Treatment and long term follow up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a somali cat with pyruvate kinase deficiency

AM Harvey, PE Holt, FJ Barr, F Rizzo, S Tasker

Research output: Contribution to journalArticle (Academic Journal)peer-review

19 Citations (Scopus)

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.
Translated title of the contributionTreatment and long term follow up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a somali cat with pyruvate kinase deficiency
Original languageEnglish
Pages (from-to)424 - 431
Number of pages8
JournalJournal of Feline Medicine and Surgery
Volume9
DOIs
Publication statusPublished - Oct 2007

Bibliographical note

Publisher: Elsevier

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