Cholestasis in Dogs

 

Bile, a bitter, high alkaline fluid that is secreted by the liver, serves important functions in the digestion and removal of waste materials from the body. Once bile has been formed in the liver, it is passed into the gallbladder, where it is held until food is digested. It is then released into the small intestine, both to aid in the digestion of food and to emulsify the food so that it can be used appropriately by the body, or carried out of the body as waste.

 

Cholestasis is a term used to denote a condition in which obstruction of the bile duct prevents the normal flow of bile from the liver to the duodenum (a part of small intestine). Cholestasis can occur due to number of underlying diseases, including diseases of the liver, gallbladder, or pancreas.

 

Miniature schnauzers and Shetland sheepdogs are predisposed to pancreatitis (inflammation of the pancreas) and are incidentally at higher risk for developing cholestasis. It is commonly seen in middle-aged and older dogs, but otherwise, this can be found in both male and female dogs.

 

Symptoms and Types

 

Symptoms will vary depending upon the underlying disease that is responsible for this condition. Following are several of the symptoms related to this disease:

 

• Progressive tiredness
• Jaundice
• Polyphagia (excessive hunger and consumption of food)
• Bleeding disorders
• Weight loss
• Pale colored stools
• Orange urine

 

Causes

 

This problem can be associated with a number of diseases. Following are few of the causes that can lead to cholestasis:

 

• Cholelithiasis (stones in gallbladder/gallstones)
• Neoplasia – abnormal growth of tissue, may be malignant or benign
• Pancreatitis (inflammation of the pancreas)
• Parasitic infestation
• Blunt trauma
• Side effect following abdominal surgery

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have preceded this condition, such as trauma to the body. The history you provide may give your veterinarian clues as to which organs are causing secondary symptoms.

 

Laboratory tests will include complete blood tests, a biochemistry panel, and urinalysis. These tests will reveal abnormalities related to the underlying disease, if there is one, as well as abnormalities that are due to the bile duct obstruction itself.

 

Some patients show anemia and abnormalities related to the obstruction. The levels of waste products found in the blood will be indicative, like high levels of bilirubin in the blood. Bilirubin is a throw-away component of the bile and blood fluids; a reddish colored pigment that detaches from the red blood cells as they degrade. Under normal circumstances, bilirubin is secreted through the bile and discarded from the body as waste, giving feces its characteristic color. Due to the bile duct obstruction, too much bilirubin can remain in the blood, eventually leading to a condition of jaundice. Typically, urinalyses will also show high concentrations of bilirubin in the urine and stool samples will be pale in color.

 

Liver enzyme values may be elevated due to liver damage, and bleeding disorders are common with liver disease as well.

 

Any blood that is taken will be evaluated through laboratory evaluations of your dog. Abdominal x-ray and ultrasound imaging can be used to examine the interior of the liver, pancreas, and gall bladder. In some cases, where laboratory testing and other techniques are not helpful for diagnosis, exploratory surgery may be used for diagnosis. Diagnostic surgery also carries the advantage of correcting the problem at the same time if it is found in the course of discovering the underlying issues.

 

If your dog is found to be suffering from a form of neoplasia, an abnormal growth of tissue that is affecting the functioning ability of the bile duct, your veterinarian will need to determine whether the tissue is benign or cancerous. Further treatment will depend upon that outcome.

 

  

 

 

Bilious Vomiting Syndrome in Dogs

 

Bile serves important functions in the digestion of food and removal of waste materials from the body. Bile is created in the liver and stored in the gallbladder until food has been ingested. It is then released into the small intestine to aid in digestion of food and to emulsify the food so that it can be used appropriately by the body.

 

Bilious vomiting syndrome occurs when bile abnormally enters the stomach from the intestine, causing irritation and vomiting. The presence of bile is indicated by a watery, yellow-green substance in the vomit contents. If vomiting does not occur and the bile remains in the stomach, the irritation to the stomach can lead to gastric reflux.

 

Vomiting is usually seen in the morning or late night just before eating, especially in dogs that are fed once daily. This might be due to prolonged periods between meals, or to related stomach inactivity, which aggravates the bile reflux.

 

This condition is commonly seen in older dogs but can occur at any age. Both genders are equally affected.

 

Symptoms and Types

 

• Chronic intermittent vomiting containing bile
• Usually takes place in the morning or late night
• Abdominal discomfort
• Nausea
• Lack of appetite
• Weight loss

 

Causes

 

• The exact cause is still unknown
• Diseases causing gastritis or inflammation of intestine, modifying gastrointestinal motility
• It is presumed to be caused by stomach and intestinal reflux, which often occurs when a dog’s stomach has remained empty for a long period of time

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, a background history of symptoms, possible incidents that might have led to this condition, and recent activities. As much as you can, you will need to tell your veterinarian when the symptoms began, and how frequently the vomiting occurs.

 

Your veterinarian will then perform a thorough physical exam on your dog, with a complete blood profile, a chemical blood profile, a complete blood count, and a urinalysis.

 

A history of intermittent vomiting with bile contents is usually enough for a preliminary diagnosis. In the course of diagnosing this disease, laboratory testing is not of much help as the results are usually within normal ranges. Specific radiographic and ultrasound imaging studies of the abdomen may reveal delayed stomach motility. Endoscopic examination often returns normal in these patients.

 

Esophagitis in Dogs

 

Gastrointestinal reflux, or acid reflux, is one of the most common causes of esophagitis, the term applied to inflammation of the esophagus in dogs. Acid reflux is the result of stomach acids passing into the esophageal canal, causing irritation to the tissue lining of the esophagus, the muscular tube that carries food down from the mouth cavity to the stomach.

 

Young dogs born with congenital esophageal abnormalities are at an increased risk for esophagitis. Older dogs that are being treated with anesthesia for surgery, or for other reasons, may also develop this condition. One of the most important complications of esophagitis is aspiration pneumonia, which occurs due to the entrance of food particles or liquid drops into lungs.

 

Symptoms and Types

 

• Regurgitation (returning of food or other contents from the esophagus or stomach back through the mouth)
• Increased swallowing motions
• Pain while swallowing
• Increased secretions coming out of mouth
• Difficulty swallowing
• Dog may cry while swallowing food
• Dog may extends its head and neck during swallowing
• Inability to ingest food
• Reluctance to move or lie down
• Poor appetite
• Weight loss
• Coughing
• Fever
• Dog may feel pain if you touch its neck or esophagus
• More pronounced symptoms if pneumonia develops

 

Causes

 

• Reflux of gastric and/or intestinal contents (backward flow of fluids towards esophagus)
• Accidental ingestion of irritant chemicals
• Infections
• After surgery involving the esophagus; often due to passing of the feeding tube through the esophagus
• Chronic vomiting
• Foreign body remaining in esophagus
• Animal retaining ingested pills or capsules in esophagus

 

 

Diagnosis

 

Your veterinarian will examine your dog thoroughly after taking a full history from you. You will need to give your veterinarian as much information as you can about your dog’s health, including the onset of symptoms, and any possible incidents that might have preceded this condition.

 

Routine laboratory testing will include a complete blood count, biochemistry profile, and a urinalysis, though these tests usually return as normal in such patients. However, in cases of pneumonia, changes related to the infection may be seen in laboratory results. Radiographic studies, including X-ray or ultrasound imaging, may help in the diagnosis of esophagitis. An advanced type of radiography called barium contrast radiography may reveal changes in the esophagus due to inflammation. In barium contrast radiography, barium sulfate is administered orally to the dog. The particles are suspended in the esophagus, making the esophageal canal easier to visualize on X-ray.

 

Endoscopy is also an option for diagnosis in these patients and is often a more reliable procedure for diagnosis of esophagitis. Endoscopy is an internal diagnostic tool which uses an endoscope, a rigid but flexible tube equipped with a camera and methods for retrieving tissue samples, that can be inserted into a hollow cavity, such as the esophagus. Using this method, your veterinarian can look directly into the esophagus in order to visually inspect it, to take pictures, and to take a sample for biopsy.

 

Endoscopy may also be used to remove a foreign body, if required.

 

Helicobacter Infection in Dogs

 

Under normal conditions, the Helicobacter bacteria are benign inhabitants of the intestinal tract, being found in several species, including domestic animals such as dogs, cats, ferrets and pigs, in wild animals such as cheetah’s and monkeys, and in humans. While gastric infection due to Helicobacter pylori is a major health problem in humans – it has been associated with gastritis, gastric tumor, and peptic ulcer in affected people – the significance of the Helicobacter bacterium in dogs and any correlation to gastric dysfunctions is still largely unclear (H. pylori specifically is not found in dogs).

 

Various species of Helicobacter organism have been isolated from the stomachs of cats and mixed infections can present, which sometimes complicates the diagnosis. The most common forms of Helicobacter found in dogs are Helicobacter felis and Helicobacter heilmannii. Other species of Helicobacter found in dogs are Helicobacter rappini, and Helicobater salomonis. The bacteria inhabit the mucosal lining of the stomach, and the glandular cavities.

 

There are some reports of isolation of Helicobacter from the livers of dogs with hepatitis but this remains anecdotal. Infection from this bacteria is difficult to eradicate entirely and may last from months to years – even for a lifetime, in some dogs.

 

Symptoms and Types

 

Most cases remain without any symptoms at all. In others the following symptoms may be seen:

 

• Vomiting
• Dehydration
• Poor appetite
• Bowel sounds
• Abdominal pain
• Weight loss
• Diarrhea
• Weakness
• Sudden death

 

Causes

 

Gastric Helicobacter felis, Helicobacter heilmannii, Helicobacter rappini, and Helicobater salomonis infection. The method by which this infection is transmitted remains unknown, but because of its higher prevalence in shelter dogs, oral and/or fecal transmission is considered a possibility. This assumption is supported by the presence of Helicobacter-like organisms, called GHLOs, in the vomit, feces and saliva of animals that have been infected. There is also some suspicion that the bacteria may be transmitted by water, as GHLOs have been found in some surface waters.

 

Poor sanitary conditions and overcrowding appear to facilitate the spread of infection.

 

Diagnosis

 

Establishing a definitive diagnosis of Helicobacter infection is difficult in most instances. Your veterinarian will perform a complete physical examination with routine laboratory tests including a complete blood count, biochemistry profile, and urinalysis. Your veterinarian may also take a sample from stomach wall and stain it with May-Grünwald-Giemsa, Gram, or Diff-Quik stains, which can easily demonstrate the presence of this organism by making it visible under microscope.

 

An endoscopic examination is of great help for direct observation of the stomach walls as well as for taking tissue samples for further processing. This procedure uses a device called an endoscope, a camera situated at the end of a flexible tube, which is threaded into the stomach through the esophagus. A polymerase chain reaction (PCR) test is often used both to confirm the presence of Helicobacter in a given sample and to differentiate between the species of Helicobacters. However, confirmation can also be made by taking a tissue sample using the endoscope and observing the sample through microscope.

 

Note that the presence of gastric Helicobacters in the body do not necessarily indicate an infection that needs to be treated.

 

 

Melena in Dogs

 

The term melena is used to describe stool that appears black and tarry, which occurs due to the presence of digested blood in the feces.

 

Melena typically occurs due to bleeding in the upper portion of the gastrointestinal tract. It has also been seen in dogs after they have ingested a sufficient amount of blood from the respiratory tract, for example from a nosebleed or coughing up and swallowing blood from the lungs. Melena is not a disease in itself but a symptom of some other underlying condition such as a gastrointestinal ulcer or blood clotting disorder. The dark color and tarry consistency of the feces occurs because of the digestion of blood as it passes through the intestinal tract.

 

Symptoms and Types

 

Other symptoms related to melena depend on the bleeding’s underlying cause, severity, and location.

• In patients with gastrointestinal bleeding, other symptoms might include:
  • Vomiting, with or without blood
  • Lack of appetite
  • Weight loss
  • Weakness and exercise intolerance
  • Pale mucous membranes
  • Anemia
  • Difficult or rapid breathing
  • Abdominal pain
     
• In patients with bleeding in respiratory tract, other symptoms might include:
  • Nose bleed
  • Sneezing
  • Coughing up blood
  • Pale mucous membranes
  • Anemia
  • Weakness and exercise intolerance
  • Difficult or rapid breathing
     
• In patients with abnormal blood clotting disorders, other symptoms might include:
  • Nose bleed
  • Blood in urine
  • Bright red blood in the stool
  • Blood in the eyes
  • Vomiting, with or without blood
  • Abnormal bruising
  • Anemia
  • Pale mucous membranes
  • Weakness and exercise intolerance
  • Difficult or rapid breathing

Causes

 

Melena can have many causes, including:

• Ulcers in the gastrointestinal system
• Tumors of the mouth, esophagus, stomach, or small intestine
• Gastrointestinal infections
• Foreign body in the gastrointestinal system
• Disorders involving inflammation of the intestinal tract
• Kidney failure
• Addison’s disease
• Drug toxicity
• Exposure to toxins
• Parasites
• Liver disease
• Pancreatitis
• Hormonal disorders
• Infections, cancer, or foreign bodies within the lungs or nose
• Trauma
• Disorders involving abnormal clotting of blood

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have led to this condition. The history you provide may give your veterinarian clues as to where the blood is originating from. After taking a complete history, your pet’s veterinarian will conduct a complete physical examination. Standard laboratory tests for dogs with melena can include a complete blood count (CBC), biochemistry profile, fecal examination, and urinalysis. The results of these tests will reveal how serious your dog’s melena is and possibly point to the potential underlying cause. Additional procedures and testing may also be necessary. These can include X-rays, ultrasound imaging, endoscopy, specialized blood tests, surgery, and tissue biopsies, depending on the particulars of your dog’s case.  

 

 

Dogs are known for eating things when they are not supposed to. This is especially true of puppies. Also, dogs have an excellent sense of smell, making it fairly easy to find any secret hiding spots for the chocolate. This can be a dangerous combination when there is chocolate around the house.

 

Chocolate is derived from the roasted seeds of Theobroma cacao, which contains certain properties that can be toxic to animals: caffeine and theobromine. If ingested, these two ingredients can also lead to various medical complications and may even prove fatal for your dog.

 

If you would like to learn how chocolate poisoning can affect cats, please visit this page in the petMD Health Library. Also, go to our Chocolate Toxicity Meter for more information on the dangers of chocolate poisoning and its effects.

 

Symptoms and Types

 

• Vomiting
• Diarrhea
• Increased body temperature
• Increased reflex responses
• Muscle rigidity
• Rapid breathing
• Increased heart rate
• Low blood pressure
• Seizures
• Advanced signs (cardiac failure, weakness, and coma)

 

The amount and type of chocolate ingested is also important, as they are the determining factors for the severity of the toxicity. The three types of chocolate that you must be aware of are:

 

1. Milk Chocolate – Mild signs of toxicity can occur when 0.7 ounces per pound of body weight is ingested; severe toxicity occurs when two ounces per pound of body weight is ingested (or as little as one pound of milk chocolate for a 20-pound dog).
2. Semi-Sweet Chocolate – Mild signs of toxicity can occur when 0.3 ounce per pound of body weight is ingested; severe toxicity occurs when one ounce per pound of body weight is ingested (or as little as six ounces of semi-sweet chocolate for a 20-pound dog).
3. Baking Chocolate – This type of chocolate has the highest concentration of caffeine and theobromine. Therefore, as little as two small one-ounce squares of baking chocolate can be toxic to a 20-pound dog (or 0.1 ounce per pound of body weight).

 

Causes

 

In the right quantities chocolate can become toxic for any dog. So be wary of feeding your pet anything that might contain chocolate and always keep it out of reach.

 

Diagnosis

 

Your veterinarian will perform a complete physical exam, including a chemical blood profile, electrolyte panel and a urinalysis. These tests will help determine if there is a chocolate/caffeine overdose.
 

Blood can also be taken to test for theobromine concentrations, while an ECG is performed to help determine if the heart is showing any abnormalities in rhythm or conduction of heart beats.

 

 

Gastroduodenal Ulcer in Dogs

 

Gastroduodenal ulcer disease refers to ulcers found in the dog’s stomach and/or the first section of the small intestine, also known as the duodenum.

 

These uclers often develop because the mucosal lining of the stomach or intestinal lumen (which comes in direct contact with food and is responsible for nutrient absorption) is exposed. There are various factors that may alter these protective mechanisms.

 

Although the formation of these ulcers are less common in cats, they do occur. If you would like to learn more about how the disease affects cats, please visit this page in the PetMD health library.

 

Symptoms and Types

 

There are many symptoms that can develop as a result of gastroduodenal ulcers, of which some may remain undetected until the dog’s condition becomes severe. For instance, dogs are less likely to show clinical evidence of gastrointestinal bleeding.

 

The following are some of the more common symptoms:

 

• Anemia
• Weakness
• Weight loss
• Loss of appetite
• Rapid heart rate
• Vomiting (most often seen)
• Blood in vomiting (hematemesis)
• Black tarry stool due to presence of digested blood (melena)
• Abdominal pain (animal may stand in praying position)

 

Causes

 

Accidental poisoning is one of the leading causes of gastroduodenal ulcer disease. This can be in the form of plant intoxication (e.g., mushrooms, castor beans, sago palm), pesticide or rodenticide toxicity, chemical poisoning (e.g., ethylene glycol, phenol), or heavy metal poisoning (e.g., zinc, iron, arsenic).

 

Gastroduodenal ulcers are common in German Shepherds heavily medicated on ibuprofen. Rottweilers also have increased incidence of stomach perforation and ulcers.

 

Other common causes of gastroduodenal ulcer disease include:

 

• Gastrointestinal obstructions (i.e., tumors)
• Hyperacidity of the stomach
• Severe trauma (e.g., shock, head injury, burns)
• Gastrointestinal parasites
• Infectious diseases (bacterial, fungal, viral)
• Kidney or liver failure
• Adverse drug reaction
• Pythiosis (a condition cause by water mold)
• Helicobacter infection
• Sustained strenuous exercise

 

 

Diagnosis

 

Your dog’s veterinarian will take detailed history and after conducting the physical examination, routine laboratory testing will be carried out. Complete blood count, biochemistry profile, and urinalysis can help in diagnosing this problem along with complications, if any.

 

Blood testing, for example, may reveal anemia in patients with bleeding, whereas in cases with chronic blood loss, iron deficiency anemia may be seen. In some dogs, decreased number of platelets (cells important for blood clotting) and white blood cells may be seen. Fecal material is also analyzed to see if blood is present in it or not, while abdominal X-rays and ultrasounds assist in diagnosing any foreign body, mass in the stomach or duodenum.

 

In case of tumor, thoracic X-ray may help in finding the metastasis of tumor to lungs. Endoscopy, a procedure in which a veterinarian will look directly into the stomach and duodenum using an endoscope, is the method of choice for definitive diagnosis. In addition, endoscopy allows the veterinarian to remove any foreign bodies and take a biopsy. A rigid or flexible tube will also be inserted in the stomach and duodenum in order to take photographs.

 

Esophageal Obstruction in Dogs

 

Dogs tend to eat unusual things. When a dog ingests foreign material or foodstuffs too large to pass through the esophagus (the throat), the esophagus can become blocked.  Small-breed dogs, especially terriers, are most apt to have esophageal foreign bodies. Esophageal foreign bodies cause mechanical blockage, swelling, and death of the throat tissue.

 

Symptoms and Types

 

• Retching
• Gagging
• Loss of energy
• Loss of appetite
• Depression
• Excessive salivation, drooling
• Regurgitation
• Restlessness
• Trouble swallowing
• Trouble breathing
• Persistent gulping

 

Causes

 

Obstruction of the esophagus occurs with objects that are of a size, shape, or texture that will cause them to get stuck in the esophagus.

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have led to this condition. You should describe anything your think your dog might have eaten that could have become lodged in its throat (e.g., toys, panties, golf balls). Your veterinarian will do a physical exam, with an X-ray of the esophagus and chest. Another diagnostic tool that is useful for imaging is an esophagoscope, for seeing the interior of the esophagus. These imaging steps are crucial for making a concrete diagnosis and for making an accurate estimation of the exact place in the esophagus that is being affected, and of the degree of damage caused to your dog’s esophagus. Standard tests will also include a chemical blood profile, complete blood count, urinalysis and an electrolyte panel. Usually, the bloodwork results will return as normal.

 

 

Peritonitis in Dogs

 

Peritonitis is often associated with acute abdominal pain due to the sudden inflammation of the abdominal tissues, or peritoneum, hence the name for the condition. This causes fluid to shift into the peritoneal cavity, leading to severe dehydration and electrolyte imbalance. Peritonitis may be due to infectious causes such as the stomach flu or non-infectious causes such as a hernia.

 

While younger dogs tend to have acute abdomen due to infectious and traumatic causes, malignant cancers are more often the cause of acute abdomen in older dogs. It is crucial to determine the underlying cause of the acute abdomen as your veterinarian may have to perform emergency surgery to resolve it.

 

Symptoms and Types

 

• Lethargy
• Trembling
• Crying, Whimpering
• Abnormal posture (i.e., may be “guarding” the stomach by curling up, or leaning forward with back end higher in attempt to relieve pain)
• Heavy breathing
• Swollen abdomen (may be rigid to the touch
• Diarrhea, which may be black (also referred to as melena)
• May have vomiting if the stomach or intestines are involved

 

Causes

 

Infectious Causes

• Holes in the dog’s stomach lining
• Viruses of the stomach or intestinal tract
• Feline infectious peritonitis virus
• Viral enteritis (stomach flu)
• Parasites of the stomach or intestines
• Bacterial infection of the uterus
• Abscesses of the liver, spleen, and/or pancreas

 

Non-infectious Causes 

• Tumors
• Cancers
• Poisoning
• Congenital Defects
• Trauma to the abdomen, possibly involving rupture of organs (hernia)
• Rupturing of the ureters (tubes which carry urine), bladder or of a pregnant uterus
• Congenital hernia causing entrapment of organs
• Obstruction of the urethra or ureters
• Kidney or gallbladder obstruction (e.g., calculi deposits)
• Gastric dilation and volvulus

 

Diagnosis

 

Your veterinarian will need a complete medical history to begin to identify what is causing the acute abdomen. The history you provide may give your veterinarian clues as to which organs are causing the sudden abdominal pain. He or she will also perform a complete physical examination to see if the pain is really in the abdomen and not the kidneys or back. If your dog has a swollen abdomen, your veterinarian will use a fine needle to withdraw some of the fluid from the abdomen to send to the laboratory for analysis.

 

A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, an electrolyte panel and a urinalysis. Your veterinarian may also use a syringe to take urine from your dog to be sent to a lab for examination.

 

Your veterinarian will need to use visual diagnostics to examine the abdomen internally. X-rays and ultrasound will be used to locate the source of the disturbance in the abdomen. If your dog is young (still a puppy) a parvovirus blood test may also be given.

 

 

Bile Peritonitis in Dogs

 

Bile is a bitter fluid secreted by the liver and released into the gallbladder, to be stored until is is released into the duodenum — the small intestine — after a meal is taken. Bile is an essential component in digestion, emulsifying the fats in food, thereby aiding in their absorption in the small intestine.

 

Under abnormal circumstances, however, bile can be released into the abdominal cavity, irritating the organ and causing inflammation. This may occur after injury, infection of the gallbladder, swelling of the gallbladder, blockage of the gallbladder’s ducts, or bile leakage.

 

Bile peritonitis is usually the result of a more serious underlying condition. In fact, when caused by an infection, bile peritonitis kills as many as 75 percent of those animals infected with the disease.

 

Symptoms and Types

 

Signs can be acute or chronic. However, symptoms for infectious bile peritonitis are generally acute, while those for non-infectious bile peritonitis are long-term. Such symptoms include:

 

• Abdominal pain
• Loss of energy
• Loss of appetite
• Vomiting
• Diarrhea
• Weight loss
• Abdomen swollen, larger than normal
• Yellow skin and/or yellow whites of eyes
• Collapse (if infectious)
• Fever (if infectious)

 

Causes

 

Bile peritonitis is generally caused by inflammation of the gallbladder or an injury that causes the dog’s gallbladder to rupture or break. Moreover, inflammation of the gallbladder may be due to infection or a blockage of the gallbladder ducts, which can be caused by:

 

• Cancer
• Gallstones
• Inflammation of the pancreas (pancreatitis)
• Narrowing (stenosis) of the gallbladder’s ducts

 

Diagnosis

 

Your veterinarian will perform a thorough physical exam on your dog, taking into account the background history of symptoms and possible incidents that might have precipitated this condition. A complete blood profile will be conducted as part of a standard exam, including a chemical blood profile, a complete blood count, and a urinalysis.

 

If your dog is suffering from bile peritonitis, high liver enzymes will be present in the blood chemical profile and bile will be present in the urine. Abdominal x-rays and  ultrasound will enable your veterinarian to visualize the liver and gallbladder area in the course of determining the origin of the bile leakage. Using an ultrasound to guide the process, your veterinarian may take a sample of your dog’s liver for biopsy, along with abdominal fluid that is present in the abdominal cavity. These samples will be sent to the laboratory for analysis.