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Peer-reviewed veterinary case report

Cat with gallbladder infection linked to Toxoplasma during immune

By Lo Piccolo, Francesco et al.·Published in Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere·2019·Clinic of Small Animal Medicine, Germany·View original on PubMed

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Original publication title: Toxoplasma gondii-associated cholecystitis in a cat receiving immunosuppressive treatment.

Species:
cat

Plain-English summary

A 9-year-old female domestic shorthair cat was brought in for not eating, vomiting, and signs of liver problems after being treated for a blood disorder with immunosuppressive medications. An ultrasound showed her gallbladder was inflamed, and tests confirmed she had a Toxoplasma infection. The cat was treated with antibiotics and a bile acid medication for six weeks and improved, staying stable for two years. Unfortunately, she later developed intestinal lymphoma and a recurrence of Toxoplasmosis, leading to her euthanasia. This case highlights the importance of considering Toxoplasmosis in cats on immunosuppressive therapy when they show signs of illness.

People also search for: cat vomiting treatment · Toxoplasmosis in cats · cat liver problems · cat anorexia causes · cat immunosuppressive treatment effects

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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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31814094/