Two cases of canine gallbladder carcinoid: clinical and ultrasonographic findings

Gallbladder carcinoid is a rare neoplasia that arise from the dispersed cells of the neuroendocrine system of the biliary three. This tumour have been described in humans and dogs. In the few reports we can nd in literature, canine patients a ected by this neoplasia present a combination of symptoms such as: vomiting, weight loss, lethargy, fever, melena, anaemia, hematemesis and jaundice. Haemobilia, hemocholecyst and common bile duct dila- tion have been found in few dogs presenting gallbladder car- cinoid. Clinical-ultrasonographic ndings and long term follow up of two asymptomatic dogs a ected by gallbladder carcinoid are described. Dog 1: Mixed breed, 10 years old, 28 kg, underwent ultrasonographic examination for a routine follow up control because previously a ected by low grade splenic lymphoma. Liver was sonographically normal and a 4 cm, round shaped, inhomogeneous mass was found into the gallbladder arising absence of airway disease and of clinical signs as cough, exercise intolerance, anorexia, syncope, ascites and dysp- nea, were collected from a total of 477 medical records. All dogs included in the study underwent a complete physical and echocardiographic examination. In dogs in stage B1 or B2 that presented with cough, cough was con rmed to be due to concomitant airway disease by radiographic and echocardiographic examination in conjunction with informa- tion regarding follow-up and response to therapy. From the 477 medical records, 235 had complete infor- mation regarding clinical signs. In these 235 records, 139 symptomatic dogs were identi ed. At baseline examination, 90 (64.7%) dogs presented with cough, 48 (34.5%) with exercise intolerance, 36 (25.9%) with dyspnea, 36 (25.9%) with syncope, 25 (18%) with anorexia and 8 (5.8%) with ascites. Out of the 90 dogs that had cough, 44 (48.9%) were in stage B1 or B2, which means that in these cough was caused by concomitant airway disease. Of the 177 dogs with information regarding cardiac auscultation and murmur intensity, 156 (88.1%) had a left apical systolic murmur. Mur- mur grades were mainly between 2 and 5 (95.6%). The mean SBP was 149.5 ± 26.51 mmHg (n= 63), and the mean HR was 135 ± 37.9 bpm (n= 477). The ndings of this study regarding clinical signs reported are in agreement with the results from previous studies. The concomitant presence of airway disease seems to represent the higher risk factor for coughing in dogs with MMVD. There- fore, this should be taken into account when considering diagnosis and clinical management of these dogs. from its wall. This mass presented a massive Doppler vascu- lar signal. Bile was hypoechoic and inhomogeneous with a small amount of biliary sludge. Common bile duct (CBD) diameter was normal (< 3 mm). Visceral lymphadenopathy was not reported Dog 2: English Bulldog, 9 years old, 30 kg, underwent ultrasonographic examination because of a routine control of urate cystolithiasis. Liver was sonographically normal and a 1,5 cm, round shaped, inhomogeneous mass with regular margins was found into the gallbladder. This mass pre- sented a massive Doppler vascular signal. Fluid content of gallbladder was anechoic. CBD diameter was normal (< 3 mm). Visceral lymphadenopathy was not reported. Dogs underwent laparotomic cholecystectomy and hepatic biopsy. Any abdominal lesion was found during sur- gery, the patency of CBD was veri ed with a retrograde catheterization and no blood or clots were found into the gallbladder or biliary three. Histology and immunohistochemistry con rmed the diagnosis of gallbladder carcinoid. Hepatic biopsy did not reveal any alteration except from a mild portal hepatitis. Dogs recovered well and they remained asymptomatic; they were sonographically evaluated 3 and 12 months after surgery and no abnormalities attributable to metastasis were found. However both dogs presented a CBD dilation (almost 1 cm) without any sign of post-hepatic jaundice. CBD dilation have been described in humans with an history of cholecystectomy and it seems to be related to senior age.