the animal is at risk for recurrent bacterial infections of the biliary tract.
- Gallbladder mucocele occurs when mucus builds up in the gallbladder and creates a mucocele (cyst). The buildup causes the gallbladder to stretch and grow larger than normal. Mucoceles can also create secondary problems like sludge build-up. Sludge forms when bile remains in the gallbladder for too long. As many as 25% of dogs with gallbladder mucoceles are asymptomatic. Blood work and abdominal ultrasound are used to diagnose this condition. Traditional treatment includes choleretics (substances that increase the volume of secretion of bile from the liver), antibiotics, and antioxidants.
- Gallbladder stones (Cholelithiasis) are formed from cholesterol, bilirubin, and other components in very saturated bile. The stones can float in the gallbladder or one of the ducts and cause bile to back up. The stones can also completely obstruct the duct(s) and result in more serious problems, such as a gallbladder rupture. In cats, gallstones are generally associated with bile duct inflammation. Most cats and dogs with gallstones show no signs or display discomfort only after eating. Abdominal ultrasound can identify the presence of gallstones in the gallbladder but identifying them within the bile ducts is more challenging. In patients with symptoms or potential secondary problems, surgery to remove the stones is traditionally recommended. Asymptomatic patients may not require treatment, but careful monitoring is recommended.
- Extrahepatic Biliary Obstruction (EHBO) is a more serious and secondary condition to other gallbladder problems such as gallstones, gallbladder mucocele, and tumors. It can occur as a result of pancreatitis and other inflammatory conditions that cause stricture (narrowing of the bile ducts). Symptoms include lethargy, vomiting, and fever. Blood work may show elevated liver enzymes (ALP, ALT, AST and GGP). Regardless of the cause, surgical exploration is generally required and possibly removal of the gallbladder. Cats with infections in the biliary tract are at risk for serious complications during surgery.
- Gallbladder rupture is a very serious life-threatening condition requiring immediate surgical intervention. Rupture can be caused by trauma or by EHBO, mucocele, tumors or gallstones left untreated. The rupture leads to leakage of bile into the abdomen, causing a condition called bile peritonitis, which may be fatal if the rupture is not repaired. The symptoms of vomiting, abdominal pain and fever are similar to EHBO, and so it is essential to seek urgent treatment when observing these symptoms. Surgery to remove the gallbladder (Cholecystectomy) will be needed with potential follow-up of antibiotics.
- Cancer that originates in the gallbladder or bile ducts is not common but is more often seen in older dogs. Tumors usually obstruct the flow of bile, which backs up and causes other problems. Conventional treatment may include surgery and chemotherapy.
What preventative measures can I take to keep my pet’s gallbladder and biliary system in balance?
The liver is the detoxifying organ in the body and as part of the biliary system, liver problems will flow to the bile ducts, gallbladder and pancreas. Gallbladder disease can occur when the liver has been injured through use of pesticides, medications, and toxic food. Some ways to keep the liver and gallbladder in balance include:
- Diet: Nutritional deficiency is the number one cause of gallbladder problems. A species-appropriate, meat-based diet is essential for good gallbladder health. Studies show that dogs and cats that consume sugar, refined grains, processed meats, and low-fat food products - all found in dry kibble food - may have an increased risk of gallstone disease. In Traditional Chinese Veterinary Medicine (TCVM), the liver and gallbladder are ruled by the Wood element. Animals with liver and gallbladder problems often have a blood deficiency. Foods such as beef, rabbit, chicken, carrots, celery, broccoli and spinach will tonify the blood and help restore balance to the liver and gallbladder.
- Bloodwork and physical examination: Stay current with your pet’s bloodwork and annual exam, and as he/she ages, have bloodwork screened at least twice a year.
- Monitor weight: Keep your pet at a healthy weight, and do not allow him or her to become overweight. An overweight pet is prone to a host of problems.
- Minimize environmental toxins: Environmental toxins in the water and air, as well as flea, tick, and deworming medications can cause bile sludging. Overvaccination and toxins in processed food are also to blame.
Vitamins and supplements used for liver and biliary system health include:
- Milk thistle is often the herb of choice among holistic veterinarians because it is a powerful antioxidant and blocks the entry of toxins into the liver and removes them at the cellular level.
- Curcumin/Turmeric Extract is a potent antioxidant and anti-inflammatory.
- Dimethyglycine (DMG) is an amino acid that helps rebuild liver cells and encourages the elimination of toxins in the body.
- SAMe (S-Adenosylmethionine) supports liver function through methylation and formation of glutathione.
- Vitamin E protects the liver from copper accumulation.
- Vitamin B12 is an important vitamin needed for proper digestion and absorption of food.
- Methionine is an amino acid needed for proper detoxification of the liver. Methionine helps metabolize fats, preventing their build-up in the liver. It is a powerful antioxidant and helps maintain glutathione. Glutathione is the liver's most important detoxifier.
- N-Acetyl-L-Cysteine (NAC) is an amino acid that aids in the removal of toxins from the liver.
- Artichoke Leaf helps to normalize liver metabolism and promote bile flow.
- Dandelion - Dandelion leaf encourages proper liver function by suppressing fat accumulation in the liver.
Dogs and cats can live without a gallbladder, but taking preventative measures will ensure that your pet may never have to experience this type of surgery. Gallbladder removal also requires careful post-surgical monitoring for the life of the pet. Know the signs of gallbladder problems, monitor your pet regularly, and call your veterinarian if you notice any symptoms. Never skip the annual exam and if your dog or cat is at higher risk for gallbladder disease, have them checked at least twice annually.