- Email: [email protected]
Cytological findings of bile samples from dogs and cats
A D V AN C ES
right-sided transhepatic approach, or intraoperatively during laparoscopy or laparotomy. Extensive data was collected on all animals included in this study.
Results
Cytological Findings of Bile Samples from Dogs and Cats Background Cholecystocentesis may be performed as part of the complete diagnostic work up of hepatobiliary diseases in small animals. In this institution, positive bacterial culture results occur in up to 30% of bile samples from dogs and cats with hepatobiliary disorders. Commonly cultured bacteria include normal inhabitants of the gastrointestinal tract, such as Escherichia coli and Enterococcus spp. Ascending migration from the gut has thus been accepted as the most plausible pathomechanism for bactibilia; however, experimental studies have also documented that hematogenous spread of bacteria from the portal vein is possible. Only scant information on cytological findings of bile aspiration is found in the veterinary literature. Findings include presence of single and mixed bacteria in both canine and feline bile samples, with or without cytological evidence of inflammation.
Objectives
••To describe cytological findings of bile
aspirates in a large number of dogs and cats.
••To compare findings with concurrent
bacterial culture results and additional clinical pathological data.
••To assess for potential complications,
in order to determine the usefulness of cytological evaluation.
Procedure This retrospective study evaluated a large database for specific cases to fit a specific criteria. Main indication for cholecysto centesis included clinical findings or serum biochemistry results suggestive of hepatic or biliary disease, abnormal appearance of the liver or biliary tree on imaging or during exploratory laparotomy, and follow-up after previous diagnosis of biliary disease. Gallbladder aspiration was performed either percutaneously under ultrasound guidance, predominantly by
A total of 140 bile samples were submitted to this laboratory for cytological examination. There was a broad representation in this group. Seventy-one percent of canine bile samples revealed neither microorganisms nor inflammation on cytological examination. Neither microorganisms nor inflammatory cells were found in 70% of cat samples. The measured total nucleated cell count failed to correlate with cytological findings in both canine and feline bile samples. Clinical complications directly associated with cholecystocentesis were identified in 4 dogs (8%) and 1 cat (1%).
Author Conclusions The authors described the presence of microorganisms, inflammation, or both in about 30% of bile aspirates from a large group of dogs and cats. They documented that cholecystocentesis is associated with relatively little risk and that cytological analysis of bile yields clinically relevant results that culture alone cannot provide. The article strongly recommends submitting fresh smears along with bile fluid to the laboratory and encourages a wider recognition of the diagnostic utility of cholecystocentesis in small animal practice.
Inclusions Four figures, 2 tables, 17 references.
Editor Annotation The objective of this retrospective study was to determine the diagnostic utility of cytological assessment of bile aspirates. The authors describe cytologic findings of bile aspirates in 56 dogs and 78 cats and compared the findings with concurrent bacterial culture results and additional clinical pathologic data. Included was a working diagnosis, concurrent diseases, and any potential complications. The results revealed that 30% of canine and 22% of feline bile aspirates had infectious agents identified. Inflammation was found in 5% of canine and 19% of feline samples. Microorganisms were identified on 24% of the cytology samples and 21% of cultures. The most common bacteria cultured were E. coli (14.8%) and Enterococcus spp. (6.7%). Only canine
P age 5
pancreatic lipase immunoreactivity was significantly associated with the presence of microorganisms, inflammatory cells, or both. Two dogs suffered complications (bile peritonitis). Their conclusion was that cholecystocentesis can be performed with relatively low risk and has a high yield of relevant cytologic observations that proceed and complement culture. When culturing bile, cytology should also be performed. (MM) Peters LM, Glanemann B, et al. Cytological findings of 140 bile samples from dogs and cats and associated clinical pathological data. JVIM 2016;30:123-131.
right-sided transhepatic approach, or intraoperatively during laparoscopy or laparotomy. Extensive data was collected on all animals included in this study.
Results
Cytological Findings of Bile Samples from Dogs and Cats Background Cholecystocentesis may be performed as part of the complete diagnostic work up of hepatobiliary diseases in small animals. In this institution, positive bacterial culture results occur in up to 30% of bile samples from dogs and cats with hepatobiliary disorders. Commonly cultured bacteria include normal inhabitants of the gastrointestinal tract, such as Escherichia coli and Enterococcus spp. Ascending migration from the gut has thus been accepted as the most plausible pathomechanism for bactibilia; however, experimental studies have also documented that hematogenous spread of bacteria from the portal vein is possible. Only scant information on cytological findings of bile aspiration is found in the veterinary literature. Findings include presence of single and mixed bacteria in both canine and feline bile samples, with or without cytological evidence of inflammation.
Objectives
••To describe cytological findings of bile
aspirates in a large number of dogs and cats.
••To compare findings with concurrent
bacterial culture results and additional clinical pathological data.
••To assess for potential complications,
in order to determine the usefulness of cytological evaluation.
Procedure This retrospective study evaluated a large database for specific cases to fit a specific criteria. Main indication for cholecysto centesis included clinical findings or serum biochemistry results suggestive of hepatic or biliary disease, abnormal appearance of the liver or biliary tree on imaging or during exploratory laparotomy, and follow-up after previous diagnosis of biliary disease. Gallbladder aspiration was performed either percutaneously under ultrasound guidance, predominantly by
A total of 140 bile samples were submitted to this laboratory for cytological examination. There was a broad representation in this group. Seventy-one percent of canine bile samples revealed neither microorganisms nor inflammation on cytological examination. Neither microorganisms nor inflammatory cells were found in 70% of cat samples. The measured total nucleated cell count failed to correlate with cytological findings in both canine and feline bile samples. Clinical complications directly associated with cholecystocentesis were identified in 4 dogs (8%) and 1 cat (1%).
Author Conclusions The authors described the presence of microorganisms, inflammation, or both in about 30% of bile aspirates from a large group of dogs and cats. They documented that cholecystocentesis is associated with relatively little risk and that cytological analysis of bile yields clinically relevant results that culture alone cannot provide. The article strongly recommends submitting fresh smears along with bile fluid to the laboratory and encourages a wider recognition of the diagnostic utility of cholecystocentesis in small animal practice.
Inclusions Four figures, 2 tables, 17 references.
Editor Annotation The objective of this retrospective study was to determine the diagnostic utility of cytological assessment of bile aspirates. The authors describe cytologic findings of bile aspirates in 56 dogs and 78 cats and compared the findings with concurrent bacterial culture results and additional clinical pathologic data. Included was a working diagnosis, concurrent diseases, and any potential complications. The results revealed that 30% of canine and 22% of feline bile aspirates had infectious agents identified. Inflammation was found in 5% of canine and 19% of feline samples. Microorganisms were identified on 24% of the cytology samples and 21% of cultures. The most common bacteria cultured were E. coli (14.8%) and Enterococcus spp. (6.7%). Only canine
P age 5
pancreatic lipase immunoreactivity was significantly associated with the presence of microorganisms, inflammatory cells, or both. Two dogs suffered complications (bile peritonitis). Their conclusion was that cholecystocentesis can be performed with relatively low risk and has a high yield of relevant cytologic observations that proceed and complement culture. When culturing bile, cytology should also be performed. (MM) Peters LM, Glanemann B, et al. Cytological findings of 140 bile samples from dogs and cats and associated clinical pathological data. JVIM 2016;30:123-131.