Cholelithiasis in dogs and cats: when to operate?
9-year-old Poodle in which several choleliths are found in the gallbladder on an ultrasound done for another reason. It has no gastrointestinal signs, bilirubin is normal, liver enzymes are normal or mildly increased and the common bile duct is not dilated.
What is the most appropriate approach?
chevron_right Show answer and explanation
A. Immediate preventive cholecystectomy
Most asymptomatic choleliths cause no problems. Operating without an indication exposes the animal to unnecessary surgical risk.
B. Clinical, laboratory and ultrasound monitoring; surgery only if there is obstruction, cholecystitis, rupture or infection
Correct. In dogs, choleliths are often an incidental finding. They are treated when they cause signs: they are then removed (cholecystectomy, choledochotomy) and the stones and bile are cultured.
C. Ursodeoxycholic acid to dissolve the stones
In dogs and cats, choleliths are usually made of bile pigments and calcium carbonate, not cholesterol, so ursodiol does not dissolve them.
D. Prolonged empirical antibiotic
Without signs of infection it is not indicated and promotes resistance. If cholecystitis is suspected, bile is cultured before treating.
lightbulb Key takeaway
In cats, choleliths are more often associated with cholangitis and biliary obstruction, so look for underlying biliary disease. In either species, a common bile duct stone with dilation and rising bilirubin is surgical.
Test yourself with 10 random questions
Gastroenterology · 100 questions, a different test every time
Related questions
Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.