Gallbladder mucocele in dogs: kiwi-fruit pattern and biliary sludge
10-year-old Shetland Sheepdog with hypothyroidism, vomiting and cranial abdominal pain. ALP and GGT are elevated. The gallbladder is distended, with echogenic contents radially striated from the periphery and a hypoechoic rim; the contents do not move when the dog changes position.
What is the most likely diagnosis and the appropriate approach?
chevron_right Show answer and explanation
A. Gallbladder mucocele; in a dog with clinical signs, cholecystectomy is recommended
Correct. Immobile contents with radial striations (kiwi-fruit pattern) or a stellate pattern are typical of mucocele. Shetland Sheepdogs and endocrinopathies (hypothyroidism, Cushing's) predispose. With clinical signs or suspected rupture, cholecystectomy is the treatment of choice.
B. Biliary sludge; no treatment required
Biliary sludge is echogenic, casts no shadow and slowly shifts with gravity when the patient changes position. It is common and incidental in older dogs, but here the contents are immobile and organised.
C. Cholelithiasis; dissolve the stones with ursodeoxycholic acid
Choleliths are hyperechoic foci with distal acoustic shadowing, which are not described here. In dogs, ursodeoxycholic acid does not reliably dissolve gallstones.
D. Emphysematous cholecystitis; percutaneous cholecystocentesis as treatment
Gas in the wall or lumen causes reverberation and dirty shadowing, not radial striations. Cholecystocentesis does not treat a mucocele and, with a distended gallbladder and compromised wall, increases the risk of bile leakage.
lightbulb Key takeaway
Mobile, gravity-dependent sludge = almost always incidental; immobile kiwi or stellate contents = mucocele. Look for signs of rupture (discontinuous wall, free fluid, hyperechoic pericholecystic fat) and investigate endocrinopathies. An asymptomatic mucocele may be monitored, but a symptomatic one is surgical.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.