What’s new in tech & diagnostics (2023–2025)

• Near-infrared fluorescence (NIRF) cholangiography with indocyanine green (ICG) during surgery
  • 2024 clinical study (27 dogs; 17 with GBM) showed fluorescent intra-op cholangiography can confirm cystic/common bile duct patency without catheterizing and flushing the ducts—potentially reducing manipulation-related complications. PLOS
  • 2025 case report used ICG to verify duct patency in a dog with a ruptured GBM—the first veterinary case report of its kind. PubMedPMC
  • Dose/timing pilots (2023–2024) refined practical ICG protocols for dogs. Wiley Online Library
• CT vs ultrasound: better triage when the picture is muddy
  A 2025 prospective study found ultrasound and CT perfectly agreed on identifying GBMs, while CT picked up more cholelithiasis (stones); takeaway: US remains first line, CT helps if stones/rupture questions linger or US is equivocal. FrontiersPubMedResearchGate
• Contrast-enhanced ultrasound (CEUS)
  CEUS is now a well-supported add-on: in a 65-dog series, it improved recognition of wall edema/necrosis or rupture and helped distinguish mass-like hyperplasia/polyps from sludge (GBMs/sludge stay non-enhancing). Useful if you’re deciding “urgent surgery vs monitor.” PubMed
• Surgical trends that change outcomes
  • Evidence continues to favor earlier (elective) cholecystectomy—mortality is markedly lower than when dogs present sick or ruptured. PubMedAVMA Journals
  • Multi-center and long-term data suggest some dogs do well without routine bile-duct catheterization/flushing, supporting a less invasive approach—particularly when paired with modern imaging (NIRF/CEUS). PMCMDPI
• Pathophysiology updates
  New work supports a role for abnormal lipid metabolism & increased lipogenesis in GBM pathogenesis—one reason dyslipidemia management matters for prevention. PMC
• Genetics: where we are
  A mutation in ABCB4 (MDR3) is strongly associated with GBM in Shetland Sheepdogs and appears in a few other breeds, but broader studies showed mixed/limited association outside Shelties—so genetic tests should be interpreted cautiously (useful for breeding decisions; not definitive risk prediction). PMCSAGE Journals
  Commercial ABCB4 cheek-swab tests exist for Cocker Spaniels; just know a “clear” result doesn’t eliminate risk and a “carrier” doesn’t guarantee disease. AnimaLabs©

Practical prevention & early catch—especially for Cocker Spaniels

Cocker Spaniels are over-represented among GBM cases. Focus on screening + lipid/endocrine control + diet and know when to discuss early surgery.

1. Annual screening from middle age
   • Starting ~6–7 years: fasting chemistry + lipid panel (cholesterol, triglycerides) and abdominal ultrasound. Increase ultrasound to every 6–12 months if you see biliary sludge, rising ALP/GGT, or dyslipidemia. (GBMs are often first spotted on US; risk rises with endocrine disease/dyslipidemia.) PubMed+1
2. Aggressively manage lipids (key for Cockers)
   • Low-fat, therapeutically formulated diet; add omega-3 (fish oil) per your vet to lower TGs/cholesterol; consider fiber; refractory cases may need fibrates or other lipid-lowering meds under veterinary supervision. Today’s Veterinary PracticePubMedMSPCA-Angell
   • Avoid high-fat treats and be wary of some prescription diets that are relatively high in fat for other conditions. Today’s Veterinary Practice
3. Find and treat endocrine drivers
   • Screen for and manage hypothyroidism and Cushing’s (hyperadrenocorticism)—common comorbidities in GBM cohorts. PubMed
4. Avoid known accelerants
   • Glucocorticoids (when alternatives exist) and high-fat diets can hasten mucocele maturation in predisposed dogs; use only when necessary and monitored. Merck Veterinary Manual
5. Medical preventives you can discuss with your vet
   • Ursodeoxycholic acid (UDCA) is often used for biliary sludge/early cholestasis; evidence for true “prevention” is limited, but many internists still use it in select at-risk dogs. Vin
6. Know when to talk surgery early
   • If your Cocker repeatedly shows a classic “kiwi/stellate” GBM pattern or progressive sludge with ductal extension—but is still clinically stable—ask about elective cholecystectomy at a referral center. Outcomes are consistently better before obstruction/rupture/sepsis. Modern tools (CEUS, NIRF ICG) help surgeons operate more safely with less biliary manipulation. PubMed+1PMC

Quick checklist for a Cocker Spaniel owner

• Keep body weight lean; feed a vetted low-fat plan. Today’s Veterinary Practice
• Add omega-3s (dose via your vet), recheck triglycerides in ~6–8 weeks. PubMed
• Run yearly fasting labs + abdominal US from ~6–7 years (earlier if any endocrine disease). PubMed
• Minimize steroids and avoid high-fat diets unless specifically indicated. Merck Veterinary Manual
• If ultrasound shows advancing sludge/GBM pattern, discuss elective surgery rather than waiting for an emergency. PubMed
• Treat hypothyroidism/Cushing’s promptly if diagnosed. PubMed
• Consider ABCB4 testing if you’re breeding Cockers; for pet dogs, use results cautiously as they’re not definitive risk predictors. SAGE JournalsAnimaLabs©