Extrahepatic biliary atresia in a 4-week-old Pug.

Abstract

OBJECTIVE: To report diagnosis and surgical therapy of extrahepatic biliary atresia in a dog. STUDY DESIGN: Clinical report. ANIMAL: Dog (n&#x2009;=&#x2009;1). METHODS: A 4-week-old female intact Pug presented with acholic feces, lethargy, and poor weight gain. On the basis of the stool color and abdominal ultrasonography findings, extrahepatic biliary atresia was suspected. Intraoperatively, no major duodenal papilla was identified and cholecystoduodenostomy was performed. RESULTS: One day postoperatively the stool color was considered normal. On ultrasonographic examinations up to 6 months after surgery, the gall bladder remained small and the stoma was functional. Serum biochemical profile after 10 months had a mild increase in alanine-aminotransferase (149&#x2009;U/L; reference interval [RI], 0-85&#x2009;U/L) whereas alkaline phosphatase and glutamate dehydrogenase were within normal limits. At 15 months, clinical examination was normal and blood ammonia concentration was within normal limits (43&#x2009;&#xb5;mol/L; RI: <100&#x2009;&#xb5;mol/L) but bile acid concentrations were still markedly elevated (fasting, 95&#x2009;&#xb5;mol/L [RI: <20&#x2009;&#xb5;mol/L] to postprandial, 127&#x2009;&#xb5;mol/L [RI: <35&#x2009;&#xb5;mol/L]). CONCLUSIONS: Ultrasonography and stool color can be helpful noninvasive diagnostic evidence in extrahepatic biliary atresia. Surgical correction with cholecystoduodenostomy with a good clinical outcome is possible even in very young dogs. Long-term prognosis in dogs with extrahepatic biliary atresia is unknown.