Bile is an essential part of a dog’s nutrition and overall health. It plays an exceptional role in digestion, particularly in the breakdown of fats in dogs. Bile also aids in the liver's waste product removal. However, when something gets in the way of this process, it can be dangerous.
Bile accumulates in the liver and bloodstream when it cannot flow normally. It’s a condition called cholestasis. Cholestasis is a cholestatic disease in dogs and can cause a number of health issues for your best friend.
But why should you care about this? Essentially, the liver is the organ responsible for a number of bodily functions, including detoxification, digestion, metabolism, blood clotting, and vitamin storage.
When something puts extra stress on the liver, such as the accumulation of bile, it can trigger a series of complications. Some cases of cholestasis in dogs are mild, while other cases can lead to other health issues.
In this blog, we’re here to tell you everything you need to know about canine cholestasis. This includes all the ins and outs of the causes, signs, and treatments.
What Are the Types of Cholestasis in Dogs?
Not all cases of cholestasis in dogs are the same. There are primarily two types: intrahepatic and extrahepatic.
Intrahepatic Cholestasis
The intrahepatic type of cholestasis occurs when something inside the liver is preventing bile from flowing normally. These causes include those that directly affect liver tissue and the small bile ducts in the liver. Common causes include:
Cholangitis. Cholangitis is one of the many infections that can cause cholestasis in dogs. This is the inflammation of the bile ducts and liver tissue, which is usually caused by a bacterial infection. Here, the bile ducts swell and create a narrow path for bile to exit the liver.
Chronic Hepatitis. A condition characterized by the long-term inflammation of the liver. Chronic hepatitis slowly damages the cells of the liver and bile ducts. Over time, this can progress to scarring and blockages.
Liver Fibrosis and Cirrhosis. Liver tissue scarring is also another cause of cholestasis in dogs. When it spreads throughout, it turns into cirrhosis. The thick scar tissue can disrupt the structure of the liver and bile ducts.
Liver Tumors. Tumors can grow inside the liver. These growths can press on the bile ducts or may cause obstructions within them. As a result, bile flow is obstructed.
Toxin Ingestion. Toxic substances for dogs, such as alcohol and xylitol, can also result in severe liver disease in dogs.
Other Causes. Other issues, such as copper hepatopathy, leptospirosis, and trauma to the liver, can also be the cause of cholestasis in dogs.
Extrahepatic Cholestasis
On the other hand, extrahepatic cholestasis happens when there’s a blockage of the bile ducts located outside of the liver. This prevents bile from getting to the intestines. The usual reasons are:
Choledocholithiasis. A condition in which gallstones form in the bile duct. This can obstruct bile flow from the liver and gallbladder to the intestines.
Gallbladder Mucocele. This condition happens when thick mucus accumulates inside the gallbladder. As a result, there will be swelling and blockage. This buildup prevents bile from leaving and can stretch the gallbladder until it obstructs the passageway entirely.
Gallstones and Foreign Bodies. Gallstones are hard mineral deposits that form in the gallbladder and may lodge in the bile ducts, blocking bile flow.
Pancreatitis. The inflammation of the pancreas can also result in swelling of the bile duct, which narrows the passageway.
Tumors Near the Bile Ducts. Tumors located on the pancreas, within the bile ducts, and other nearby areas can also apply pressure on the bile ducts themselves. This restricts bile flow.
Other Causes. Other factors, such as trauma, parasites, and infection, can also affect nearby organs, which will affect the bile ducts.
What Are the Symptoms of Cholestasis in Dogs?
When your dog’s bile flow is restricted, it builds up quickly in the liver and bloodstream. Ultimately, it results in:
Jaundice. Jaundice is one of the most visible signs of cholestasis in dogs, and it happens when the bilirubin builds up in the blood. It causes a yellowish tint in the gums, eyes, and skin of affected dogs.
Pale Stools. The color of the stool will also be affected. This can make the stool turn pale or dull. It's a strong indicator that the bile has not reached the intestines.
Dark Urine. Excess bile pigments can also pass into the urine, creating a darker color. It can be one of the earliest signs that pet owners discover.
Loss of Appetite and Weight Loss. Dogs with cholestasis will lose interest in eating due to nausea or the general feeling of discomfort. In the long term, this can lead to weight loss.
Vomiting and Nausea. Bile backup and liver dysfunction often make dogs feel nauseated, which leads to vomiting. In some cases, dogs may also vomit up bile, which can look yellow-green. Too much vomiting can lead to dehydration.
Lethargy and Weakness. Dogs with cholestasis may seem unusually tired and lethargic. They might not want to play or move at all from their resting positions.
Abdominal Pain and Discomfort. Affected dogs can show signs of belly pain. They can be seen constantly hiding, retreating, isolating, and whining.
How Do Vets Diagnose Cholestasis in Dogs?
The way to diagnose cholestasis in dogs starts with a physical assessment. We’ll look at your dog’s symptoms and review its medical history. Your observations at home will also be needed to guide our process.
Next, we’ll proceed to tests such as a urinalysis, bloodwork, and imaging. A urinalysis can check for bilirubin in the urine, which can confirm the presence of bile in the bloodstream. Urine tests also enable us to rule out other possible conditions, such as kidney disease.
Bloodwork is a major test in diagnosing canine cholestasis. It works by checking alkaline phosphatase and gamma-glutamyl transferase, which are enzymes of the liver. These can indicate bile flow restriction. Other findings can include increased bilirubin levels.
An abdominal ultrasound can also be used to check the conditions of the liver, bile ducts, and gallbladder. It's a great tool that enables us to check for any tumors, gallstones, or foreign objects.
If we need more information, we can do a liver biopsy, bile culture, and cytology.
How Is Cholestasis in Dogs Treated?
The key to treating this disease is to look at the underlying cause. After diagnosis, our vets will provide an accurate and appropriate treatment process to help your dog recover. This can consist of:
Medical Management
If cholestasis is caused by inflammation, infection, or thickened bile, we can start by prescribing a series of medications suited to the cause. These can include antibiotics, steroids, anti-inflammatories, hepatoprotective drugs, and vitamin supplements.
These medicines aim to restore the normal flow of bile while reducing the stress on your dog’s liver.
Surgical Treatment
If the cause is a physical one, then we’ll proceed to more invasive maneuvers to remove the gallstone, tumor, or foreign object.
Cholecystectomy. This procedure is used to treat gallbladder mucocele. Here, the gallbladder itself is removed. Because of this removal, the dog’s bile will flow directly from the liver to the intestines.
Choledochotomy. A choledochotomy creates a small incision on the common bile duct to remove the obstructive agents involved.
Biliary Duct Surgery. This can remove the blockages along the bile ducts, restoring natural bile flow.
Tumor Removal. Removing tumors along the liver and nearby areas will also be an option.
Regardless of the cause, supportive care is an essential part of a dog’s path to recovery. This may include IV fluids, pain-relief medications, anti-nausea medicines, and nutritional support. Some dogs may need to be hospitalized for consistent recovery and constant monitoring.
Prognosis and Recovery of Dogs With Cholestasis
Generally, the prognosis for cholestasis in dogs is good if caught early. Treatable issues, such as infections and gallbladder mucocele, can make the treatment process easier compared to much more complex ones.
If cholestasis is caused by cancer, advanced liver disease, or severe trauma, then the outcome can be more uncertain. These causes might require long-term care and ongoing treatments. Unfortunately, some dogs may not fully recover their liver function.
The recovery time will vary depending on the cause of the dog’s cholestasis. Many will need regular blood tests and supportive care to ensure a smooth recovery. Dogs with chronic conditions may need lifelong medications and special diets.
“A healthy dog is a happy dog. The more attention we give to their health, the happier they become.”
- Dr. Leticia Maia
Final Thoughts
While it’s a serious disease, cholestasis in dogs is a treatable condition. The key is early detection, which means routine visits are recommended. As soon as you notice any of the signs, get your dog to the vet. Let’s keep your dog happy for the years to come.
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