Abstract
PICO question
 In dogs with an uncomplicated gallbladder mucocele, is the long-term survival when surgically managed superior, inferior, or equal to those medically managed?
 
 Clinical bottom line
 Category of research question
 Treatment and prognosis
 The number and type of study designs reviewed
 Three papers were critically reviewed. All of the studies were retrospective analyses of medical records, two of which were cohort studies, and one which was a case control study
 Strength of evidence
 Weak
 Outcomes reported
 There is some evidence that surgical management of gallbladder mucoceles is associated with longer survival times than medically managed cases, although there is no direct analysis of uncomplicated vs complicated cases
 Conclusion
 We cannot clearly make a conclusion based on the available evidence. To date, there is only one retrospective analysis that directly compares the long-term survival of cases medically vs surgically managed, but this study does not separate uncomplicated vs complicated cases of gallbladder mucocele. In order to more accurately determine which type of treatment should be recommended for uncomplicated cases of gallbladder mucoceles, a prospective study comparing long-term survival with each treatment should be performed. These studies should also standardise medical management in order to more accurately compare survival time to surgical treatment
 
 How to apply this evidence in practice
 The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
 Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
 
Highlights
Additional data was collected from the gallbladder mucocele MST – mean survival time (GBM) cases – absence of specific clinical signs, approach to case management, medications prescribed, presence or absence of gallbladder rupture, outcome, and cause of death
26/34 (76%) of the Border Terriers survived greater than 1 year and there was no statistically significant difference in survival time according to breed status
While the researchers did provide some survival data for the GBM cases, over 50% of the population were still alive at the time of census they could not calculate an MST
Summary
Population: Dogs with ultrasonographic diagnosis of GBM from three referral centres in the United Kingdom. 99 dogs with GBM, of which 51 were Border Terriers and 48 were of various other breeds: o 77/99 were surgically managed o 12/99 were medically managed o 10/99 were euthanised prior to receiving treatment. Additional data was collected from the GBM cases – absence of specific clinical signs, approach to case management (surgical or medical), medications prescribed, presence or absence of gallbladder rupture, outcome (survival 7 days, 6 months, and 1 year post diagnosis; total survival time), and cause of death. 26/34 (76%) of the Border Terriers survived greater than 1 year and there was no statistically significant difference in survival time according to breed status. There was not a statistically significant difference in 7 days, 6 months, or 1 year survival between medically managed and surgically managed groups
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