Gallbladder  Mucoceles

There are two research groups actively studying gallbladder mucoceles in dogs.  Both are listed below:

1. Research at North Carolina State University:

Medical Resolution of Gallbladder Mucocele Formation in Dogs

Jody Gookin DVM, PhD.  This study is sponsored by the ASSA through the Shetland Sheepdog Donor Advised Fund administered by AKC Canine Health Foundation, Grant #02544: Medical Resolution of Gallbladder Mucocele Formation in Dogs.  Total Grant Amount: $220,333.00; Grant Period: 9/1/2019 - 8/31/2022.

Our long-term goal is to pinpoint the underlying cause of mucocele formation in dogs and to formulate a rational treatment strategy to prevent or medically resolve them.

We were recently awarded a grant from the American Kennel Club Canine Health Foundation #02544 and with generous support from Royal Canin to investigate medical resolution of gallbladder mucocele formation in dogs. The overall objective of the research is to establish if mucocele formation can be reversed by correcting the course of noteworthy metabolic disturbances that we have painstakingly documented in these dogs.

Our central hypothesis is that mucocele formation can be reversed by treating dogs with a combination of essential dietary factors documented to be significantly lower in the blood and/or bile of dogs that form mucoceles compared to normal dogs. This hypothesis was formulated based on strong published data [1] generated by support from the AKC Canine Health Foundation (Grant #01986) demonstrating that dogs with mucocele formation are relatively deficient in dietary compounds that play essential roles in normal metabolism and/or whose biological activity may contribute to maintenance of normal secretory function of the gallbladder epithelium. The rationale for the proposed studies is that any demonstration that these compounds can reverse mucocele formation will be of immediate benefit to dogs with this disease, even if we have yet to identify the primary cause.

To address our hypothesis, we will determine the impact of supplementation of these dietary compounds on progression of mucocele formation in dogs whose owners have declined immediate surgical management of the gallbladder disease. Twenty dogs will be treated with standard of care therapy consisting of a Royal Canin prescription diet, SAMe, and ursodeoxycholic acid. Twenty dogs will be treated with standard of care therapy and supplements. Both groups of dogs will have their gallbladders examined by ultrasound every 3 months for one year.

Cases are being actively solicited for this study through NC State Veterinary Hospital Clinical Studies Core outreach to North Carolina veterinarians, through partnership with Veterinary Specialty Hospital of the Carolinas, through the Triangle Shetland Sheepdog Club, ASSA, Border Terrier Club of America, and AKC Health Liaison contacts for the Shetland sheepdog, Cocker Spaniel, Border Terrier, Bichon Frise, Pug, Pomeranian, Beagle, Chihuahua, and miniature Schnauzer breed clubs.

Since initiation of the study on October 1, 2019, 64 dogs have undergone medical record and/or ultrasound image review or prospective gallbladder ultrasound screening for possible inclusion in the study of which 2 dogs are currently actively enrolled.

To qualify for the study, dogs must be diagnosed with a developing gallbladder mucocele that contains unsolidified content not exceeding 30% of the gallbladder lumen and have no ultrasonographic or bloodwork evidence of gallbladder rupture or biliary obstruction. Dogs cannot have any concurrent medical illnesses that would be expected to decrease the likelihood of 1-year survival, must be compliant with oral medications and must not have any food allergies, intolerances, aversions, or medical conditions that would preclude exclusive consumption of Royal Canin Gastrointestinal Low Fat dry or canned dog food for a duration of 1 year. The study requires mandatory visits to the North Carolina State University Veterinary Hospital once every 3 months for 1 year for performance of an abdominal ultrasound examination and collection of blood, urine, and a fecal sample (paid for by study).

TO OBTAIN MORE INFORMATION ABOUT THIS STUDY PLEASE CONTACT:

Dr. Jody L. Gookin (Principal Investigator)

Jody_Gookin@ncsu.edu

[1] Gookin JL, Mathews KG, Cullen J, et al. Qualitative metabolomics profiling of serum and bile from dogs with gallbladder mucocele formation. PloS one 2018;13:e0191076.

2. Research at Virginia Maryland College of Veterinary Medicine

Evalulation of Gallbladder motility in dogs:

AKC Canine Health Foundation Grant # 02644-A: Evaluation of gallbladder motility assessed via ultrasonography in dogs with hyperlipidemia. Grant Amount: $9,148.  Primary investigator: Stefanie DeMonaco, DVM, MS. Grant period: February 1, 2019 - January 31, 2021.

Study Description:

Gallbladder (GB) diseases are frequently recognized in dogs as a significant cause of illness. Currently, the cause of GBM is unknown making treatment and preventative strategies difficult.  Dogs with GBM have poor GB motility and often increased lipid levels, such as cholesterol and triglycerides, leading to the possibility that increased lipid levels may lead to abnormal GB motility and eventually GBM formation.  Breeds with inherited disorders resulting in increased lipid levels, such as Shetland Sheepdogs, are the same breeds that have the highest risk for GB mucocele formation.   However, it has yet to be determined if increased lipid levels are associated with impaired GB motility in dogs. We will utilize ultrasound to compare GB motility between healthy dogs and those with increased lipid levels to determine if increased lipid levels are associated with abnormal GB motility.  If this is the case, diets and medications aimed to reduce lipid levels in conjunction with vigilant monitoring for the development of GB disease may prove beneficial to prevent or reduce severity of illness and risk of death, particularly in predisposed breeds.

We are looking for:

1)         Dogs with hyperlipidemias (increase plasma cholesterol or triglycerides)

2)         Healthy dogs (normal biochemistry and physical examination)

All enrolled dogs will undergo a physical examination, a blood draw, and an abdominal ultrasound.

Study covers the following fees:

Research exam fee, abdominal ultrasound, plasma biochemistry at the teaching hospital of Virginia Maryland College of Veterinary Medicine.  There are no other fees associated with this study.

Contact Information:

Stefanie M. DeMonaco, DVM, MS, DACVIM (SAIM)

Virginia Maryland College of Veterinary Medicine

email: demonaco@vt.edu

540-231-4280

Study Update, January, 2020: “Since starting recruitment in February of 2019 we have 24 patients (4 controls and 20 affected patients). Our goals are to get 6 more affected dogs (hyperlipidemic) and then we will work on getting age match controls. … Of all the patients enrolled, we have 9 Shelties!”