Increasing age and severe intraoperative hypotension associated with nonsurvival in dogs with gallbladder mucocele undergoing cholecystectomy

J Am Vet Med Assoc. 2023 Sep 4;261(12):1-9. doi: 10.2460/javma.23.06.0305. Print 2023 Dec 1.

Abstract

Objective: To identify prognostic indicators and inflammatory markers associated with nonsurvival in dogs with gallbladder mucoceles (GBMs) following cholecystectomy and to evaluate C-reactive protein (CRP) and haptoglobin concentrations in dogs with GBMs compared to healthy controls.

Animals: 25 dogs that underwent cholecystectomy for removal of GBM and 20 healthy control dogs.

Methods: A prospective, multicenter cohort study. Survival outcomes to hospital discharge and 2 weeks postdischarge were recorded from medical records. Laboratory variables, inflammatory markers (CRP and haptoglobin), and 25-hydroxyvitamin(OH) D (25[OH]D) concentrations were measured preoperatively. Associations between signalment, clinicopathologic variables, acute patient physiologic and laboratory evaluation (APPLEFAST) scores, inflammatory markers, 25(OH)D concentration, and survival were analyzed using logistic regression.

Results: 76% (19/25) and 68% (17/25) of dogs survived to hospital discharge and 2 weeks postdischarge, respectively. For each additional year of age, the odds of nonsurvival in hospital and 2 weeks postdischarge increased by 2.2 (P = .01; 95% CI, 1.2 to 5.0) and 1.7 (P = .04; 95% CI, 1.0 to 3.2), respectively. Intraoperative systolic blood pressure ≤ 65 mm Hg increased the probability of nonsurvival in hospital (P < .04). Gallbladder perforation, APPLEFAST scores, and preoperative serum concentrations of CRP, haptoglobin, and 25(OH)D were not associated with survival. Serum CRP and haptoglobin concentrations were greater in dogs with GBM compared to controls (P < .001).

Clinical relevance: Increasing age and intraoperative systolic blood pressure ≤ 65 mm Hg were associated with nonsurvival in dogs with GBM undergoing cholecystectomy. Serum CRP, haptoglobin, and 25(OH)D were not associated with nonsurvival postcholecystectomy in this sample population.

Keywords: APPLE fast; C-reactive protein; biliary disease; haptoglobin; vitamin D.

Publication types

  • Multicenter Study

MeSH terms

  • Aftercare
  • Animals
  • Cholecystectomy / veterinary
  • Cohort Studies
  • Dog Diseases* / pathology
  • Dogs
  • Gallbladder Diseases* / surgery
  • Gallbladder Diseases* / veterinary
  • Haptoglobins
  • Hypotension* / veterinary
  • Mucocele* / surgery
  • Mucocele* / veterinary
  • Patient Discharge
  • Prospective Studies

Substances

  • Haptoglobins