gall bladder Reem et. al.

Anatomical forms of Domestic Cat (Felis catus do-

I mesticus ) gall bladder in Egypt with its relation to their biliary system

1 1 2 1 II Reem R.T. *, Alaa H.E. , Farghali H.A. , Maher M.A.

1 Department of Anatomy and Embryology, faculty of veterinary medicine, Cairo University, III Egypt. 2 Department of Surgery, Anesthesiology and Radiology, faculty of veterinary medicine, Cairo University, Egypt.

With 9 figures. Received January, accepted for publication February,2019 IV Digit

Abstract the liver to the right of the median th C In order to help veterinarians in appli- plane and close to the 8 intercostal cation of surgical procedures in cat space, and the gall bladder was seen Fig (8): Tarsal bones, Metatarsals and digits (with horny claws) of tree Kangaroo. Dorsal and detection of gall bladder disease both viscerally as well as the parietally view. (A), the plantar (solar) side of the foot of Lumholtz’s tree-kangaroo after Flannery et al., so that, we gathered twenty-one do- (Dyce et al. 2010). 1999 (B) and the phalanges of the IV digit and the horny claw (C). mestic and concluded that three The differences in the forms of gall Ft fibular tarsal (calcaneus), Tt tibial tarsal (Talus), Ct central tarsal, Ta1,2,3,4 1st,2nd ,3rd,4th main forms were collected; single gall tarsal bones respectively, Mt 2,3,4,5 2nd, 3rd, 4th, 5th metatarsal bones respectively, P proximal bladder congenitally may be organized phalanx, M middle phalanx, D distal phalanx, s sesamoid bones. Roman numerals refer to bladder, duplex fundus and bilobed from the miscarriage of vacuoliation of digit numbers. gall bladder. Both the gall bladder the gall bladder and bile duct divertic- Notice 1) the joined II, III digits and the largest IV digit. forms and the hepatic ducts distribu- ulum (Mayhew et al. 2002). Gall blad- 2) The position of the “planter” sesamoid bones in the digits IV, V is at the plantar tion were not related. The bile duct was der malformations were monitored as surface of constructed from the left and right he- septated gall bladder, bilobed gall proximal extremity of the proximal phalanx. It is put here to show only its size. patic ducts in addition to the cystic one. bladder and Duplex gall bladder (Ma- In some cases, we explored that a hato, 2010 and Ergin et al. 2013). Also, short common hepatic duct. So- some diseases may affect the gall nographically, the gall bladder ap- bladder shape as emaciated without peared differ in conformance, encir- appetite cat would have distended cled by echogenic wall and adjacent to rounded gall bladder (Meyer, 2013). the right medial lobe laterally and the quadrate lobe medially. Using sonar devices for localizing the site of gall bladder, it was at the right Gall bladder, bile duct, cranial part of abdomen (Kook, 2013). A B C D E F G Keywords: Fig (9): Solar view of: hepatic duct, corrosive cast, cat. Only the gall bladder and cystic duct A Brushtail possum, B Musky rat-kangaroo, C Black Dorcopsis, D Black-footed rock-wallaby, can be simply monitored ultraso- E Bennett’s tree-kangaroo, F Grizzled tree-kangaroo, G Lumholtz’s tree-kangaroo. Introduction nographically in normal cats while the (Source: Flannery et al., 1999. Retrieved from: http://thetreehare.blogspot.co.uk/) The gall bladder was situated between rest extrahepatic and intrahepatic the right medial and quadrate lobes of structures were not detected except in

J. Vet. Anat. 35 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al. a diseased condition (Penninck et al. We explored another 3 live cats; by us- Pear shaped gall bladder (Figs. 3C) duct (Figs. 5A, B, D/1) was relatively 2010 and D’Anjou & Penninck, 2015). ing the B-mode scan (Pie medical) or was curved with broad fundus, slightly long and coiled, The left hepatic duct The gall bladder, cystic duct, bile duct Doppler device (EXAGO, Echo control concave hepatic surface, convex gas- (Figs. 5A,B,D/3) established by the lo- and hepatic duct composed the biliary medical, France) with a linear multi fre- tric surface and folded neck connected bar ducts from both left and quadrate system (Center, 2009 and Kook, quency transducer using a frequency with zigzag cystic duct. The distended lobes and it received ,in most cases 2013). Three to five hepatic ducts in of 7.5 MHz. After that the same cats fundus gall bladder (fig.3D) was large the papillary process branch (Fig. cats opened in to the cystic duct to were euthanized as mentioned for the and rounded joined with wide body 5D/3,8,9,10,15). The right hepatic duct form the bile duct after the fusion with radiological examination. For obtaining which decreases upward to reach by (Figs. 5A, B, D/2) was established by the last hepatic duct (Brockman, contrast X-ray films, the specimens the narrow neck. The truncated fundus the joining of the right medial lobar 2013). A short common hepatic duct were injected by lead oxide dissolved gall bladder (fig.3E) has a shorter left duct (from the right medial lobe) and received the cystic duct constructing in turpentine oil into the major duode- fundic end and a narrow-bended neck the right lateral lobar duct (drained the the bile duct (Budras & Habel, 2003). nal papilla. The films were taken by us- attaching with a coiled cystic duct. right lateral lobe as well as the caudate ing the radiographic device (Fisher im- process by the Ramus processus cau- Duplex fundus gall bladder (fig. 4A) Material and Methods aging, Chicago, USA). datus) (Fig. 5D/2, 5, 16, 17). It must be was a single gall bladder with two The experiments were conducted by noted that the right hepatic duct in broad fundic parts which were divided the international ethical standards set Results three specimens was only formed by externally only by a sagittal groove and by the institutional animal care and use In the most of the gathered cat livers, the union of the right lateral and right a single body and neck. It was situated committee (Vet. CU. IACUC) the gall bladder was situated in the medial lobar ducts which drained their in a very deep fossa (fig. 1C) of gall VetCU1111201808. The present study fossa of gall bladder more superficial respective lobes (Figs. 5A, B/2, 16, bladder made by the whole the quad- was constructed on twenty-one do- between the right medial (fig.1c) and 17). In such conditions, the branch of rate lobe and has a small part of the mestic cats (Felis catus domesticus) the quadrate lobes (fig. 1d) where its the caudate process opened directly right medial one. which were adult, apparently healthy ends did not extend to the liver ventral into the bile duct (Figs. 5A, B/4, 5). of both sexes with average body margin, also appear on visceral sur- Bilobed gall bladder (fig. 4B) with both In the second Group, in some speci- weight; 2.900-3.500 Kg. The animals face only (fig. 1A). In another speci- double fundus and corpus attached mens, the bile duct was formed by the were euthanized using I\V10 mg/kg Di- mens, the gall bladder clarified on the with single neck which narrowing grad- union of the cystic duct with a short azepam. Nine cats were dissected liver parietal surface at the level of the ually to join a twisting cystic duct. A th common hepatic duct (Figs. 5C, 6): freshly for gall bladder morphology 7 intercostal space (Figs.1B, C, D huge fossa of gall bladder was sur- The cystic duct (Figs. 5C, 6/1) was then fixed by 10% formalin. Another &2),also they were more larger in size rounded viscerally by right medial and long and tortious. The common he- nine cats were injected with colored la- and length to out stretch nearly to the quadrate lobes and both lobes of gall patic duct (Figs. 5C, 6/ 6) was short, tex neoprene into the major duodenal level of the liver ventral borders . bladder appeared while parietally only established by the fusion of the left he- papilla and then fixed by freezing or by In our work on cat gall bladder, three the ventral part of left lobe of gall blad- patic duct collected both left lobes and formalin overnight. Further dissection main forms were collected; single gall der was viewed. occurred and then transferred to con- bladder, duplex fundus and bilobed papillary process (Fig. 5C/3, 9, 10, 15) centrate HCL for three days. The spec- gall bladder. The present investigation classified as well as receiving the duct of the imens were photographed using Olym- the formation of the bile duct and the quadrate lobe in one specimen (Fig. In most of the specimens the gall blad- pus digital camera SP-600UZ 12 mega terminations of the hepatic ducts into 6/8), while the right hepatic duct der was single, with different shapes; pixel. The anatomical nomenclature two groups; The first most common drained the right medial lobe branch relatively large oval (Fig.3A, B) or pear used in this study was in accordance where the bile duct was formed by the and the quadrate lobar branch (Fig. shaped (Figs. 3C) or distended fundus with the Nomina Anatomica Veteri- cystic duct with the left and right he- 5C/2,8). In such specimens, the right (fig.3D) or truncated fundus (fig.3E). naria 2017 (6th edition). patic ducts (Figs.5A, B, D), The cystic lateral lobar branch and the branch of

J. Vet. Anat. 36 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al. a diseased condition (Penninck et al. We explored another 3 live cats; by us- Pear shaped gall bladder (Figs. 3C) duct (Figs. 5A, B, D/1) was relatively 2010 and D’Anjou & Penninck, 2015). ing the B-mode scan (Pie medical) or was curved with broad fundus, slightly long and coiled, The left hepatic duct The gall bladder, cystic duct, bile duct Doppler device (EXAGO, Echo control concave hepatic surface, convex gas- (Figs. 5A,B,D/3) established by the lo- and hepatic duct composed the biliary medical, France) with a linear multi fre- tric surface and folded neck connected bar ducts from both left and quadrate system (Center, 2009 and Kook, quency transducer using a frequency with zigzag cystic duct. The distended lobes and it received ,in most cases 2013). Three to five hepatic ducts in of 7.5 MHz. After that the same cats fundus gall bladder (fig.3D) was large the papillary process branch (Fig. cats opened in to the cystic duct to were euthanized as mentioned for the and rounded joined with wide body 5D/3,8,9,10,15). The right hepatic duct form the bile duct after the fusion with radiological examination. For obtaining which decreases upward to reach by (Figs. 5A, B, D/2) was established by the last hepatic duct (Brockman, contrast X-ray films, the specimens the narrow neck. The truncated fundus the joining of the right medial lobar 2013). A short common hepatic duct were injected by lead oxide dissolved gall bladder (fig.3E) has a shorter left duct (from the right medial lobe) and received the cystic duct constructing in turpentine oil into the major duode- fundic end and a narrow-bended neck the right lateral lobar duct (drained the the bile duct (Budras & Habel, 2003). nal papilla. The films were taken by us- attaching with a coiled cystic duct. right lateral lobe as well as the caudate ing the radiographic device (Fisher im- process by the Ramus processus cau- Duplex fundus gall bladder (fig. 4A) Material and Methods aging, Chicago, USA). datus) (Fig. 5D/2, 5, 16, 17). It must be was a single gall bladder with two The experiments were conducted by noted that the right hepatic duct in broad fundic parts which were divided the international ethical standards set Results three specimens was only formed by externally only by a sagittal groove and by the institutional animal care and use In the most of the gathered cat livers, the union of the right lateral and right a single body and neck. It was situated committee (Vet. CU. IACUC) the gall bladder was situated in the medial lobar ducts which drained their in a very deep fossa (fig. 1C) of gall VetCU1111201808. The present study fossa of gall bladder more superficial respective lobes (Figs. 5A, B/2, 16, bladder made by the whole the quad- was constructed on twenty-one do- between the right medial (fig.1c) and 17). In such conditions, the branch of rate lobe and has a small part of the mestic cats (Felis catus domesticus) the quadrate lobes (fig. 1d) where its the caudate process opened directly right medial one. which were adult, apparently healthy ends did not extend to the liver ventral into the bile duct (Figs. 5A, B/4, 5). of both sexes with average body margin, also appear on visceral sur- Bilobed gall bladder (fig. 4B) with both In the second Group, in some speci- weight; 2.900-3.500 Kg. The animals face only (fig. 1A). In another speci- double fundus and corpus attached mens, the bile duct was formed by the were euthanized using I\V10 mg/kg Di- mens, the gall bladder clarified on the with single neck which narrowing grad- union of the cystic duct with a short azepam. Nine cats were dissected liver parietal surface at the level of the ually to join a twisting cystic duct. A th common hepatic duct (Figs. 5C, 6): freshly for gall bladder morphology 7 intercostal space (Figs.1B, C, D huge fossa of gall bladder was sur- The cystic duct (Figs. 5C, 6/1) was then fixed by 10% formalin. Another &2),also they were more larger in size rounded viscerally by right medial and long and tortious. The common he- nine cats were injected with colored la- and length to out stretch nearly to the quadrate lobes and both lobes of gall patic duct (Figs. 5C, 6/ 6) was short, tex neoprene into the major duodenal level of the liver ventral borders . bladder appeared while parietally only established by the fusion of the left he- papilla and then fixed by freezing or by In our work on cat gall bladder, three the ventral part of left lobe of gall blad- patic duct collected both left lobes and formalin overnight. Further dissection main forms were collected; single gall der was viewed. occurred and then transferred to con- bladder, duplex fundus and bilobed papillary process (Fig. 5C/3, 9, 10, 15) centrate HCL for three days. The spec- gall bladder. The present investigation classified as well as receiving the duct of the imens were photographed using Olym- the formation of the bile duct and the quadrate lobe in one specimen (Fig. In most of the specimens the gall blad- pus digital camera SP-600UZ 12 mega terminations of the hepatic ducts into 6/8), while the right hepatic duct der was single, with different shapes; pixel. The anatomical nomenclature two groups; The first most common drained the right medial lobe branch relatively large oval (Fig.3A, B) or pear used in this study was in accordance where the bile duct was formed by the and the quadrate lobar branch (Fig. shaped (Figs. 3C) or distended fundus with the Nomina Anatomica Veteri- cystic duct with the left and right he- 5C/2,8). In such specimens, the right (fig.3D) or truncated fundus (fig.3E). naria 2017 (6th edition). patic ducts (Figs.5A, B, D), The cystic lateral lobar branch and the branch of

J. Vet. Anat. 37 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al. the caudate process fused to form Concerning the distended fundus gall pancreatic ducts observed in the in- that the ultrasonographic examination what could be called duct hepatica bladder which was large and rounded vestigated cat specimens, agreed with of the liver was difficult due a portion of dextra accessoria (Fig. 5C/5, 7, 17) joined with wide body; these findings NAV (2017) in the same animals as the liver being obscured by the overly- which opened directly into the bile agreed with Meyer (2013) who docu- well as in the guinea pig (Stan, 2013). ing stomach (Burk & Feeney, 2003). duct. The latter gave a very narrow mented that it was due to loss of appe- In cats, a linear multifrequency trans- In the present investigation in cat, in ductule to the right medial lobe dor- tite of cat. ducer with working frequency 7.5 MHz the right medial hypo-chondral trans- sally and laterally. It must be noted that, the liver investi- was used to scan cat's liver which verse scan, the identification of the an- The cat bile duct (Ductus chole- gated specimen of bilobed gall bladder nearly agreed with Mannion and Lang echoic gall bladder with distinct echo- dochus) (Figs. 6, 7/4) was relatively revealed that the right lobe presented (2008) and Brioschi et al. (2014) who genic wall contributed to the determi- two small buds connected together; long, passed through the hepatoduo- also declared using the same range of nation of the two bordering lobes of the this condition was not recorded in rel- denal ligament (Fig. 7A/J), where it in- frequency but with a curved array liver; the quadrate and the right medial evant references. tegrated with the pancreatic duct transducer for abdominal ultrasonog- lobes. The observation of the gall blad- (Figs.6,7B/21) and penetrated the du- Brockman (2013) determined that the raphy in cats. Meanwhile, Lamb (1990) der was in accordance to that of odenal wall to open on the major duo- common hepatic duct was not present offered using a 5 MHz transducer. Our (Mannion, 2008; Dennis et al. 2010 denal papilla encircled by the hepato- and the lobar hepatic ducts joined indi- examination on the liver was per- and Brioschi, et al. 2014) but was not pancreatic ampulla (Figs. 6,7) 2-2.5 vidually with the cystic duct to form the formed while the animals in dorsal re- recorded in the statement of Burk and cm distal to pylorus. bile duct, which was in contradic- cumbency as asserted by (Lamb, Feeney (2003) and Santos (2014) who tion with our conclusions that the bile 1990; Partington & Biller 1996 and announced that the gall bladder wall Discussion duct was formed by the union of the Dennis et al. 2010) in cats. However, was poorly visualized or not identified Dyce et al. (2010) summarized that the cystic duct with a short common he- other authors recommended using a at all. Incoherence to the anatomic de- dog gall bladder was situated in the patic duct. combination of positions; right lateral, scription of the feline gall bladder, it fossa of gall bladder more superficial Similar observation of Dyce et al. left lateral and dorsal recumbency varied considerably in shape and size between the right medial and the (2010) that the biliary ducts drained (Mannion, 2008 and Kealy et al. 2011) as approved by Burk and Feeney quadrate lobes of the liver and ap- the caudate and the right lateral lobes and Mannion (2008) who added that (2003). peared on both parietal and visceral of the liver entered the bile duct di- the gall bladder was better detected Having the opinion that the intrahe- surfaces, which was similar to our ob- rectly. Conversely, in other collected with the animal in lateral recumbency. patic bile ducts could not be evident on servations in cat in cases of the dis- specimens in our work the two ducts tended gall bladder, duplex fundus and merged to form the right accessory he- In the current study, the ultraso- a general ultrasonographic examina- the bilobed gall bladder. Per-contra, in patic duct, also in exceptional cases, nographic approach was trans ab- tion in normal cats as that demons- case of the single oval and pear- that caudate process branch entered dominal percutaneous epigastric in trated by (Burk and Feeney, 2003; shaped gall bladders, they appeared separately the bile duct. cats this approach was in consent to Dennis et al. 2010; Kealy et al. 2011). only viscerally. Banzato et al. 2015. However, the liver The entrance of the bile and pancre- Conclusion In agreement with the description of was observed from a ventral ab- atic ducts into the duodenum termi- Three main forms were collected; sin- Mahato (2010) and Ergin et al. (2013), dominal approach (Dennis et al. 2010) nated together as observed in the cat those different forms of cat gall bladder or by placing the transducer just cau- gle gall bladder, duplex fundus and bi- specimens were in accordance with were collected as the duplex fundus dal to the xiphisternum (Lamb, 1990 lobed gall bladder. The single gall and bilobed gall bladder. In addition, (Center, 2009 and Lehner & McAnulty, and Dennis et al. 2010) or beneath the bladder with different shapes; rela- our results on cat liver concerning the 2010). Regarding the presence of the costal arch (Burk & Feeney, 2003). All tively large oval or pear shaped or dis- gall bladder shape were supported by hepatopancreatic ampulla encircling whoever agreed that the liver could be tended fundus or truncated fundus. In Mayhew et al. (2007). the common orifice of the bile and accessible unlike what was proposed some forms of gall bladder were out

J. Vet. Anat. 38 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al. the caudate process fused to form Concerning the distended fundus gall pancreatic ducts observed in the in- that the ultrasonographic examination what could be called duct hepatica bladder which was large and rounded vestigated cat specimens, agreed with of the liver was difficult due a portion of dextra accessoria (Fig. 5C/5, 7, 17) joined with wide body; these findings NAV (2017) in the same animals as the liver being obscured by the overly- which opened directly into the bile agreed with Meyer (2013) who docu- well as in the guinea pig (Stan, 2013). ing stomach (Burk & Feeney, 2003). duct. The latter gave a very narrow mented that it was due to loss of appe- In cats, a linear multifrequency trans- In the present investigation in cat, in ductule to the right medial lobe dor- tite of cat. ducer with working frequency 7.5 MHz the right medial hypo-chondral trans- sally and laterally. It must be noted that, the liver investi- was used to scan cat's liver which verse scan, the identification of the an- The cat bile duct (Ductus chole- gated specimen of bilobed gall bladder nearly agreed with Mannion and Lang echoic gall bladder with distinct echo- dochus) (Figs. 6, 7/4) was relatively revealed that the right lobe presented (2008) and Brioschi et al. (2014) who genic wall contributed to the determi- two small buds connected together; long, passed through the hepatoduo- also declared using the same range of nation of the two bordering lobes of the this condition was not recorded in rel- denal ligament (Fig. 7A/J), where it in- frequency but with a curved array liver; the quadrate and the right medial evant references. tegrated with the pancreatic duct transducer for abdominal ultrasonog- lobes. The observation of the gall blad- (Figs.6,7B/21) and penetrated the du- Brockman (2013) determined that the raphy in cats. Meanwhile, Lamb (1990) der was in accordance to that of odenal wall to open on the major duo- common hepatic duct was not present offered using a 5 MHz transducer. Our (Mannion, 2008; Dennis et al. 2010 denal papilla encircled by the hepato- and the lobar hepatic ducts joined indi- examination on the liver was per- and Brioschi, et al. 2014) but was not pancreatic ampulla (Figs. 6,7) 2-2.5 vidually with the cystic duct to form the formed while the animals in dorsal re- recorded in the statement of Burk and cm distal to pylorus. dog bile duct, which was in contradic- cumbency as asserted by (Lamb, Feeney (2003) and Santos (2014) who tion with our conclusions that the bile 1990; Partington & Biller 1996 and announced that the gall bladder wall Discussion duct was formed by the union of the Dennis et al. 2010) in cats. However, was poorly visualized or not identified Dyce et al. (2010) summarized that the cystic duct with a short common he- other authors recommended using a at all. Incoherence to the anatomic de- dog gall bladder was situated in the patic duct. combination of positions; right lateral, scription of the feline gall bladder, it fossa of gall bladder more superficial Similar observation of Dyce et al. left lateral and dorsal recumbency varied considerably in shape and size between the right medial and the (2010) that the biliary ducts drained (Mannion, 2008 and Kealy et al. 2011) as approved by Burk and Feeney quadrate lobes of the liver and ap- the caudate and the right lateral lobes and Mannion (2008) who added that (2003). peared on both parietal and visceral of the liver entered the bile duct di- the gall bladder was better detected Having the opinion that the intrahe- surfaces, which was similar to our ob- rectly. Conversely, in other collected with the animal in lateral recumbency. patic bile ducts could not be evident on servations in cat in cases of the dis- specimens in our work the two ducts tended gall bladder, duplex fundus and merged to form the right accessory he- In the current study, the ultraso- a general ultrasonographic examina- the bilobed gall bladder. Per-contra, in patic duct, also in exceptional cases, nographic approach was trans ab- tion in normal cats as that demons- case of the single oval and pear- that caudate process branch entered dominal percutaneous epigastric in trated by (Burk and Feeney, 2003; shaped gall bladders, they appeared separately the bile duct. cats this approach was in consent to Dennis et al. 2010; Kealy et al. 2011). only viscerally. Banzato et al. 2015. However, the liver The entrance of the bile and pancre- Conclusion In agreement with the description of was observed from a ventral ab- atic ducts into the duodenum termi- Three main forms were collected; sin- Mahato (2010) and Ergin et al. (2013), dominal approach (Dennis et al. 2010) nated together as observed in the cat those different forms of cat gall bladder or by placing the transducer just cau- gle gall bladder, duplex fundus and bi- specimens were in accordance with were collected as the duplex fundus dal to the xiphisternum (Lamb, 1990 lobed gall bladder. The single gall and bilobed gall bladder. In addition, (Center, 2009 and Lehner & McAnulty, and Dennis et al. 2010) or beneath the bladder with different shapes; rela- our results on cat liver concerning the 2010). Regarding the presence of the costal arch (Burk & Feeney, 2003). All tively large oval or pear shaped or dis- gall bladder shape were supported by hepatopancreatic ampulla encircling whoever agreed that the liver could be tended fundus or truncated fundus. In Mayhew et al. (2007). the common orifice of the bile and accessible unlike what was proposed some forms of gall bladder were out

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Cat gall bladder Reem et. al. stretched nearly to the level of the liver Abdominal ultrasound features and veterinary anatomy, 4th Ed. Saunders, practice. Chapter 4: Imaging of the ventral borders. Both the gall bladder reference values in 21 healthy rabbits. London. general abdomen, Published by john forms and the hepatic ducts distribu- Veterinary Record 4:176. Wiley and sons, pp 38. Ergin, I., Senel, O.O., Sen, Y. and tion were not related. The bile duct was Brioschi, V., Roussetm, N. and Bumin, A. (2013): Bilobed gallbladder Mayhew, P.D., Holt, D.E., McLear, constructed from the left and right he- Ladlow, J.F. (2014): Imaging Diagno- in a cat. Revue Méd. Vét.;164 (10):453- R.C. and Washabau, R.J. (2002): patic ducts in addition to the cystic one. sis—Extrahepatic Biliary Tract Ob- 456. Pathogenesis and outcome of extrahe- In some cases, we explored that a struction Secondary to A Biliary For- patic Biliary obstruction in cats. J. small short common hepatic duct by the un- Kealy, J.K., McAllister, H. and Gra- eign Body in a Cat. Vet Radiol Ultra- ham, J.P. (2011): Diagnostic Radiol- anim pract; 43:247-25. ion of the previous two hepatic ducts, sound 55(6):628–63. and joined with the cystic duct estab- ogy and Ultrasonography of the Dog Meyer, T. (2013): Primary liver cancer. th lishing the bile duct. In the present Brockman, D.J. (2013): Surgery of the and Cat, 5 edition, by Saunders, an Br. J. Cancer; 108 (4):995-996. study, the caudate process branch and Extrahepatic Biliary Tract in Cats and imprint of Elsevier Inc. . World Small Animal Veterinary Nomina Anatomica Veterinaria NAV the right lateral branch, each drained Kook, P.H. (2013): Gall bladder dis- Association World Congress Proceed- (2017): The International Committee its respective hepatic portion. Com- eases in dogs and cats. Research ings. 38th annual congress, Auckland, on Veterinary Gross Anatomical No- monly, these two branches merged to gate, Clinic for Small Animal Internal New Zealand. menclature, Published by the Editorial form a single duct that could be named Medicine, Vetsuisse-Faculty, Univer- Committee Hannover (Germany), Co- right accessory hepatic duct which en- Budras, K. and Habel, R.E. (2003): sity of Zurich, Zurich, Switzerland. lumbia, MO (U.S.A.), Ghent (Belgium), tered the "original" right hepatic duct of Bovine anatomy, An illustrated text, Lamb, C.R. (1990): Abdominal ultraso- Sapporo (Japan), 6th edition (Revised the right medial lobe. The sonographic Sclutersche publisher. nography in small animals: Examina- investigation of the gall bladder was version). Burk, R.L. and Feeney, D.A. (2003): tion of the liver, spleen and pancreas. mainly confined to the left medial hy- Small Animal Radiology and Ultraso- Journal of Small Animal Practice; 31: 6- Partington, B. and Biller, D. (1996): pochondriac, middle xiphoid and right nography: A Diagnostic Atlas and Text, 15. Liver In: R. Green (Editor) Small Ani- medial hypochondriac epigastric re- SAUNDERS, Elsevier Science, USA. mal Ultrasound, chapter 6. Lippincot- gion. The gall bladder in cat was varied Lehner, C.M. and McAnulty, J.F. Raven Publishers, Philadelphia, pp. in conformation, bordered by the right Center, S.A. (2009): Diseases of the (2010): Management of extrahepatic 105-130. medial lobe laterally and the quadrate gall bladder and biliary tree. J. small biliary obstruction: A role for temporary lobe medially surrounded by echo- animal practice; 39(3):543-598. percutaneous biliary drainage. Com- Penninck, D.G., Brisson, J.O. and genic wall. pendium: continuing education for vet- Webster, C.R.L. (2010): Sonographic D’Anjou, M.A. and Penninck, D. erinarians. assessment of gallbladder volume in (2015): Liver. In: Penninck DG and normal cats. Vet Radiol Ultrasound; 51: Acknowledgment D’Anjou MA (eds). Atlas of small ani- Mahato, N.K. (2010): Septate gallblad- 665–666. We would like to give a voice to profes- mal ultrasonography, 2nd ed. Ames, der: gross and histological perspec- sor doctor Salah Mohamed Hagrass; IA, Blackwell Publishing, pp 220–222. tives in an uncommon occurrence. Int. Santos, D.C.D. (2014): Ultrassono- professor of Anatomy and Embryol- J. Anatom. Variat.: 3, 70-72. grafia Abdominal De Gatos Pediatricos ogy, faculty of veterinary medicine, Dennis, R., kirberger, R.M., Barr, F. Diagnostic ultra- Higidos. Master Thesis. Universidade Cairo University, for his valuable and and Wrigley, R.H. (2010): Handbook Mannion, P. (2008): of Small animal Radiology and Ultra- sound in small animal practice. Chap- Federal De Lavras, Brazil. constructive work. ter 5: the liver and spleen, Published by sound, Techniques and Differential Di- Comparative study nd Stan, F.G. (2013): References agnoses, 2 edition, Elsevier Limited. john Wiley and sons, pp 50. of the stomach morphology in rabbit Banzato, T., Bellini, L., Contiero, B., Dyce, K.M., Sack, W.O. and Wens- Mannion, P. and Lang, J. (2008): Di- and chinchilla. Agro life scientific jour- Selleri, P. and Zotti, A. (2015): ing, C.J.G. (2010): Textbook of agnostic ultrasound in small animal nal, Bucuresti, Romania;2:73-78.

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Cat gall bladder Reem et. al. stretched nearly to the level of the liver Abdominal ultrasound features and veterinary anatomy, 4th Ed. Saunders, practice. Chapter 4: Imaging of the ventral borders. Both the gall bladder reference values in 21 healthy rabbits. London. general abdomen, Published by john forms and the hepatic ducts distribu- Veterinary Record 4:176. Wiley and sons, pp 38. Ergin, I., Senel, O.O., Sen, Y. and tion were not related. The bile duct was Brioschi, V., Roussetm, N. and Bumin, A. (2013): Bilobed gallbladder Mayhew, P.D., Holt, D.E., McLear, constructed from the left and right he- Ladlow, J.F. (2014): Imaging Diagno- in a cat. Revue Méd. Vét.;164 (10):453- R.C. and Washabau, R.J. (2002): patic ducts in addition to the cystic one. sis—Extrahepatic Biliary Tract Ob- 456. Pathogenesis and outcome of extrahe- In some cases, we explored that a struction Secondary to A Biliary For- patic Biliary obstruction in cats. J. small short common hepatic duct by the un- Kealy, J.K., McAllister, H. and Gra- eign Body in a Cat. Vet Radiol Ultra- ham, J.P. (2011): Diagnostic Radiol- anim pract; 43:247-25. ion of the previous two hepatic ducts, sound 55(6):628–63. and joined with the cystic duct estab- ogy and Ultrasonography of the Dog Meyer, T. (2013): Primary liver cancer. th lishing the bile duct. In the present Brockman, D.J. (2013): Surgery of the and Cat, 5 edition, by Saunders, an Br. J. Cancer; 108 (4):995-996. study, the caudate process branch and Extrahepatic Biliary Tract in Cats and imprint of Elsevier Inc. Dogs. World Small Animal Veterinary Nomina Anatomica Veterinaria NAV the right lateral branch, each drained Kook, P.H. (2013): Gall bladder dis- Association World Congress Proceed- (2017): The International Committee its respective hepatic portion. Com- eases in dogs and cats. Research ings. 38th annual congress, Auckland, on Veterinary Gross Anatomical No- monly, these two branches merged to gate, Clinic for Small Animal Internal New Zealand. menclature, Published by the Editorial form a single duct that could be named Medicine, Vetsuisse-Faculty, Univer- Committee Hannover (Germany), Co- right accessory hepatic duct which en- Budras, K. and Habel, R.E. (2003): sity of Zurich, Zurich, Switzerland. lumbia, MO (U.S.A.), Ghent (Belgium), tered the "original" right hepatic duct of Bovine anatomy, An illustrated text, Lamb, C.R. (1990): Abdominal ultraso- Sapporo (Japan), 6th edition (Revised the right medial lobe. The sonographic Sclutersche publisher. nography in small animals: Examina- investigation of the gall bladder was version). Burk, R.L. and Feeney, D.A. (2003): tion of the liver, spleen and pancreas. mainly confined to the left medial hy- Small Animal Radiology and Ultraso- Journal of Small Animal Practice; 31: 6- Partington, B. and Biller, D. (1996): pochondriac, middle xiphoid and right nography: A Diagnostic Atlas and Text, 15. Liver In: R. Green (Editor) Small Ani- medial hypochondriac epigastric re- SAUNDERS, Elsevier Science, USA. mal Ultrasound, chapter 6. Lippincot- gion. The gall bladder in cat was varied Lehner, C.M. and McAnulty, J.F. Raven Publishers, Philadelphia, pp. in conformation, bordered by the right Center, S.A. (2009): Diseases of the (2010): Management of extrahepatic 105-130. medial lobe laterally and the quadrate gall bladder and biliary tree. J. small biliary obstruction: A role for temporary lobe medially surrounded by echo- animal practice; 39(3):543-598. percutaneous biliary drainage. Com- Penninck, D.G., Brisson, J.O. and genic wall. pendium: continuing education for vet- Webster, C.R.L. (2010): Sonographic D’Anjou, M.A. and Penninck, D. erinarians. assessment of gallbladder volume in (2015): Liver. In: Penninck DG and normal cats. Vet Radiol Ultrasound; 51: Acknowledgment D’Anjou MA (eds). Atlas of small ani- Mahato, N.K. (2010): Septate gallblad- 665–666. We would like to give a voice to profes- mal ultrasonography, 2nd ed. Ames, der: gross and histological perspec- sor doctor Salah Mohamed Hagrass; IA, Blackwell Publishing, pp 220–222. tives in an uncommon occurrence. Int. Santos, D.C.D. (2014): Ultrassono- professor of Anatomy and Embryol- J. Anatom. Variat.: 3, 70-72. grafia Abdominal De Gatos Pediatricos ogy, faculty of veterinary medicine, Dennis, R., kirberger, R.M., Barr, F. Diagnostic ultra- Higidos. Master Thesis. Universidade Cairo University, for his valuable and and Wrigley, R.H. (2010): Handbook Mannion, P. (2008): of Small animal Radiology and Ultra- sound in small animal practice. Chap- Federal De Lavras, Brazil. constructive work. ter 5: the liver and spleen, Published by sound, Techniques and Differential Di- Comparative study nd Stan, F.G. (2013): References agnoses, 2 edition, Elsevier Limited. john Wiley and sons, pp 50. of the stomach morphology in rabbit Banzato, T., Bellini, L., Contiero, B., Dyce, K.M., Sack, W.O. and Wens- Mannion, P. and Lang, J. (2008): Di- and chinchilla. Agro life scientific jour- Selleri, P. and Zotti, A. (2015): ing, C.J.G. (2010): Textbook of agnostic ultrasound in small animal nal, Bucuresti, Romania;2:73-78.

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Cat gall bladder Reem et. al.

Fig. (1): A photograph showing the position of the gall bladder on the parietal surfaces of the cat’s liver.

A. Gall bladder does not appear on parietal surface in the large oval and pear-shaped single ones. B.C.D. Gall bladder appeared parietally in distended fundus, truncated fundus and bi- lobed gall bladder, respectively.

Fig. (3): A photograph showing different shapes of single cat gall bladder.

A.B. relatively large oval gall bladders, C. pear shaped, D. distended large fundus, E. Trun- cated fundus Fig. (2): A photograph showing the position of the gall bladder of cat on the parietal surface of the liver at the level of the 7th intercostal space.

J. Vet. Anat. 42 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al.

Fig. (1): A photograph showing the position of the gall bladder on the parietal surfaces of the cat’s liver.

A. Gall bladder does not appear on parietal surface in the large oval and pear-shaped single ones. B.C.D. Gall bladder appeared parietally in distended fundus, truncated fundus and bi- lobed gall bladder, respectively.

Fig. (3): A photograph showing different shapes of single cat gall bladder.

A.B. relatively large oval gall bladders, C. pear shaped, D. distended large fundus, E. Trun- cated fundus Fig. (2): A photograph showing the position of the gall bladder of cat on the parietal surface of the liver at the level of the 7th intercostal space.

J. Vet. Anat. 43 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al.

Fig. (4): A photograph showing the duplex fundus gall bladder (A) and the bilobed cat gall bladder (B).

Fig. (6): X-ray film showing the termination of the hepatic ducts and the formation of the bile duct which united with the main pancreatic duct to open on the major duodenal papilla sur- rounded by Hepatopancreatic ampulla in cat.

Fig. (5): Latex neoprene cast of the cat biliary system isolated;

(A, B, D): Bile duct formed by the left and the right hepatic ducts with the cystic duct, (C): Bile duct formed by the union of the cystic duct with the common hepatic duct.

Fig. (7): A photograph showing the course of the bile duct in the hepatoduodenal ligament (A), its union with the main pancreatic duct (B) and its opening on the major duodenal papilla (C) surrounded by the Hepatopancreatic ampulla in cat

J. Vet. Anat. 44 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al.

Fig. (4): A photograph showing the duplex fundus gall bladder (A) and the bilobed cat gall bladder (B).

Fig. (6): X-ray film showing the termination of the hepatic ducts and the formation of the bile duct which united with the main pancreatic duct to open on the major duodenal papilla sur- rounded by Hepatopancreatic ampulla in cat.

Fig. (5): Latex neoprene cast of the cat biliary system isolated;

(A, B, D): Bile duct formed by the left and the right hepatic ducts with the cystic duct, (C): Bile duct formed by the union of the cystic duct with the common hepatic duct.

Fig. (7): A photograph showing the course of the bile duct in the hepatoduodenal ligament (A), its union with the main pancreatic duct (B) and its opening on the major duodenal papilla (C) surrounded by the Hepatopancreatic ampulla in cat

J. Vet. Anat. 45 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al.

Legends for figs. (1 - 7) in Cat:

a. Processus caudatus; Lobus caudatus 1. Ductus cysticus a’ Processus papillaris; Lobus caudatus 2. Ductus hepaticus dexter b. Lobus hepaticus dexter lateralis 3. Ductus hepaticus sinister c. Lobus hepaticus dexter medialis 4. Ductus choledochus d. Lobus quadratus 5. Ramus processus caudatus e. Lobus hepaticus sinister medialis 6. Ductus hepaticus communis f. Lobus hepaticus sinister lateralis 7. Ductus hepaticus dextra accessoria g. Vesica fellea 8. Rr. lobi quadrati h. Lesser omentum 9. R. omentalis i. Hepatogastric ligament 10. Ramus lobi sinistri laterales J. Hepatoduodenal ligament 11. R. dorsalis lobi sinistri lateralis k. Porta hepatis 12. Truncus communis HPA: Hepatopancreatic ampulla 13. R. intermedius lobi sinistri lateralis Pv: Portal vein 14. R. ventralis lobi sinistri lateralis Pan (R): Right pancreatic lobe 15. R. lobi sinistri medialis Pan (L): Left pancreatic lobe 16. R. lobi dexter medialis 17. R. lobi dexter lateralis

18. Rr. lobi dexter lateralis 19. Left pancreatic duct Fig. (8): A photograph showing the topographic description of the abdominal regions 20. Right pancreatic duct and cat liver in situ. 21. Main pancreatic duct A. Epigastric abdominal region B. Meso-gastric abdominal region 1. Left hypo-chondral epigastric region

2. Middle (Xyphoid) epigastric region 3. Right hypo-chondral region 4. Left lateral hypo-chondral epigastric region 5. Left medial hypo-chondral epigastric region 6. Right medial hypo-chondral epigastric region 7. Right lateral hypo-chondral epigastric region HGL: Hepatogastric ligament of Lesser omentum HDL: Hepatoduodenal ligament of Lesser omentum a: Caudate process of caudate hepatic lobe

a’: Papillary process of caudate hepatic lobe’

b: Right lateral hepatic lobe ______c: Right medial hepatic lobe *Corresponding author: d: Quadrate hepatic lobe Reem R.T. e: Left medial hepatic lobe Department of Anatomy and Embryology, faculty of veterinary medicine, Cairo University, f: Left lateral hepatic lobe Egypt. g: Gall bladder [email protected]

J. Vet. Anat. 46 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al. Legends for figs. (1 - 7) in Cat: a. Processus caudatus; Lobus caudatus 1. Ductus cysticus a’ Processus papillaris; Lobus caudatus 2. Ductus hepaticus dexter b. Lobus hepaticus dexter lateralis 3. Ductus hepaticus sinister c. Lobus hepaticus dexter medialis 4. Ductus choledochus d. Lobus quadratus 5. Ramus processus caudatus e. Lobus hepaticus sinister medialis 6. Ductus hepaticus communis f. Lobus hepaticus sinister lateralis 7. Ductus hepaticus dextra accessoria g. Vesica fellea 8. Rr. lobi quadrati h. Lesser omentum 9. R. omentalis i. Hepatogastric ligament 10. Ramus lobi sinistri laterales J. Hepatoduodenal ligament 11. R. dorsalis lobi sinistri lateralis k. Porta hepatis 12. Truncus communis HPA: Hepatopancreatic ampulla 13. R. intermedius lobi sinistri lateralis Pv: Portal vein 14. R. ventralis lobi sinistri lateralis Pan (R): Right pancreatic lobe 15. R. lobi sinistri medialis Pan (L): Left pancreatic lobe 16. R. lobi dexter medialis 17. R. lobi dexter lateralis

18. Rr. lobi dexter lateralis 19. Left pancreatic duct Fig. (8): A photograph showing the topographic description of the abdominal regions 20. Right pancreatic duct and cat liver in situ. 21. Main pancreatic duct A. Epigastric abdominal region B. Meso-gastric abdominal region 1. Left hypo-chondral epigastric region

2. Middle (Xyphoid) epigastric region 3. Right hypo-chondral region 4. Left lateral hypo-chondral epigastric region 5. Left medial hypo-chondral epigastric region 6. Right medial hypo-chondral epigastric region 7. Right lateral hypo-chondral epigastric region HGL: Hepatogastric ligament of Lesser omentum HDL: Hepatoduodenal ligament of Lesser omentum a: Caudate process of caudate hepatic lobe

a’: Papillary process of caudate hepatic lobe’

b: Right lateral hepatic lobe ______c: Right medial hepatic lobe *Corresponding author: d: Quadrate hepatic lobe Reem R.T. e: Left medial hepatic lobe Department of Anatomy and Embryology, faculty of veterinary medicine, Cairo University, f: Left lateral hepatic lobe Egypt. g: Gall bladder [email protected]

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Cat gall bladder Reem et. al.

Animal species in this Issue

Domestic cat (Felis catus or Felis silvestris catus)

Fig. (9): (I) Right Medial Transverse (RMT) ultrasound scan in cat showing; a. Hypoechoic Right medial (red dots) and quadrate (yellow dots) lobes with a green Kingdom: Animalia & Phylum: Chordata & Class: Mammalia & Order: & arrow pointing at the gall bladder appearing with anechoic lumen surrounded by echo- Family: & Genus: Felis & Species: F. catus genic wall, situated between them. b. Location and direction of linear transducer (Right medial hypo-chondral epigastric The domestic cat is a small, usually furry, domesticated, and carnivorous transverse). mammal. It is often called a housecat when kept as an indoor . Cats are (II) Left Medial Longitudinal ultrasound scan showing; similar in anatomy to the other felids, with strong, flexible bodies, quick reflexes, a. In case of extended stomach, no trace of gall bladder was observed, only the hy- sharp retractable claws, and teeth adapted to killing small prey. Cat fit a poechoic heterogenous left lateral and left medial lobes appeared outlined by red and crepuscular and predatory . Cats can hear sounds too faint or blue dots, respectively. The yellow arrows are pointed at the C/S of the branches of too high in frequency for human ears, such as those made by mice and other V. hepatica lobi sinistri lateralis appearing anechoic lumen without echogenic wall. small animals. They can see in near darkness. Like most other mammals, cats b. In case of empty stomach, the pear-shaped anechoic gall bladder (yellow dots) ap- have poorer color vision and a better of smell than humans. peared surrounded by echogenic wall in close relation to only the hypoechoic quad- rate lobe appeared outlined by red dots. Noted the blue arrow pointed at the echo- The cat skull is unusual among mammals in having very large sockets and genic diaphragm. a powerful and specialized jaw. Within the jaw, cats have teeth adapted for c. Location and direction of linear transducer (Left medial hypo-chondral epigastric lon- killing prey and tearing meat. When it overpowers its prey, a cat delivers a lethal gitudinal). neck bite with its two long canine teeth, inserting them between two of the prey's d. (Left medial hypo-chondral epigastric longitudinal). vertebrae and severing its spinal cord, causing irreversible paralysis and death

Source: Wikipedia, the free encyclopaedia

J. Vet. Anat. 48 Vol. 12, No. 1, (2019) 35 - 49

Cat gall bladder Reem et. al.

Animal species in this Issue

Domestic cat (Felis catus or Felis silvestris catus)

Fig. (9): (I) Right Medial Transverse (RMT) ultrasound scan in cat showing; a. Hypoechoic Right medial (red dots) and quadrate (yellow dots) lobes with a green Kingdom: Animalia & Phylum: Chordata & Class: Mammalia & Order: Carnivora & arrow pointing at the gall bladder appearing with anechoic lumen surrounded by echo- Family: Felidae & Genus: Felis & Species: F. catus genic wall, situated between them. b. Location and direction of linear transducer (Right medial hypo-chondral epigastric The domestic cat is a small, usually furry, domesticated, and carnivorous transverse). mammal. It is often called a housecat when kept as an indoor pet. Cats are (II) Left Medial Longitudinal ultrasound scan showing; similar in anatomy to the other felids, with strong, flexible bodies, quick reflexes, a. In case of extended stomach, no trace of gall bladder was observed, only the hy- sharp retractable claws, and teeth adapted to killing small prey. Cat senses fit a poechoic heterogenous left lateral and left medial lobes appeared outlined by red and crepuscular and predatory ecological niche. Cats can hear sounds too faint or blue dots, respectively. The yellow arrows are pointed at the C/S of the branches of too high in frequency for human ears, such as those made by mice and other V. hepatica lobi sinistri lateralis appearing anechoic lumen without echogenic wall. small animals. They can see in near darkness. Like most other mammals, cats b. In case of empty stomach, the pear-shaped anechoic gall bladder (yellow dots) ap- have poorer color vision and a better sense of smell than humans. peared surrounded by echogenic wall in close relation to only the hypoechoic quad- rate lobe appeared outlined by red dots. Noted the blue arrow pointed at the echo- The cat skull is unusual among mammals in having very large eye sockets and genic diaphragm. a powerful and specialized jaw. Within the jaw, cats have teeth adapted for c. Location and direction of linear transducer (Left medial hypo-chondral epigastric lon- killing prey and tearing meat. When it overpowers its prey, a cat delivers a lethal gitudinal). neck bite with its two long canine teeth, inserting them between two of the prey's d. (Left medial hypo-chondral epigastric longitudinal). vertebrae and severing its spinal cord, causing irreversible paralysis and death

Source: Wikipedia, the free encyclopaedia

J. Vet. Anat. 49 Vol. 12, No. 1, (2019) 35 - 49