{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:51:32Z","timestamp":1792173092297,"version":"4.4.0"},"reference-count":20,"publisher":"American Veterinary Medical Association (AVMA)","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic utility of abdominal fluid bilirubin concentration-to-serum bilirubin concentration ratio (AFB:SB) measurement in detecting biliary tract rupture or leakage in dogs with gallbladder mucocele (GBM; GBM group) versus no GBM (non-GBM group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For this retrospective cross-sectional study, a search of medical records identified dogs with concurrent measurements of abdominal fluid bilirubin and serum bilirubin concentrations prior to surgery or postmortem examination for biliary tract rupture or leakage between July 1, 2007, and January 31, 2022. Results for AFB:SB and other variables of interest were compared between the GBM versus non-GBM group and those with versus without biliary tract rupture or leakage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>29 dogs were included (GBM group, n = 12; non-GBM, n = 17). Eleven GBM dogs and 7 non-GBM dogs had biliary tract rupture or leakage. The AFB:SB was &gt; 2 for 2 of 11 (18%) GBM dogs with rupture, 6 of 7 (86%) non-GBM dogs with biliary tract rupture or leakage, and 2 non-GBM dogs without identified rupture\/leakage. Abdominal fluid cytology confirmed the presence of bile in all dogs with a ruptured GBM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of AFB:SB alone frequently fails to detect biliary tract rupture or leakage in dogs with GBM; however, cytological analysis of abdominal fluid is valuable in helping to detect potential GBM rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>It is essential that primary care and emergency veterinarians be aware that an AFB:SB &gt; 2 can be indicative of biliary tract rupture or leakage in dogs; however, the ratio may not be &gt; 2 in dogs with ruptured GBM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.26.03.0228","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:10:50Z","timestamp":1781115050000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Measurement of abdominal fluid bilirubin concentration frequently fails to detect biliary tract rupture in dogs with gallbladder mucocele"],"prefix":"10.2460","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-7703","authenticated-orcid":true,"given":"Kathleen M.","family":"Aicher","sequence":"first","affiliation":[{"name":"Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2911-0874","authenticated-orcid":true,"given":"Jody L.","family":"Gookin","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3431-6049","authenticated-orcid":true,"given":"Kyle G.","family":"Mathews","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-2995","authenticated-orcid":true,"given":"Devorah M.","family":"Stowe","sequence":"additional","affiliation":[{"name":"Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"1","key":"ref1","series-title":"Can Vet J","first-page":"63","article-title":"Factors affecting survival in 516 dogs that underwent cholecystectomy for the treatment of gallbladder mucocele","volume":"63","author":"Galley M","year":"2022","unstructured":"Galley M, Lang J, Mitchell M, Fletcher J. Factors affecting survival in 516 dogs that underwent cholecystectomy for the treatment of gallbladder mucocele. Can Vet J. 2022;63(1):63-66."},{"issue":"1","key":"ref2","series-title":"J Vet Intern Med","first-page":"195","article-title":"Gallbladder mucocele: variables associated with outcome and the utility of ultrasonography to identify gallbladder rupture in 219 dogs (2007-2016)","volume":"32","author":"Jaffey JA","year":"2018","unstructured":"Jaffey JA, Graham A, VanEerde E,  Gallbladder mucocele: variables associated with outcome and the utility of ultrasonography to identify gallbladder rupture in 219 dogs (2007-2016). J Vet Intern Med. 2018;32(1):195-200. doi:10.1111\/jvim.14898. Published correction appears in J Vet Intern Med. 2018;32(3):1290. doi:10.1111\/jvim.15115"},{"issue":"2","key":"ref3","series-title":"J Vet Intern Med","first-page":"565","article-title":"Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele","volume":"36","author":"Jaffey JA","year":"2022","unstructured":"Jaffey JA, Kreisler R, Shumway K,  Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele. J Vet Intern Med. 2022;36(2):565-575. doi:10.1111\/jvim.16384"},{"key":"ref4","series-title":"Vet J","first-page":"105350","article-title":"Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele","volume":"251","author":"Jaffey JA","year":"2019","unstructured":"Jaffey JA, Pavlick M, Webster CR,  Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele. Vet J. 2019;251:105350. doi:10.1016\/j.tvjl.2019.105350"},{"issue":"3","key":"ref5","series-title":"J Am Vet Med Assoc","first-page":"359","article-title":"Clinical, ultrasonographic, and laboratory findings associated with gallbladder disease and rupture in dogs: 45 cases (1997-2007)","volume":"234","author":"Crews LJ","year":"2009","unstructured":"Crews LJ, Feeney DA, Jessen CR, Rose ND, Matise I. Clinical, ultrasonographic, and laboratory findings associated with gallbladder disease and rupture in dogs: 45 cases (1997-2007). J Am Vet Med Assoc. 2009;234(3):359-366. doi:10.2460\/javma.234.3.359"},{"issue":"9","key":"ref6","series-title":"PLoS One","first-page":"e0138988","article-title":"Excess secretion of gel-forming mucins and associated innate defense proteins with defective mucin un-packaging underpin gallbladder mucocele formation in dogs","volume":"10","author":"Kesimer M","year":"2015","unstructured":"Kesimer M, Cullen J, Cao R,  Excess secretion of gel-forming mucins and associated innate defense proteins with defective mucin un-packaging underpin gallbladder mucocele formation in dogs. PLoS One. 2015;10(9):e0138988. doi:10.1371\/journal.pone.0138988"},{"issue":"6","key":"ref7","series-title":"J Am Vet Med Assoc","first-page":"777","article-title":"Diagnosis and management of gallbladder mucocele formation in dogs","volume":"263","author":"Gookin JL","year":"2025","unstructured":"Gookin JL, Mathews KG, Seiler G. Diagnosis and management of gallbladder mucocele formation in dogs. J Am Vet Med Assoc. 2025;263(6):777-785. doi:10.2460\/javma.24.12.0789"},{"issue":"5","key":"ref8","series-title":"J Vet Intern Med","first-page":"2057","article-title":"Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both","volume":"33","author":"Parkanzky M","year":"2019","unstructured":"Parkanzky M, Grimes J, Schmiedt C, Secrest S, Bugbee A. Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both. J Vet Intern Med. 2019;33(5):2057-2066. doi:10.1111\/jvim.15611"},{"issue":"1","key":"ref9","series-title":"Am J Vet Res","first-page":"23","article-title":"Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele","volume":"83","author":"Asakawa M","year":"2021","unstructured":"Asakawa M, Fukuzawa M, Asakawa MG, Flanders JA. Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele. Am J Vet Res. 2021;83(1):23-32. doi:10.2460\/ajvr.21.09.0141"},{"issue":"10","key":"ref10","series-title":"J Am Vet Med Assoc","first-page":"1615","article-title":"Gallbladder mucocele in dogs: 30 cases (2000-2002)","volume":"224","author":"Pike FS","year":"2004","unstructured":"Pike FS, Berg J, King NW, Penninck DG, Webster CRL. Gallbladder mucocele in dogs: 30 cases (2000-2002). J Am Vet Med Assoc. 2004;224(10):1615-1622. doi:10.2460\/javma.2004.224.1615"},{"issue":"2","key":"ref11","series-title":"Vet Radiol Ultrasound","first-page":"236","article-title":"Dogs with biliary rupture based on ultrasound findings may have normal total serum bilirubin values","volume":"62","author":"Wilson K","year":"2021","unstructured":"Wilson K, Powers D, Grasperge B, Liu CC, Granger LA. Dogs with biliary rupture based on ultrasound findings may have normal total serum bilirubin values. Vet Radiol Ultrasound. 2021;62(2):236-245. doi:10.1111\/vru.12937"},{"issue":"12","key":"ref12","series-title":"J Am Vet Med Assoc","first-page":"1412","article-title":"Anicteric gallbladder rupture in dogs: 5 cases (2007-2013)","volume":"247","author":"Guess SC","year":"2015","unstructured":"Guess SC, Harkin KR, Biller DS. Anicteric gallbladder rupture in dogs: 5 cases (2007-2013). J Am Vet Med Assoc. 2015;247(12):1412-1414. doi:10.2460\/javma.247.12.1412"},{"issue":"3","key":"ref13","series-title":"Vet Clin Pathol","first-page":"114","article-title":"Three cases of canine bile peritonitis with mucinous material in abdominal fluid as the prominent cytologic finding","volume":"32","author":"Owens SD","year":"2003","unstructured":"Owens SD, Gossett R, McElhaney MR, Christopher MM, Shelly SM. Three cases of canine bile peritonitis with mucinous material in abdominal fluid as the prominent cytologic finding. Vet Clin Pathol. 2003;32(3):114-120. doi:10.1111\/j.1939-165X.2003.tb00324.x"},{"issue":"1","key":"ref14","series-title":"J Vet Clin","first-page":"17","article-title":"Atypical bile peritonitis associated with white bile in a dog with ruptured gallbladder","volume":"35","author":"Kang HM","year":"2018","unstructured":"Kang HM, Jang HJ, Kang JH, Kim G, Chang D, Na KJ. Atypical bile peritonitis associated with white bile in a dog with ruptured gallbladder. J Vet Clin. 2018;35(1):17-18. doi:10.17555\/jvc.2018.02.35.1.17"},{"issue":"3","key":"ref15","series-title":"J Am Anim Hosp Assoc","first-page":"146","article-title":"Anicteric gallbladder rupture with elevated bile acids in abdominal effusion in a dog with cholecystitis","volume":"58","author":"Pascual M","year":"2022","unstructured":"Pascual M, Fauchon E, Monti P, Valls F. Anicteric gallbladder rupture with elevated bile acids in abdominal effusion in a dog with cholecystitis. J Am Anim Hosp Assoc. 2022;58(3):146-151. doi:10.5326\/JAAHA-MS-7079"},{"issue":"3","key":"ref16","series-title":"J Small Anim Pract","first-page":"171","article-title":"Evaluation of bile acids and bilirubin in serum and abdominal fluid in dogs with abdominal effusion","volume":"66","author":"Pascual Moreno M","year":"2025","unstructured":"Pascual Moreno M, Monti P, Seth M, Valls Sanchez F. Evaluation of bile acids and bilirubin in serum and abdominal fluid in dogs with abdominal effusion. J Small Anim Pract. 2025;66(3):171-176. doi:10.1111\/jsap.13805"},{"issue":"1","key":"ref17","series-title":"J Am Vet Med Assoc","first-page":"65","article-title":"Gallbladder mucocele rupture, bile peritonitis, cholestasis, and liver inflammation and necrosis. Pathology in Practice","volume":"239","author":"Escobar MC","year":"2011","unstructured":"Escobar MC, Neel JA. Gallbladder mucocele rupture, bile peritonitis, cholestasis, and liver inflammation and necrosis. Pathology in Practice. J Am Vet Med Assoc. 2011;239(1):65-67. doi:10.2460\/javma.239.1.65"},{"issue":"2","key":"ref18","series-title":"Vet Surg","first-page":"90","article-title":"Surgical treatment of bile peritonitis in 24 dogs and 2 cats: a retrospective study (1987-1994)","volume":"26","author":"Ludwig LL","year":"1997","unstructured":"Ludwig LL, McLoughlin MA, Graves TK, Crisp MS. Surgical treatment of bile peritonitis in 24 dogs and 2 cats: a retrospective study (1987-1994). Vet Surg. 1997;26(2):90-98. doi:10.1111\/j.1532-950X.1997.tb01470.x"},{"issue":"7","key":"ref19","series-title":"J Am Vet Med Assoc","first-page":"1","article-title":"Diagnostic and surgical treatment for traumatic bile peritonitis in dogs and cats","volume":"262","author":"McAlexander HW","year":"2024","unstructured":"McAlexander HW, Grimes JA, Ullman SL,  Diagnostic and surgical treatment for traumatic bile peritonitis in dogs and cats. J Am Vet Med Assoc. 2024;262(7):1-6. doi:10.2460\/javma.24.01.0049"},{"issue":"2","key":"ref20","series-title":"Vet Radiol Ultrasound","first-page":"202","article-title":"Comparison between ultrasonographic and clinical findings in 43 dogs with gallbladder mucoceles","volume":"55","author":"Choi J","year":"2014","unstructured":"Choi J, Kim A, Keh S, Oh J, Kim H, Yoon J. Comparison between ultrasonographic and clinical findings in 43 dogs with gallbladder mucoceles. Vet Radiol Ultrasound. 2014;55(2):202-207. doi:10.1111\/vru.12120"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/264\/11\/javma.26.03.0228.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/264\/11\/javma.26.03.0228.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/264\/11\/javma.26.03.0228.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:25:14Z","timestamp":1792171514000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/264\/11\/javma.26.03.0228.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11,1]]},"references-count":20,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.2460\/javma.26.03.0228","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11,1]]}}}