Buster was brought into us with a history of appetite loss and vomiting. Buster was very lethargic and clearly unwell so we took a blood sample to investigate further. Our in house facilities processed the test immediately and the results showed that his liver enzymes and bilirubin levels were worryingly high. The results were suggestive of an obstruction of the bile flow so we performed an ultrasound examination straight away. The ultrasound examination showed that Buster was suffering from a rare condition called Gall Bladder Mucocele (referred to as ‘Kiwi Gallbladder’ as it has the characteristic kiwi fruit appearance). Gall Bladder Mucocele is a rare condition that requires immediate surgery. If left the walls of the gall bladder will necrose (die) causing the contents of the gall bladder to ooze inside the abdomen this can have devastating effects and even result in death.
Buster was put on intravenous fluid therapy to re-hydrate him and our vet Kostas was urgently called in on Saturday morning to perform the cholecystectomy on Buster. We are fortunate here at Streatham Hill vets to have such skilled surgeons to call on as this type of operation usually has to be referred to a specialist hospital. Any delay to this type of procedure could have seriously compromised the success of the surgery.
During this very challenging surgery the entire gall bladder needs to be removed as the gall bladder wall is responsible for producing this excessive mucous that is blocking the normal outflow of bile. Kostas initially made a very large mid-line incision to visualise the abdominal organs, the liver and gall bladder. The intestine was then opened first as this is where the bile duct exits, and he needed to verify that the bile duct was unobstructed before removing the gall bladder. Once this was checked the intestine was sutured and he was then able to address the gall bladder issue The gall bladder was very carefully dissected from around the liver. All manoeuvres done on the gall bladder need to be very gentle as even with mild traction or pressure their is a risk that the gall bladder will burst.
Buster’s gall bladder was successfully removed from the liver (see photo below) and bleeding was controlled with special sponges that help clotting. Afterwards, a liver biopsy was performed to make sure that the liver function is not impaired as well. Finally, the abdomen was lavaged with copious amounts of saline to reduce the risk of post-operative infection.Buster recovered nicely from the anaesthetic and started to eat two days after the surgery. He is now recovering at home with his mum and is expected to make a full recovery and have a very good quality of life.
It is important not to dismiss any ‘simple’ vomiting it can sometimes be a sign for something more serious. Fortunately in this case we were able to save Buster as the owner was vigilant and brought him to us early enough. We love a happy ending!