Gall Bladder Fistula in Bears

• Created deliberately for the "free dripping" method of collecting bear bile, between the gall bladder and the abdominal wall, by surgically opening the gall bladder and suturing it directly to the abdominal wall, or by using the abdominal mesentery to create a tube between the opened gall bladder and the abdominal wall. (P1.2002.w4)

• Open fistula (sometimes more than one) between the bears' abdominal skin and the gall bladder.
• Fistulas usually are infected.
• Note: Bears in which the fistula appears to have healed (as seen on external examination) usually have internal abscesses and gall bladder pathology. See: Gall Bladder Lesions in Bears
• An abdominal hernia is sometimes present. 

(P1.2002.w4,V.w89)

Treatment

• Antibiotics to treat chronic infection around the site of the fistula. (P1.2002.w4)
• Surgical removal of the gall bladder (cholecystectomy) and associated abscesses. (P1.2002.w4)

• These fistulae become infected because: 
  • Fistulas are created usually in unsterile operating theatres, with surgical instruments which have not been properly sterilised, and without proper aseptic preparation of the bear prior to surgery. Personnel carrying out the operations generally are not properly trained in veterinary aseptic surgery and non-sterile, inappropriate foreign materials (e.g. braided cotton suture materials) are commonly used.
  • Non-sterile objects (catheters) are repeatedly introduced through the fistula for collection of bile, introducing environmental contaminants into the gall bladder.
  • When antibiotics are given, they are generally inappropriate and used at incorrect doses and frequencies.
  • Conditions in which the bears are kept following surgery are not sterile (note: bears could not be kept in sterile conditions while maintaining any semblance of the "Five Freedoms.").

  (P1.2002.w4, P503.1.w7)

• Information on other associated gall bladder problems are provided in Gall Bladder Lesions in Bears

• History & Documentation
• Physical Examination of Mammals
• Necropsy of Mammals
• Environmental Assessment
• Treatment and Care
• Environmental and Population Management
• Preventative Medicine for Mammals
• Chapter 2 - B36 Field Manual of Wildlife Diseases - Specimen Collection and Preservation
• Chapter 3 - B36 Field Manual of Wildlife Diseases - Specimen shipment
• Appendix A - B36 Field Manual of Wildlife Diseases - Sample specimen history form

• Ursus thibetanus - Asiatic black bear