Peer-reviewed veterinary case report
Toxoplasma gondii-associated cholecystitis in a cat receiving immunosuppressive treatment.
- Journal:
- Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
- Year:
- 2019
- Authors:
- Lo Piccolo, Francesco et al.
- Affiliation:
- Clinic of Small Animal Medicine · Germany
- Species:
- cat
Plain-English summary
A 9-year-old female cat, who had been receiving medication to treat a blood condition, was brought to the vet because she had stopped eating, was vomiting, and had high liver enzyme levels. An ultrasound showed that her gallbladder and bile duct were very thickened, and tests found severe inflammation and the presence of Toxoplasma gondii, a type of parasite. She was treated with antibiotics and another medication for six weeks and seemed to recover well, staying stable for two years. However, she later showed signs of a possible intestinal cancer and was found to have a recurrence of the parasite infection. After receiving more treatment, she was euthanized. This case highlights the importance of considering Toxoplasma infection in cats that are on immunosuppressive treatment and showing signs of illness.
Abstract
A 9-year-old female neutered domestic shorthair cat diagnosed with immune-mediated thrombocytopenia that was treated with prednisolone and cyclosporine, was presented for anorexia, vomiting, increased liver enzymes, and hyperbilirubinemia. Abdominal ultrasound revealed a markedly thickened gallbladder and common bile duct wall. Bile cytology detected severe neutrophilic inflammation and protozoal zoites. Suspectedinfection was confirmed by real-time PCR of bile. The cat was treated with clindamycin and ursodeoxycholic acid for 6 weeks, recovered and remained stable for 2 years despite ongoing immunosuppressive treatment. Thereafter, the cat was presented with suspicion of intestinal lymphoma, and recurrence of toxoplasmosis was diagnosed. Following treatment with clindamycin and prednisolone over 4 weeks the cat was euthanized. This is the first report ofzoites detected in bile fluid from a cat with cholecystitis. Pathogenesis of toxoplasmosis in cats is still not fully understood. Although immunosuppression can represent a relevant predisposing factor, other factors, such as virulence of the parasite and genetic polymorphism of the host, can also play an important role. Toxoplasmosis should be included as a differential diagnosis in cats developing clinical signs of an inflammatory disease while receiving immunosuppressive treatment.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/31814094/