Peer-reviewed veterinary case report
First Case Report of Choledochoenterostomy in a Cat with Biliary Obstruction Due to Cholangiohepatitis and Papillary Stenosis
- Journal:
- Animals
- Year:
- 2025
- Authors:
- Nicole Diana Wolf et al.
- Affiliation:
- Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, 3012 Bern, Switzerland · CH
- Species:
- cat
Plain-English summary
A 2-year-old male neutered domestic shorthair cat was brought to the vet after having stopped eating, losing weight, vomiting, and drinking and urinating a lot for the past year. The vet found that the cat was very tired and had yellowish gums, indicating liver issues. Blood tests showed signs of anemia and liver problems, and an ultrasound revealed that the bile duct and gallbladder were swollen, suggesting a blockage. The cat was diagnosed with bacterial cholangiohepatitis, an infection of the liver and bile ducts, caused by two types of bacteria. After trying less invasive treatments without success, the veterinarians performed surgery to remove the gallbladder and create a new connection for bile flow. Although the cat showed some improvement after surgery, it later developed a serious infection and sadly passed away ten days later.
Abstract
A 2-year-old male neutered domestic shorthair cat was presented with a 12-month history of anorexia, weight loss, vomiting, polyuria, and polydipsia. Physical examination revealed a responsive but debilitated cat with icteric mucous membranes and a low body-condition score. Laboratory tests showed mild macrocytic anemia, elevated liver enzymes, hyperproteinemia with hypoalbuminemia, hyperbilirubinaemia, and a decreased vitamin B12 level. Abdominal ultrasound revealed marked dilation of the common bile duct (CBD) and gallbladder, consistent with suspected extrahepatic biliary tract obstruction, as well as secondary pancreatic and intrahepatic duct distension. Cytological and bacteriological analyses confirmed bacterial cholangiohepatitis due to a mixed infection with <i>Escherichia coli</i> and <i>Peptostreptococcus canis</i>. Despite initial conservative management, the cat’s clinical condition remained unchanged, prompting exploratory laparotomy. Intraoperative findings confirmed the ultrasonographic suspicions and revealed severe pancreatitis. Based these findings, a cholecystectomy, choledochoenterostomy, and placement of a cholecystostomy tube as well as an abdominal drain and jejunal feeding tube were performed. Postoperatively, the cat initially showed improvement but subsequently developed signs of sepsis requiring intensive care. Although temporary stabilization was achieved, the cat died suddenly ten days after surgery due to unknown causes. This case report highlights the diagnostic and therapeutic challenges associated with bacterial cholangiohepatitis secondary to biliary obstruction in cats and documents the first clinical application of choledochoenterostomy—a surgical procedure previously only described hypothetically in this species.
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Search related cases →Original publication: https://doi.org/10.3390/ani15172634