Peer-reviewed veterinary case report
Septic cholangiohepatitis and cholangiocarcinoma in a horse.
- Journal:
- Journal of the American Veterinary Medical Association
- Year:
- 1995
- Authors:
- Durando, M M et al.
- Affiliation:
- Department of Large Animal Clinical Sciences · United States
- Species:
- horse
Plain-English summary
An 11-year-old Warmblood gelding was diagnosed with septic cholangiohepatitis, which is an infection of the liver and bile ducts, after showing signs of intermittent belly pain and fever. A bacteria called Klebsiella pneumoniae was found in a tissue sample, but treatment with an antibiotic called gentamicin didn't help. After three weeks, the horse's condition worsened, and a follow-up ultrasound showed possible gallstones. A change in antibiotics helped improve his symptoms for a while, but five months later, he suddenly developed severe lameness in his front leg. Despite treatment, the lameness and fever returned seven months later, leading to euthanasia. A post-mortem examination showed cancer in the liver and the leg joint, suggesting that the cancer likely developed from the bile ducts. This case highlights that cancer should be considered in horses with septic cholangiohepatitis that don't respond to antibiotics.
Abstract
Septic cholangiohepatitis was diagnosed in an 11-year-old Warmblood gelding with a history of intermittent colic and fever. Klebsiella pneumoniae, susceptible to gentamicin, was cultured from the biopsy specimen. However, treatment with gentamicin was unsuccessful, and histologic examination and bacteriologic culture of a biopsy specimen obtained 3 weeks later revealed progression of the hepatic inflammation and yielded growth of gentamicin-resistant K pneumoniae. At this time, several discrete hyperechoic structures, suggestive of biliary calculi, were seen ultrasonographically. A change in antibiotic treatment was associated with gradual resolution of clinical signs. Five months after initial examination, the horse had a sudden onset of severe right forelimb lameness. The horse responded to treatment with antibiotics and phenylbutazone, but lameness and fever that was unresponsive to treatment recurred 7 months later, and the horse was euthanatized. Necropsy revealed nodules throughout the liver and a mass associated with the right metacarpophalangeal joint. Histologic and immunohistochemical examination revealed carcinomatous infiltration of the liver and metacarpophalangeal joint. The tumor was probably of biliary origin. Carcinoma should be considered in cases of septic cholangiohepatitis unresponsive to antibiotic treatment.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/7768709/