Peer-reviewed veterinary case report
Treatment and long-term follow-up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a Somali cat with pyruvate kinase deficiency.
- Journal:
- Journal of feline medicine and surgery
- Year:
- 2007
- Authors:
- Harvey, Andrea M et al.
- Affiliation:
- Department of Clinical Veterinary Science · United Kingdom
- Species:
- cat
Plain-English summary
A 2-year-old female neutered Somali cat was brought to the vet because she was vomiting and had suddenly developed jaundice, which is a yellowing of the skin and eyes. She had previously been diagnosed with a condition called pyruvate kinase deficiency, which affects red blood cells. Tests showed she had anemia, high levels of bilirubin in her blood, and elevated liver enzymes. An ultrasound revealed that her gall bladder and bile duct were swollen, indicating a blockage. During surgery, the vet found pus in the gall bladder and removed two stones made of bilirubin from the bile duct. After the surgery, the cat recovered well, and her liver function returned to normal within ten days. She was given antibiotics and a medication to help with bile flow, and she has been doing well with no signs of the stones returning for 20 months. This case is notable because it shows a successful treatment for this specific condition in a cat.
Abstract
A 2-year-old female neutered Somali cat was presented with vomiting and acute onset jaundice 1 year after diagnosis of pyruvate kinase (PK) deficiency. Diagnostic investigations revealed a moderate regenerative haemolytic anaemia, severe hyperbilirubinaemia and elevated liver enzymes. Ultrasonography revealed marked distension of the gall bladder and common bile duct (CBD), consistent with extrahepatic biliary obstruction (EHBO). At cholecystotomy, the gall bladder contained purulent material, and two obstructive choleliths were removed from the CBD by choledochotomy. The cat recovered from surgery uneventfully, and serum liver enzymes and bilirubin normalised within 10 days. Postoperative treatment consisted of cephalexin, metronidazole and ursodeoxycholic acid (UDCA). Bacterial culture of the gall bladder contents yielded a pure growth of an Actinomyces species. Cholelith analysis revealed that they consisted of 100% bilirubin. Antibiotic treatment was stopped 4 weeks after surgery but UDCA was continued indefinitely. The cat remains clinically well with no recurrence of cholelithiasis 20 months after initial presentation. This is the first report of successful treatment and long-term follow-up of a cat with EHBO due to bilirubin cholelithiasis in association with PK deficiency-induced chronic haemolysis.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/17475529/