Measurement of abdominal fluid bilirubin concentration frequently fails to detect biliary tract rupture in dogs with gallbladder mucocele.

AFB:SB ratio frequently misses GBM rupture; combine with fluid cytology analysis.

This retrospective cross-sectional study evaluated the diagnostic utility of abdominal fluid bilirubin-to-serum bilirubin ratio (AFB:SB) in detecting biliary tract rupture in dogs with and without gallbladder mucocele (GBM). Twenty-nine dogs were analyzed: 12 with GBM and 17 without GBM. Among GBM dogs with rupture, only 18% (2/11) had AFB:SB > 2, compared to 86% (6/7) of non-GBM dogs with rupture. The study revealed that AFB:SB measurement alone has poor sensitivity for detecting ruptured GBM in dogs. However, abdominal fluid cytological analysis successfully identified bile in all dogs with ruptured GBM, demonstrating superior diagnostic value. The authors conclude that while AFB:SB > 2 can indicate biliary tract rupture, normal or low ratios do not exclude ruptured GBM. Clinicians should not rely solely on AFB:SB ratio but should perform concurrent cytological examination of abdominal fluid when GBM rupture is suspected.

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