Cholestasis in dogs: signs, symptoms and treatment. Biliary dyskinesia in a dog symptoms Blockage of the bile ducts in a dog

Unfortunately, many owners are faced with a disease such as cholecystitis in dogs. This pathology occurs when the normal function of the bile ducts is disrupted, which leads to the development of inflammation in the gallbladder.

Due to poor outflow, bile becomes denser and more caustic. In this case, there is a danger of injury to the walls of the bladder, which leads to the formation of ulcers on it. If the disease is not treated, bile will leak into the abdominal cavity through the resulting holes. This threatens to happen without urgent surgery, otherwise the pet will die.

There are several factors that provoke the development of cholecystitis.

Cholecystitis can develop in dogs that are frequently fed smoked meats.

These include:

An unbalanced diet is considered a provocateur of many diseases, including cholecystitis. The correct structure of the gastric mucosa is maintained due to the presence of a sufficient amount of carotene in the body. It is he who is responsible for the restoration of failed cells. Therefore, a lack of vitamin A in a pet’s diet negatively affects its health.

An unbalanced diet is the main cause of cholecystitis in dogs.

How to recognize the disease

It is almost impossible to find out about the presence of the disease until the first symptoms appear. If your dog begins to behave strangely, you should watch it. When the first clinical signs of cholecystitis appear, the pet should be immediately referred to a veterinarian for further diagnosis.

Symptoms of cholecystitis

The chronic form differs in its manifestation from the acute one. It is characterized by slight deviations in the behavior of the animal.

It can be detected by the following symptoms:

• decreased activity, the animal sleeps a lot;
• lack of appetite, refusal of water;
• orange urine, light-colored feces, as bilirubin in the blood has increased sharply;
• intestinal disorders;
• severe hair loss ();
• The main position of the pet is on its stomach, with its back arched.

The acute form of cholecystitis occurs if measures are not taken in time and the disease starts.

When the disease worsens, there is a real threat to the pet’s life. When the bile ducts are completely blocked, the bladder stretches and bursts, causing peritonitis.

With cholecystitis, dogs often develop jaundice.

How is the disease diagnosed?

At the first visit, the doctor interviews the owner, finds out the symptoms and examines the pet. He assesses the condition of the skin, mucous membranes, and fur. Probes the abdominal area.

If there is a suspicion of cholecystitis, then the veterinarian prescribes the following diagnostic procedures:

• Ultrasound to identify pathologies that cause inflammation of the digestive system and gallbladder;
• x-rays to determine the presence or absence of stones;
• general blood test - identifying the content of leukocytes, an increased level of which indicates inflammation;
• urine and stool analysis to assess bilirubin levels;
• liver biopsy gives an idea of ​​​​the viscosity of bile and its stagnation;
• Bile analysis allows you to determine the causative agent of the infection;
• diagnostic laparotomy - performed if there is a possibility of peritonitis.

Drug treatment

When starting treatment, first of all you should relieve dangerous symptoms and save your pet from dehydration. Glucose solution and calcium gluconate will help alleviate the general condition. Having normalized it, you can begin to directly eliminate the causes of the disease.

Treatment of cholecystitis should only be prescribed by a veterinarian after examining the dog.

Important. The doctor makes prescriptions and selects treatment depending on each specific case. In this case, the degree of neglect of the disease, its form and cause of occurrence play an important role. The individual characteristics of the dog are also taken into account, such as age, weight, general condition, concomitant diseases and other factors.

The following medications are used to treat cholecystitis:

The last but not least important step in treatment is heat-based physical therapy. Such procedures relieve the effects of inflammation, improve blood flow and relieve pain.

Diet for cholecystitis

Special nutrition will help return the body to normal functioning. It is the basis for effective treatment, as it places minimal stress on the gastrointestinal tract.

In case of cholecystitis, the dog is put on a special diet.

Dog food for cholecystitis is selected by a veterinarian. Most often, specialized foods are prescribed aimed at restoring normal digestion. Dry cheap food is completely excluded.

If the pet also eats homemade food, then certain restrictions are introduced.

The dog's diet is based on the consumption of the following foods:

• lean meats, such as chicken or turkey;
• boiled cereals such as rice and buckwheat;
• calcium-rich foods - cottage cheese, any unsweetened sour milk with a low fat content;
• vegetables rich in vitamin A;

Having figured out what to feed your sick pet, you need to choose the right diet. It is best if there are at least five meals. Food must be fresh and served pureed. When the disease worsens, the animal needs to fast for about a day.

Disease prevention

It is very important to monitor your dog’s weight and prevent obesity.

Let's present the main ones:

You need to monitor your dog’s health and take preventive measures, then this disease can be avoided. If there is a suspicion of cholecystitis, then timely diagnosis and competent treatment will help avoid complications.

The causes of biliary tract dysfunction can be due to sins in the diet, when fatty, fried and smoked foods predominate, irregular meals, when a person leads a sedentary lifestyle, excess body weight, and biliary dyskinesia often occurs (in 85-90% of cases). ) against the background of diseases of the stomach, duodenum, liver diseases, chronic tonsillitis and caries.

There are two types of biliary dyskinesia.

The first is hyperkinetic, when the gallbladder contracts too much and severe spasmodic pain occurs in the right hypochondrium, reminiscent of “colic.”

The second is hypokinetic, when the gallbladder contracts less, and because of this, less bile is supplied than is needed for the digestion process. The pain with this type is dull and usually occurs after eating.

How to understand that you have biliary dyskinesia?

If you experience symptoms such as pain in the upper abdomen that does not disappear after defecation, nausea, vomiting, pain at night, a feeling of bitterness in the mouth, then you need to contact a therapist or gastroenterologist to undergo an examination.

Symptoms of biliary dyskinesia

There are hyperkinetic (hypertonic) and hypokinetic (hypotonic) forms of dyskinesia. Hyperkinetic dyskinesia is observed more often in individuals with vagotonia. Patients regularly experience severe

Colin-shaped pain in the right hypochondrium with irradiation to the right scapula and shoulder. The pain recurs several times a day, is short-lived, and is not accompanied by an increase in body temperature. Neurovegetative and vasomotor syndromes are often revealed:

Hypokinetic dyskinesia is characterized by persistent dull, painful pain in the right hypochondrium, poor appetite, belching, lightheadedness, bitterness in the mouth, bloating, constipation, and slight pain in the gallbladder area. It occurs more often in individuals with a predominant tone of the sympathetic nervous system. Dyskinesia is typical of the connection between pain and anxiety and neuro-emotional stress; an increase in ESR, leukocytosis or other changes in the blood are not noticed.

Treatment of biliary dyskinesia

Treatment of biliary dyskinesia begins with the exclusion of neurotic and diencephalic disorders. For hyperkinetic forms of dyskinesia, sedatives are used (Elenium, seduxen, sodium bromide, ankylosing spondylitis), for hypokinetic forms, tonics (aloe, ginseng). For patients with the hypertensive form, cholinergic antispasmodics are recommended (atropine, metacin, platyphylline, papaverine, aminophylline, no-spa - one tablet three times a day) together with choleretics (lyobil, decholine, hologon, cholenzyme, oxafenamide - 1-2 tablets each). 3-4 times a day), thermal procedures (mud, ozokerite applications, diathermy, inductothermy) and low-mineralized mineral waters (Essentuki No. 4 and 20, Slavyanovskaya, Smirnovskaya, Narzan No. 7).

For hypotonic dyskinesias, cholecystokinetics are used (Magnesium sulfate, olive oil, pantocrine, pituitrin, sorbitol, xylitol), alkaline mineral waters with high mineralization (Essentuki No. 17, Batalinskaya, Arzni, Morshynskaya No. 6 in warm form), tubages. Systematic treatment of dyskinesias can prevent the development of cholecystitis and cholelithiasis.

Treatment primarily requires constant adherence to dietary recommendations, a diet with limited fatty and fried foods. It is necessary to exclude alcohol, carbonated drinks, and smoking. If this disease is neglected, gallstones may form in the gallbladder, threatening its inflammation and subsequent removal.

Establishing diagnosis

The main diagnostic method is ultrasound examination of the gallbladder on an empty stomach and after taking a choleretic breakfast. It is also necessary to evaluate markers of liver function, such as (AST) and alkaline phosphorus.

The diagnosis of biliary dyskinesia is established due to clinical findings with a lack of signs of organic damage to the biliary tract. Duodenal intubation helps, which allows you to distinguish between disorders of the tone and function of the gallbladder, and the state of the sphincter apparatus of the extrahepatic bile ducts. Cholecystography reveals an increased shadow of the gallbladder, delayed or frequent emptying. Sometimes prolapse or size of the gallbladder is noticed, but without deformation or other organic changes.

Prevention of dyskinia consists in creating conditions in favor of good outflow of bile and improving the regulatory mechanisms of bile excretion: treatment of neurotic disorders, alternation of work and rest, prevention of conflict situations, adequate sleep, staying in the fresh air, doing gymnastics and sports, eating at the same time time, systematic bowel movements.

Biliary dyskinesia - symptoms and treatment

Biliary dyskinesia is a disease in which the motility of the gallbladder is impaired and the functioning of the bile ducts malfunctions, which causes stagnation of bile or its excessive secretion.

This disorder occurs mainly in women. As a rule, patients of young age (20-40 years) and thin build suffer from biliary dyskinesia. In some women, there is a strong relationship between the exacerbation of complaints and the period of the menstrual cycle (exacerbation occurs 1-4 days before the onset of menstruation), and the disease can also worsen during menopause.

Since this disease causes changes in the properties of bile, the absorption of some important substances and fat-soluble vitamins is impaired. At risk are women with diseases related to the genital area, as well as people who are often exposed to stress.

There are two main forms of gallbladder dyskinesia:

• Hypertonic (hyperkinetic) – the tone of the gallbladder is increased;
• Hypotonic - the tone of the gallbladder is reduced.

Causes

Why does biliary dyskinesia occur, and what is it? Primary causes of biliary dyskinesia:

1. Long-term, systematic violation of the diet (irregular meals, overeating, the habit of eating heavily before bed, abuse of spicy and fatty foods).
2. Disorders of neurohumoral regulatory mechanisms of the biliary tract.
3. Sedentary lifestyle, congenital underdeveloped muscle mass.
4. Neurocirculatory dystonia, neuroses, stress.

Secondary causes of biliary dyskinesia:

1. Previously suffered acute viral hepatitis.
2. Helminths, infections (giardiasis).
3. When the neck or body of the gallbladder is bent (organic causes).
4. For cholelithiasis, cholecystitis, gastritis, gastroduodenitis, peptic ulcer, enteritis.
5. Chronic inflammatory processes of the abdominal cavity (chronic inflammation of the ovaries, pyelonephritis, colitis, appendicitis, etc.).
6. Hormonal disorders (menopause, menstrual irregularities, insufficiency of the endocrine glands: hypothyroidism, lack of estrogen, etc.).

Most often, biliary dyskinesia is a background symptom and not a separate one. It indicates the presence of stones in the gall bladder, the occurrence of pancreatitis, or other abnormalities in the function of the gall bladder. The disease can also develop as a result of eating certain foods: sweets, alcohol, fatty and fried foods. Severe psychological or emotional stress can cause the onset of dyskinesia.

Classification

There are 2 types of dyskinesia:

1. Dyskinesia of the hypokinetic type: the gallbladder is otanic (relaxed), it contracts poorly, stretches, and has a much larger volume, which is why bile stagnation occurs and its chemical composition is disrupted, which can lead to the formation of gallstones. This type of dyskinesia is much more common.
2. Dyskinesia of the hyperkinetic type: the gallbladder is in constant tone and reacts sharply to the entry of food into the lumen of the duodenum with sharp contractions, releasing a portion of bile under great pressure.

Accordingly, depending on what type of biliary dyskinesia you have, the symptoms of the disease and treatment methods will vary.

Considering the symptoms of dyskinesia, it is worth noting that they depend on the form of the disease.

Mixed variants of JVP usually manifest themselves:

• pain and heaviness in the right side area,
• constipation or their alternation with diarrhea,
• loss of appetite,
• pain when palpating the abdomen and right side,
• fluctuations in body weight,
• belching, bitterness in the mouth,
• general disorder.

The following symptoms are characteristic of hypotonic dyskinesia:

• aching pain arising in the right hypochondrium;
• heaviness in the stomach;
• constant feeling of nausea;
• vomiting.

The hypotonic form of the disease is characterized by the following set of symptoms:

• acute pain, periodically occurring in the right hypochondrium, with pain radiating to the back, neck and jaw. As a rule, such pain lasts about half an hour, mainly after eating;
• constant feeling of nausea;
• vomiting with bile;
• decreased appetite;
• general weakness of the body, headaches.

It is important to know that the disease not only manifests itself in a gastroenterological clinical picture, but also affects the general condition of patients. Approximately every second adult diagnosed with biliary dyskinesia initially consults a dermatologist due to symptoms of dermatitis. These skin symptoms indicate problems with the gastrointestinal tract. At the same time, patients are concerned about regular skin itching, accompanied by dryness and flaking of the skin. Blisters with watery contents may occur.

Diagnosis of biliary dyskinesia

The following laboratory and instrumental examination methods are prescribed:

• general blood and urine analysis,
• stool analysis for lamblia and coprogram,
• liver tests, blood biochemistry,
• conducting an ultrasound examination of the liver and gall bladder with a choleretic breakfast,
• performing fibrogastroduodenoscopy (swallow the “sweetheart”),
• if necessary, gastric and intestinal intubation is performed with bile samples taken by stage.

However, the main method for diagnosing VVP is ultrasound. Using ultrasound, you can evaluate the anatomical features of the gallbladder and its tract, check for the presence of stones and see inflammation. Sometimes a stress test is performed to determine the type of dyskinesia.

Treatment of biliary dyskinesia

• Treatment of hyperkinetic form of dyskinesia. Hyperkinetic forms of dyskinesia require dietary restrictions on mechanical and chemical food irritants and fats. Table No. 5 is used, enriched with products containing magnesium salts. To relieve spasms of smooth muscles, nitrates, myotropic antispasmodics (no-spa, papaverine, mebeverine, hymecromone), anticholinergics (gastrocepin), as well as nifedipine (Corinfar), which reduces the tone of the sphincter of Oddi up to 3 times a day, are used.
• Treatment of hypokinetic form of dyskinesia. You should apply a diet within the framework of table No. 5; for hypokinetic dyskinesias, food should be enriched with fruits, vegetables, products containing plant fiber and magnesium salts (edible bran, buckwheat porridge, cottage cheese, cabbage, apples, carrots, meat, rosehip decoction). Vegetable oil, sour cream, cream, and eggs also contribute to emptying the gallbladder. It is necessary to establish normal functioning of the intestines, which reflexively stimulates contraction of the gallbladder. Cholekinetics (xylitol, magnesium sulfate, sorbitol) are also prescribed.

Patients with biliary dyskinesia are advised to undergo observation by a gastroenterologist and neurologist, and annual health courses in balneological sanatoriums.

Physiotherapy

In the hypotonic-hypokinetic variant, diadynamic currents, faradization, sinusoidal modulated currents, low-pulse currents, low-intensity ultrasound, pearl and carbon dioxide baths are more effective.

In the case of hypertonic-hyperkinetic form of dyskinesia, patients are recommended inductothermy (disc electrode is placed above the right hypochondrium), UHF, microwave therapy (MW), high-intensity ultrasound, novocaine electrophoresis, ozokerite or paraffin applications, galvanic mud, pine, radon and hydrogen sulfide baths.

Diet for dyskinesia

Any advice on how to treat biliary dyskinesia will be useless if you do not adhere to certain dietary rules that help normalize the condition of the biliary tract.

Proper nutrition will help create favorable conditions for the normal functioning of the gastrointestinal tract and normalize the functioning of the biliary tract:

• everything highly salty, sour, bitter and spicy is prohibited;
• seasonings and spices are limited, fried foods are prohibited;
• fat in the diet is sharply limited, replacing it as much as possible with vegetable oils;
• a strict ban is imposed on potentially harmful and irritating products (chips, nuts, soda, fast food, salted fish);
• All nutrition is initially given in a warm and semi-liquid form, especially during painful attacks;
• All food is boiled, steamed or stewed, baked in foil.

Sample menu for the day:

1. Breakfast: soft-boiled egg, milk porridge, tea with sugar, sandwich with butter and cheese.
2. Second breakfast: any fruit.
3. Lunch: any vegetarian soup, baked fish with mashed potatoes, vegetable salad (for example, cabbage), compote.
4. Afternoon snack: a glass of milk, yogurt, fermented baked milk or kefir, a couple of marshmallows or marmalades.
5. Dinner: steamed meatballs with vermicelli, sweet tea.
6. Before bed: a glass of kefir or drinking yogurt.

Treatment of children with biliary dyskinesia

In children with biliary dyskinesia, treatment is carried out until bile stagnation and signs of bile outflow disturbance are completely eliminated. In case of severe pain, it is advisable to treat the child first in a hospital setting, and then in a local sanatorium.

Timely diagnosis of biliary tract dysfunctions and proper treatment of children, depending on the type of detected disorders, can prevent the formation of further inflammatory diseases of the gallbladder, liver, pancreas and prevent early stone formation in the gallbladder and kidneys.

Prevention

To prevent pathology from developing, follow these rules:

• a full night's sleep of at least 8 hours;
• go to bed no later than 11 pm;
• alternate mental and physical work;
• walks in the open air;
• eat well: eat more plant foods, cereals, boiled animal products, less -
• fried meat or fish;
• exclude psychologically traumatic situations.

Secondary prevention (that is, after the occurrence of biliary dyskinesia) consists of its earliest detection, for example, with regular preventive examinations. Biliary dyskinesia does not reduce life expectancy, but affects its quality.

Good to know:

One comment

I am very grateful for the information received. I was diagnosed a couple of years ago, but knowing that the disease was not dangerous, I honestly did not connect the developing symptoms with dyskinesia. I stick to the diet because I suffer from hypothyroidism.

And a completely unexpected discovery for me was that depression, fatigue, tearfulness against the background of decent hormone tests are symptoms of dyskinesia! Now, knowing the enemy by sight, I will fight him.

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Biliary dyskinesia - causes, symptoms, forms and treatment methods

Biliary dyskinesia is a difficult flow of bile from the liver into the bladder and through the ducts. A distinctive feature of the disease is the absence of pathological changes in the structure of the liver and gallbladder with ducts. During examination, doctors identify two types of gallbladder dysfunction in patients - either its contraction is too slow or its contraction is too fast/frequent. According to statistics, men suffer from biliary dyskinesia more often than women (about 10 times).

Classification

The definition of the form of dyskinesia depends on how the gallbladder contracts:

• hypermotor - in this case, the contraction of the organ is very frequent and rapid. A similar form of the disease in question is characteristic of young people;
• hypomotor - contraction occurs slowly, the activity of this function of the gallbladder is significantly reduced. According to statistics, hypomotor biliary dyskinesia is often diagnosed in patients over 40 years of age and in patients with persistent neuroses/psychoses.

Depending on the cause of the development of the pathology in question, doctors can divide it into two types:

• primary dyskinesia - it is usually associated with congenital anomalies in the structure of the biliary tract;
• secondary - the disease is acquired during life and is a consequence of pathologies in other organs of the gastrointestinal tract (for example, secondary biliary dyskinesia often “accompanies” pancreatitis - an inflammatory process in the pancreas).

Causes of development of biliary dyskinesia

If we are talking about the primary type of the disease in question, then its causes are:

• narrowing of the gallbladder;
• doubling (bifurcation) of the bile ducts and bladder;
• constrictions and septa located directly in the cavity of the gallbladder.

All these causes are congenital anomalies and are detected in early childhood during examination.

A secondary type of dyskinesia of the gallbladder and ducts can develop against the background of the presence of the following factors:

• gastritis - an inflammatory process on the mucous membrane of the inner walls of the stomach;
• the formation of ulcers on the mucous membrane of the stomach and/or duodenum - peptic ulcer;
• cholecystitis - inflammation of the gallbladder;
• pancreatitis - an inflammatory process in the pancreas;
• duodenitis is a pathological inflammatory process in the duodenal mucosa;
• hepatitis of viral etiology is a systemic disease in which the liver is affected by viruses;
• hypothyroidism – decreased functionality of the thyroid gland.

In addition, the reasons that can lead to the development of dyskinesia of the gallbladder and ducts include neuroses - mental disorders that are not only well understood by the patient themselves, but are also subject to treatment, until complete recovery.

There are documented cases of diagnosing biliary dyskinesia against the background of a sedentary lifestyle, excess weight (stage 2-3 obesity), excessive physical activity (especially if heavy lifting is constantly occurring) and after psycho-emotional breakdowns.

Symptoms of biliary dyskinesia

The clinical picture of the described pathology is quite pronounced, so diagnosis does not present any difficulties for specialists. The main symptoms of biliary dyskinesia are:

1. Pain in the right hypochondrium , gallbladder and bile ducts - in the right hypochondrium. It can have a different character:

• with increased contractile activity of the gallbladder - acute, paroxysmal, with irradiation to the scapula and right shoulder. Occurs either after intense physical activity or eating fatty foods in large quantities;
• if the contractile activity of the bladder is reduced, then the pain will be of a completely different nature - dull, aching, constant (episodes of absence of pain are very rare), patients feel a feeling of fullness in the right hypochondrium;
• biliary colic - always occurs acutely, suddenly, differs in intensity, and is accompanied by increased heart rate. Increased blood pressure (not in all cases). Since the pain is too severe, the patient experiences a feeling of anxiety and fear of death.

1. Cholestatic syndrome (manifestations of pathology in the liver and biliary tract):

• jaundice - the skin, sclera of the eyeballs, mucous membranes of the mouth and saliva turn yellow in different shades;
• enlarged liver - in some cases the patient himself can feel it;
• change in the color of stool - it becomes noticeably light;
• change in urine color – it becomes distinctly dark;
• itching of the skin without a specific localization.

1. Digestive system disorders:

• bloating;
• loss of appetite;
• nausea and vomiting;
• bad breath from the mouth;
• bitter taste in the mouth;
• dry mouth.

1. Neurosis is a mental disorder that can be cured (reversible):

• irritability and insomnia;
• increased sweating (hyperhidrosis);
• chronic fatigue syndrome;
• headaches - they are not constant, they are periodic.

The above symptoms cannot appear at the same time. For example, cholestatic syndrome is diagnosed in only half of patients with biliary dyskinesia, and bitterness and dryness in the oral cavity are more characteristic of hyperdyskinesia (contractile activity of the gallbladder is increased).

Diagnostic methods

Based solely on the pronounced symptoms of biliary dyskinesia, no specialist can make a diagnosis. To make a final verdict, doctors carry out the following activities:

1. Questioning the patient and analyzing the description of the disease - how long ago the first attacks of pain or other symptoms appeared, what they may be associated with (according to the patient).
2. Collecting an anamnesis of the patient’s life - have there been any cases of diagnosing the disease in question in his relatives, are there any diagnosed chronic diseases of the gastrointestinal tract, have he taken any medications for a long time, have he been diagnosed with benign/malignant tumors, in what conditions does the patient work? (meaning the presence/absence of toxic substances at work).
3. Physical examination - the doctor determines what color the patient’s skin, sclera and mucous membranes are (whether there is jaundice or not), whether obesity is present, palpation (feeling) will help identify liver enlargement.
4. Laboratory tests - general and biochemical blood tests, general urine analysis, lipid profile (detects the level of fat in the blood), markers of hepatitis of viral etiology, examination of feces for worm eggs.

After this examination, the doctor can diagnose biliary dyskinesia, but to confirm it, the patient will also be prescribed an instrumental examination of the body:

• ultrasound examination of all abdominal organs;
• ultrasound examination of the gallbladder “with a test breakfast” - first an ultrasound scan is performed on an empty stomach, then the patient eats a fairly fatty breakfast and after 40 minutes a repeat ultrasound scan of the gallbladder is performed. This procedure makes it possible to find out in what form the disease in question occurs;
• duodenal intubation - using a special intestinal probe, the duodenum is examined and bile samples are taken for laboratory testing;
• FEGDS (fibroesogastroduodenoscopy) – examines the mucous membranes of the stomach, duodenum, and esophagus;
• oral cholecystography - the patient drinks a contrast agent and after half an hour the gallbladder can be examined for the presence of developmental anomalies;
• ERCP (endoscopic retrograde cholangiopancreatigraphy - one study combines both x-ray and endoscopic methods. This allows you to directly examine the bile ducts;
• hepatobiliary scintigraphy is a radioisotope method in which the patient is injected with a radioactive drug (intravenously), which accumulates in the liver and biliary tract, which makes it possible to study their complete and accurate image.

Treatment methods for biliary dyskinesia

The goal of treatment procedures is to ensure a complete outflow of bile from the liver. It will not be possible to do this solely with medications; an integrated approach is needed.

Therapy for biliary dyskinesia includes:

1. Creating and following a daily routine:

• a competent combination of work and rest - for example, night sleep should not be less than 8 hours;
• Take regular walks in the fresh air;
• When performing sedentary work, do gymnastics every 2 hours - we are talking about the simplest bending, squats, and twisting the body.

1. Strict diet:

• Spicy/fatty/smoked foods and canned food (homemade and industrial) are excluded from the menu;
• salt intake is reduced - it is permissible to take no more than 3 grams of salt per day;
• regularly drink mineral water - it can be different, which is suitable for a particular patient is determined by the attending physician or nutritionist;
• Food should be taken in small portions, but the frequency of meals should be large - up to 6-7 per day.

1. Medications:

• choleretic drugs – choleretics;
• enzyme preparations;
• Cholespasmolytics.

1. Additional medical procedures:

• tubing of the gallbladder (cleansing) - taking choleretic drugs in a lying position on the right side with a heating pad in the area of ​​​​the anatomical location of the liver and biliary tract;
• regular duodenal intubation - cleansing the duodenum after the release of bile;
• electrophoresis;
• acupuncture;
• diadynamic therapy;
• acupressure;
• hirudotherapy (treatment with leeches).

Surgical intervention is absolutely impractical, therefore surgical treatment of biliary dyskinesia is never prescribed. On the recommendation of a gastroenterologist or therapist, the patient can be referred to a psychotherapist (if he has neuroses).

Treatment of biliary dyskinesia with folk remedies

Treatment of biliary dyskinesia with herbal preparations is also approved by official medicine - doctors recommend taking a course of using decoctions/tinctures of medicinal herbs twice a year. Here are two of the most effective and safe recipes:

1. Prepare the following herbs:

• elecampane root – 10 g;
• marshmallow root – 10 g;
• calendula (flowers) – 15 g;
• chamomile (flowers) – 10 g.

Mix the indicated plants and take only 2 tablespoons of the resulting mixture. They should be poured with half a liter of water, boiled and simmered over low heat for at least 7 minutes. Then the broth is infused (40-60 minutes), filtered and the resulting amount is drunk in small sips half an hour before meals three times a day. Duration of treatment – ​​3 weeks.

1. Mix plantain leaves (30 g), calendula flowers and sage leaves (10 g each), mint/rosehip/cumin (15 g each), cinquefoil (herb) and raspberry leaves (20 g each). And the preparation and administration scheme is the same as for the previous decoction.

Among the traditional methods, the following recipes can be distinguished:

• if the contraction of the gallbladder is reduced, a cold compress should be applied under the right hypochondrium at the time of an attack of pain, and in case of increased contractile activity, a hot compress should be applied.
• for a month, in the morning on an empty stomach, drink a glass of milk mixed with carrot juice in a 1:1 ratio;
• in case of pain syndrome against the background of diagnosed hypertensive dyskinesia, you should do an enema with corn oil - one tablespoon of oil per liter of warm water.

There are also treatment methods with sand and clay, essential oils and vegetable juices, but there is no confirmation from official medicine regarding the advisability of such procedures. Any treatment with folk remedies should be carried out only after consultation with the attending physician and with regular monitoring of the dynamics of the disease.

Possible complications

As a rule, with biliary dyskinesia, patients seek help from doctors almost immediately after the first attack of pain. But many of them, having relieved the unpleasant symptoms, stop the prescribed treatment, thereby provoking the development of complications:

• chronic cholecystitis – inflammation of the gallbladder that lasts more than 6 months in a row;
• the formation of stones in the gallbladder and its ducts – cholelithiasis;
• chronic pancreatitis – inflammation of the pancreas for 6 months;
• atopic dermatitis is a skin disease that is a consequence of a decrease in the level of immunity;
• duodenitis is an inflammatory process on the lining of the duodenum.

Biliary dyskinesia has a fairly favorable prognosis and does not shorten the patient’s life expectancy. But in the absence of proper treatment and non-compliance with the nutritionist’s recommendations, the development of the above complications is inevitable. And even these diseases are not life-threatening, but the patient’s condition will worsen significantly and eventually lead to disability.

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Dyskinesia of the gallbladder and biliary tract

A pathology of a functional nature, manifested by disturbances in the outflow of bile, is called dyskinesia of the gallbladder. With such a disorder, the contractile function of the organ, including the biliary tract, is disrupted. The release of bile secretion into the duodenum becomes inadequate, which causes disruptions in the digestive system. VSD and bladder dyskinesia itself account for no more than 12% of all diseases of the organ and in 70% of cases are acquired.

Biliary dyskinesia mainly affects female representatives - according to statistics, the pathology is diagnosed in them 10 times more often than in men. The prevalence of the disease in women is due to the peculiarity of metabolism and periodic hormonal disruptions - during gestation, menopause, and the use of oral contraceptives. Gallbladder dyskinesia is also detected in childhood; in most cases, adolescents aged 12–14 years and infants are affected.

Anatomy of the gallbladder

The gallbladder has a hollow structure and is localized in the upper quadrant of the abdomen on the right, under the extreme rib. The organ has a bag- or pear-shaped shape, one end is wide, the other is narrow. Optimal sizes are 5–14 cm in length, 3–5 cm in width. The volume when the stomach is not filled with food is 30–80 ml; with congestion, the capacity increases significantly. The constituent structural elements of the gallbladder are the bottom, body, neck - the narrowest part, from which the cystic duct emerges, which flows into the hepatic duct. By their fusion, a common bile duct is created - the common bile duct, which passes into the initial part of the duodenum.

The gallbladder has a complex structure:

• epithelial layer, the structure of which includes squamous epithelial cells and glandular cells;
• muscle layer, represented by muscle fibers of a smooth structure with circular circulation;
• connective tissue membrane - the outer layer of an organ with a vascular network located in it.

The gallbladder, as the main organ of the biliary system, acts as a repository for the accumulation, concentration and preservation of bile produced by the liver. Liver cells constantly synthesize bile, up to 1500 ml per day, which flows through the intrahepatic channels into the cavity of the bladder. Periodically, the gallbladder releases a certain portion of bile secretion into the duodenum, where digestive processes begin.

Mechanism of bile release

The process of releasing bile secretion from the bladder occurs during synchronized contraction of the walls of the organ and relaxation of the sphincter of Oddi muscles. The autonomic nervous system, special hormones (motilin, gastrin) and neuropeptides responsible for bladder motility are responsible for the release of bile. With the harmonious interaction of structures during food intake, the gall muscles contract, which causes an increase in pressure inside the organ. At the same time, the Lutkens-Martynov sphincter relaxes - bile secretion is released into the cystic duct, from there entering the common bile duct. Bypassing the sphincter of Oddi, bile flows into the duodenum, where the process of breaking down food is activated.

Bile secretion is necessary for proper, complete digestion. The main functions of bile:

• stimulation of appetite and increased motility of the small intestine;
• conversion of pepsin enzymatic abilities;
• participation in the breakdown and absorption of lipids and fat-soluble vitamins;
• stimulation of the production of mucous secretions and intestinal hormones;
• activation of enzymes involved in protein breakdown;
• acceleration of the process of epithelial division in the surface layer of the intestine;
• antibacterial effect.

Reasons for the development of pathology

In gastroenterology, gallbladder dyskinesia is divided into primary and secondary. This division is based on the reasons that provoked the disease. Also in modern gastroenterology, they are actively studying the theory of a disruption in the functioning of liver cells, which immediately produce bile with a changed composition.

In the primary form of gallbladder dyskinesia, the causes of dysfunction lie in functional disorders caused by congenital imperfections of the organ and the pathways through which bile secretions circulate. Risk factors leading to the development of the primary form of dyskinesia:

• exposure to stressful situations, malfunctions of the nervous system provoke a discrepancy between the contractile function and relaxation of the walls of the gallbladder and sphincters;
• unhealthy diet - eating large amounts of food, abuse of fatty and fried foods, eating dry food, long time intervals between meals;
• physical inactivity combined with muscle hypertrophy and low body weight;
• diseases of allergic origin - food intolerance, atopic dermatitis;
• a hereditary factor that increases the risk of developing dyskinesia in offspring if one of the parents has pathology.

The secondary form of dyskinesia is presented in the form of structural transformations in the bile ducts and ducts, formed due to past and existing pathologies. Common causes of secondary dyskinesia:

The classification of dyskinesia is based on the types of motor impairment. From this position, pathology is divided into hypo- and hypertensive.

• Hypotonic dyskinesia, or hypomotor, is a type of pathology that manifests itself in the form of a weak ability of the gallbladder to contract. The movement of bile through the ducts occurs at a slow pace. Hypomotor dyskinesia most often develops in people over 40 years of age.
• Hypertensive dyskinesia (hypermotor) is associated with the accelerated ability of the organ and ducts to contract. It is detected more often in individuals with dominance in the parasympathetic part of the nervous system, causing high tension in the gallbladder.
• The hypotonic-hyperkinetic form of dyskinesia is a mixed variant of the disorder. The contractile capabilities of the bladder are unstable, capable of accelerating and slowing down regardless of food intake.

Symptoms

The type of dyskinesia has primary importance on the nature of the clinical picture of the disease. The symptoms of hyper- and hypomotor dyskinesia are radically different. In case of hypotonic course of the pathology, the patient is worried about the following signs:

• Pain syndrome, and the pain is constant and lasts a long time, is aching or bursting in nature. Localization - right upper quadrant of the peritoneum, under the lower edge of the costal arch, often the pain is diffuse. A typical feature of pain is intensification immediately during and immediately after eating food. The cause of the pain syndrome is associated with stretching of the bladder cavity due to bile accumulated in a large volume.
• Belching throughout the day, regardless of food intake.
• Nausea and occasional vomiting with the presence of bile appear when the diet is violated and are caused by irritation of the nerve endings of the gastrointestinal tract.
• Bitter taste in the mouth that occurs on an empty stomach, after intense exercise or food. The feeling of bitterness in the mouth occurs due to the reflux of bile into the stomach cavity and esophagus, from where it enters the oral cavity in small volumes.
• Increased gas formation in combination with painful release of gases is caused by inadequate digestion of food due to a lack of bile secretion.
• Persistent loss of appetite due to inadequate secretion of bile into the duodenum.
• Impaired defecation, with loose stools occurring rarely with hypomotor dyskinesia, and constipation occurring frequently.
• Excessive weight gain occurs with long-term dyskinesia and is caused by a slowdown in fat metabolism and increased accumulation of fat deposits in the hypodermis.

Additionally, hypomotor dyskinesia of the gallbladder is manifested by alarming symptoms from the autonomic nervous system. The reasons for their occurrence are not fully understood. A patient with hypomotor dyskinesia may be bothered by:

• intense sweating;
• increased salivation;
• decreased heart rate;
• hypotension;
• redness of the skin on the face.

Symptoms indicating the course of dyskinesia of the hyperkinetic type:

• Colicky pain with a clear localization in the right side under the lower rib, radiating to the shoulder girdle or heart area. The pain syndrome develops after stress, ingestion of hard-to-digest food, intense physical activity and lasts about 20 minutes. Attacks often occur in several episodes per day.
• Poor appetite and weight loss. A decrease in muscle mass occurs due to inadequate absorption of nutrients from food.
• Diarrhea that occurs during an attack and immediately after eating. Frequent loose stools occur due to the asynchronous release of bile secretion in large volumes into the lumen of the small intestine.
• Disorders of the autonomic nervous system in the form of sweating, tachycardia, stabbing pain in the heart, increased blood pressure.

There are a number of common manifestations characteristic of all types of dyskinesia: yellowing of the skin and eye sclera against the background of significant stagnation of bile, the appearance of a dense gray coating on the surface of the tongue, discoloration of feces with simultaneous darkening of urine. Some patients with dyskinesia have a dulled sense of taste. With the mixed type, the symptoms of gallbladder dyskinesia are combined and manifest in varying degrees of intensity.

Survey

Diagnosis of suspected biliary dyskinesia is complex and involves a number of procedures, including a physical examination with a history, laboratory and instrumental methods. The doctor who determines the tactics and complex of diagnostic procedures is a gastroenterologist. Sometimes an examination by a neurologist is required. The purpose of diagnosis is to identify the type of motility disorder, the general condition of the bladder and biliary tract, and to establish background pathologies.

List of necessary laboratory procedures:

Confirming the diagnosis of “gallbladder dyskinesia” without a visual study of the condition of the organ through high-precision studies is not possible. Ultrasound (ultrasound) is considered the most informative, painless and gentle method. Using ultrasound, the shape, volume, motor activity of the organ, and the presence of anomalies in the structure are determined. Classic echo signs when visualizing the gallbladder in patients with dyskinesia:

• the organ is significantly increased in volume - a sign of stagnant processes and hypotonic JVP;
• an organ that is smaller than adequate in size is a sign of an overly active ability to contract against the background of hypertensive dyskinesia;
• hypertrophied bladder walls signal severe inflammation in acute or chronic form;
• the presence of moving focal structures in the bladder cavity signals the development of cholelithiasis;
• with an increased diameter of the common bile duct we are talking about dyskinesia of the bile ducts;
• the detection of fixed, clearly defined elements is an alarming sign indicating obstruction of the bile ducts or sphincters by stones.

High information content about the presence of destructive changes in the organs of the biliary system is provided by radiological methods, including:

• cholecystography (with the ingestion of substances containing iodine as a contrast), the purpose of which is to identify the structure of the bladder and ducts, the preservation of the reservoir function of the organ, and capacity;
• cholangiography is a method that allows you to examine the bile ducts, their patency and motility by introducing contrast through percutaneous puncture;
• infusion cholecystography - a study with intravenous infusion of contrast, allowing to assess the contractility of the sphincter of Oddi;
• Retrograde endoscopic cholangiography is performed using an endoscope and allows not only to assess the condition of the gallbladder cavity, but also to remove small stones from the ducts.

Treatment tactics

• drug treatment;
• correction of nutrition and lifestyle;
• physiotherapy;
• use of mineral waters.

Drug treatment for gallbladder dyskinesia is selected based on the type of pathology. For hypermotor dyskinesia the following is prescribed:

• Cholekinetics that help increase the contractility of the bladder while simultaneously decreasing the tone of the bile ducts. Taking cholekinetics - Gepabene, Galstena - helps accelerate the release of bile secretion, dilutes it and normalizes its flow into the duodenum.
• Drugs with analgesic and antispasmodic effects help relieve pain and spasms, relax the muscles in the walls of the gallbladder, ducts, and sphincter of Oddi. Among the antispasmodics, Paraverine and Drotaverine are prescribed, for severe pain syndrome - intramuscularly, for moderate pain - orally. Analgesics, including narcotics (Tramadol), are indicated to relieve severe pain during an attack.
• Among the drugs with a sedative effect are bromides and drugs based on plant extracts (tincture of valerian). Sedatives help restore normal functioning of the autonomic nervous system and relieve dystonic symptoms.

For dyskinesia of the hypomotor type, drug treatment consists of other drugs:

• Choleretics are drugs with a choleretic effect that improve the motility of the organ and ducts. Choleretics (Cholenzim, Allochol), when taken as a course, normalize digestion and lower the concentration of cholesterol in the blood.
• Probeless tubes based on xylitol and sorbitol are indicated for congestion, but not exacerbation. The purpose of tubage is to improve the release of bile secretions from the bladder and ducts. To achieve a positive result, the procedure is carried out weekly, with a course of at least 6 procedures.
• Preparations with a tonic effect for correcting the neuro-emotional state - tincture of echinacea, ginseng - improve metabolism, normalize blood pressure, and increase the body's adaptive capabilities.

In case of a mixed course of dyskinesia, drugs with prokinetic and antiemetic effects are prescribed - Motilium, Cerucal. Papaverine and No-shpa are suitable for relieving painful spasms. For all forms of pathology with a predominance of VSD symptoms, it is necessary to take antidepressants (Melipramine, Elivel, Sertraline) and painkillers - Ketorolac, Dexamethasone, Anaprilin.

Other therapeutic measures

Simultaneously with the main therapy, activities are carried out that increase the positive effect of treatment - physiotherapy, getting rid of background pathologies, taking mineral waters. Physiotherapy for hypermotor dyskinesia includes electrophoresis on the gallbladder area, laser and paraffin applications. Amplipulse therapy is useful for patients with hypokinetic bladder dysfunction. Sometimes hirudotherapy, acupuncture and acupressure courses have a good effect on normalizing the functioning of the biliary tract with dyskinesia.

Treatment using mineral waters is carried out outside the acute period and helps strengthen the body and restore the digestive system. Patients diagnosed with hypertensive dyskinesia benefit from taking mineral waters with low mineralization (Narzan); in the hypotonic version, it is optimal to drink water with a high concentration of minerals and salts (Essentuki 17). Regardless of the form of dyskinesia, patients are advised to stay in sanatoriums and resorts with a focus on treating the digestive system.

Lifestyle and diet

Patients with dyskinesia must adjust their lifestyle for a speedy recovery. A full night's sleep of at least 8 hours, going to bed at the same time (no later than 23-00), an established nutrition system with time intervals between meals (3-4 hours), alternating physical and intellectual work - simple measures , compliance with which supports optimal metabolism and smooth functioning of all organs, including the biliary tract.

A diet for a diagnosis of gallbladder dyskinesia is necessary regardless of the type of disorder; without a review of the diet, the effect of treatment will be minimal. The purpose of dietary nutrition is to spare and normalize the functioning of the digestive tract. The duration of the diet depends on the severity of the pathology, but on average it is prescribed up to 4 months. After recovery, it is necessary to avoid dietary errors and gradually expand the diet.

A diet for patients with dyskinesia involves excluding a number of foods from the diet:

• fatty meat and fish;
• salty, fatty, smoked, sour, spicy, fried foods;
• alcohol;
• vegetables high in acids and fiber - sorrel, peas, beans;
• fresh baked goods and baked goods, sweet confectionery;
• fatty dairy products;
• canned food and products with additives and flavor enhancers.

If a patient has a confirmed hyperkinetic type of pathology, products that promote excess bile secretion are excluded from the diet - sausages, chicken egg yolk, pork and veal (even boiled).

The diet for patients with hypo- and hypermotor dyskinesia includes savory baked goods made from second-grade flour, meat, poultry and fish with minimal fat content, fresh or thermally processed vegetables, soups with cereals and pasta, low-fat fermented milk products. Sweet fruits are allowed for consumption - bananas, peaches, soft pears. Drinks you can take include vegetable or fruit juices, weak tea with added milk, and compotes.

The basic principle of the diet for dyskinesia is split meals in small portions. Overeating is unacceptable. Preference in heat treatment is given to boiling, baking, stewing. During the period of relapse, food should be thoroughly crushed and served in a homogeneous puree form. Outside the acute period, food is served as usual. An important rule when organizing meals is to limit the daily dose of salt to 3 g in order to avoid stagnation of excess fluid in the body.

Phytotherapy

Along with other biliary pathologies, biliary dyskinesia can be treated with traditional medicine. Doctors often recommend taking infusions and decoctions of medicinal herbs in addition to drug therapy. However, herbal treatment should begin after the relapse has ended and the acute manifestations have subsided.

With a confirmed hypertensive form of dyskinesia, the following recipes will help alleviate the patient’s condition and speed up recovery:

• peppermint infusion - add 250 ml of boiling water to 10 g of raw material, leave to brew for 30 minutes, filter and take the poml half an hour before breakfast, lunch, dinner;
• licorice root decoction - 10 g of raw material is poured into a glass of boiling water and kept in a water bath for 25 minutes, filtered and drunk 30 minutes before the main meal.

If a patient has hypokinetic dyskinesia, herbs with a choleretic effect - corn silk and immortelle - will help improve the motility of the gallbladder. Additionally, such herbs improve the functioning of the gastrointestinal tract and remove excess cholesterol from the body.

• Infusion of corn silk - add a glass of boiling water to 10 g of raw material, let it brew for half an hour, filter. Take a quarter glass 30 minutes before meals. The course lasts 3 weeks.
• Immortelle decoction - 30 g of raw material is poured into 300 ml of boiling water and kept in a water bath for 30 minutes, constantly stirring the composition. After cooling, filter and drink 50 ml three times a day, before meals. The course of treatment is at least 21 days.

If a person suffers from a mixed type of pathology, it is recommended to take chamomile tea. Regular use will help relieve inflammation, improve intestinal motility and gallbladder motility, and relieve dyspeptic signs of dyskinesia in the form of flatulence and bloating. Additionally, chamomile tea relieves negative manifestations of the nervous system - normalizes sleep and improves appetite. The preparation method is simple - 10 g of chamomile flowers are steamed with 200 ml of boiling water, left for 5 minutes, filtered. You can drink tea up to 4 times a day, for a long time.

Patients with gallbladder dyskinesia require constant medical supervision. With early detection of the disease, adequately selected treatment and annual maintenance therapy, lifelong diet and healthy lifestyle, the prognosis for recovery is favorable. Refusal of treatment and ignoring medical prescriptions always lead to negative consequences in the form of early stone formation and inflammation of the gallbladder.

It would seem, what could people and dogs have in common? But it turns out that our smaller brothers suffer from the same diseases as people.

One of these ailments is cholecystitis. This disease behaves very secretly and is diagnosed at fairly late stages, so owners need to know what cholecystitis is in a dog, how it manifests itself and what causes it.

Cholecystitis and its classification

Normally, bile, consisting of bile acids, water, bilirubin, cholesterol and electrolytes, is located in the gallbladder and passes from here to the duodenum, where it plays an important role in the digestive process:

• promotes the digestion of fats by breaking them down into small particles;
• improves the absorption of processed fats;
• enhances the elimination of cholesterol.

Any disruption in this well-established process is the cause of disease of the biliary system. Cholecystitis is a pathological condition caused by inflammation of the mucous membrane of the gallbladder in dogs and damage to its ducts.

Acute and chronic cholecystitis are also distinguished.

What causes cholecystitis?

Veterinarians believe that dogs suffer from cholecystitis for the following reasons:

Most often, problems with the biliary system occur in middle-aged or elderly animals, and in German shepherds the risk of cholecystitis is especially high.

Symptoms of cholecystitis

The liver and gallbladder are the most important organs that have a direct impact on digestion and many metabolic processes in the dog’s body. Therefore, any failure in this mechanism has a very negative impact on the general condition of the animal, its appetite and has certain signs.

The dog owner should pay close attention to his pet if he observes the following symptoms:

1. Deterioration in the dog’s well-being, expressed by weakness, apathetic behavior, and drowsiness.
2. Changes in the structure of the coat - it stops shining, becomes inelastic, and may fall out.
3. The dog's appetite decreases, it may even refuse food completely and lose weight.
4. Problems arise with the gastrointestinal tract - the dog may suffer from vomiting or intestinal upset.
5. The animal has pain in the right side and when stroking this area, the dog whines and worries.
6. In severe cases, a yellow color may appear in the whites of the eyes and the mucous membranes of the nose and mouth.
7. Urine becomes orange-yellow, and feces, on the contrary, become discolored.
8. Sometimes the temperature may rise.

Many of the symptoms listed may also apply to other diseases, so only a veterinarian can make an accurate diagnosis.

Diagnosis of the disease and treatment of cholecystitis

To make an accurate diagnosis, your veterinarian will prescribe your pet a comprehensive examination, which includes various types of diagnostics:

1. General and biochemical blood tests.
2. General urine analysis.
3. Ultrasound of the abdominal organs.
4. X-ray.

According to the results of a blood test, changes in liver parameters are visible, which, first of all, indicate problems with the gallbladder. An ultrasound examination will show congenital abnormalities of the gallbladder, excess bile, suspension or sediment.

After diagnosis, the animal is prescribed comprehensive treatment.

If the disease is in an acute phase, then to begin with the dog may be prescribed therapeutic fasting for 2-3 days or a strict diet following a certain diet.

To begin with, the veterinarian will prescribe ascorbic, salicylic acid and calcium, which will help relieve inflammation. Then, with the help of antispasmodics, spasm of the bile ducts and the gallbladder itself is eliminated.

If the disease is detected in the later stages, therapy does not give the desired result and symptoms appear, then a surgical operation can be performed to remove the gallbladder, after which, if the animal follows a diet and maintains a healthy lifestyle, it can live for a long time.

Malova O.V.
doctor at the veterinary center "Academ Service" in Kazan.
Specialization - ultrasound diagnostics, radiography, therapy.
Sergeev M.A.
senior lecturer at the Kazan State Academy of Veterinary Medicine, veterinarian at the LCC KSAVM. Specialization - therapy, obstetrics and gynecology.

Biliary sludge (bile sludge)- a specific nosological form that appeared due to the introduction of ultrasound imaging methods into clinical practice - means “heterogeneity and increased echogenicity of the contents of the gallbladder.” According to the latest classification of cholelithiasis, in humans, biliary sludge is classified as the initial stage of cholelithiasis, and requires mandatory timely and adequate therapy.
In the veterinary literature, there are isolated reports regarding biliary sludge in dogs, and the presence of sediment in the gallbladder is regarded as an accidental finding and is often not taken into account by veterinary therapists. A retrospective study was conducted to determine the incidence of biliary sludge in dogs, the need for treatment, and therapy for this pathology was also developed.
Research methods. The studies were carried out in dogs of various ages, sexes and breeds admitted to the treatment and consultation center of the KSAVM and the veterinary center "Academ Service" in the period 2009-2012.
Ultrasound examinations of the abdominal organs were performed on PU-2200vet and Mindrey DC-7 scanners with a sensor frequency of 5-11 MHz. The following ultrasonographic parameters of the gallbladder were studied: echogenicity, distribution, quantity, mobility of the contents, echogenicity and thickness of the organ wall, changes in the bile ducts, as well as ultrasound characteristics of the liver, gastrointestinal tract, and pancreas. When biliary sludge was detected in dogs, a general analysis of whole blood and a biochemical analysis of blood serum were performed. The urine and feces of animals were examined.

Results. During ultrasound examination, the echographic picture of altered bile in the gallbladder in dogs can be very diverse; from a practical point of view, several types of sludge should be distinguished:
1 - a suspension of mobile fine particles in the form of point, single or multiple formations that do not produce an acoustic shadow; 2 - echo-heterogeneous bile with the presence of moving flakes, clots that do not have an acoustic shadow; 3 - echo-dense bile in the form of sediment without an acoustic shadow, which, when the position of the animal’s body in space changes, “breaks” into fragments; 4 - echo-dense, hyperechoic (“putty-like”) sediment that does not have an acoustic shadow, which does not “break” into smaller fragments, but slowly flows along the wall of the organ or remains motionless. 5 - echo-dense bile, filling the entire volume of the organ, its echogenicity is comparable to that of the liver parenchyma (“hepatization of the gallbladder”). 6 - stationary hyperechoic sediment, having an acoustic shadow of varying degrees of severity.

Sludge of the 1st and 2nd types is observed quite often in dogs of different ages, genders, breeds, both in animals with clinical signs of pathology of the hepatobiliary system and gastrointestinal tract, but also in other diseases, especially accompanied by anorexia and gastrointestinal atony tract, can also be observed in clinically healthy dogs. The prognosis in these cases is favorable: sludge may disappear without treatment, but in some cases certain therapeutic measures and diet therapy are required.

Biliary sludge of types 3, 4, 5 and 6 in the form of sediment of varying density, mobility and quantity is less common in dogs. Most often it was detected in females, among the leading breeds were cocker spaniels and poodles, as well as their crosses, small breeds (especially toys and Yorkshire terriers), as well as dogs of other breeds and outbred individuals. Obesity and treatment with glucocorticoids were identified as probable predisposing factors. Concomitant pathologies included diseases of the liver, gastrointestinal tract, and pancreas. The prognosis in these cases is cautious, and in cases of types 5 and 6 of sludge, in most cases it is unfavorable. The treatment is long-term, different from that prescribed for types 1 and 2 of sludge, and mandatory ultrasound monitoring of the effectiveness of therapy.
Specific clinical signs, as well as hematological and biochemical parameters of blood, urine and feces, that clearly indicate the presence of biliary sludge in an animal have not been established.
Conventional treatment with ursodeoxycholic acid drugs is very expensive and not every animal owner agrees to bear such material costs, therefore, as a means of therapy, we have developed methods for effective treatment and prevention of the formation of biliary sludge, combining two approaches: reducing the lithogenicity of bile and improving the contractile function of the gallbladder.

Cholestasis in dogs is not very common and cats are more susceptible to it, which makes this disease more dangerous. It is an insufficiency of bile outflow and secretion, which manifests itself as a result of disruption of the bile ducts. Cholestasis in dogs can be extagepatic and intrahepatic, and occurs due to viral, toxic and other damage to liver cells. Among the most striking symptoms of this disease are the following:

• Pale stool;
• Increased appetite;

Also, cholestasis in a dog, the symptoms of which will help identify the disease in the early stages, can manifest itself through the presence of jaundice, severe itching and discoloration of feces.

Dog cholestasis - treatment and prevention.

It is possible to accurately determine whether your dog has cholestasis or not only under the careful supervision of an experienced veterinarian. To do this, he must conduct a number of tests, which will allow him to make a clear diagnosis. In addition to the above symptoms, cholestasis in a dog is characterized by increased levels of cholesterol, bile acids, direct bilirubin and alkaline phosphatase in the blood. Since it can be a harbinger of many even more serious diseases, its treatment should be approached very responsibly. Advanced cholestasis can lead to the development of severe enteritis, cholangitis, tumor formation, and so on.

Treatment methods are selected individually, depending on the condition of the animal and the cause of the disease. Based on this, both conservative and surgical interventions can be used.

It is worth noting that failure to provide assistance in a timely manner will lead to problems with the functioning of the gallbladder and liver, so if you notice symptoms of cholestasis in your pet, immediately contact a specialist to carry out all the necessary tests.