Document Detail


Treatment and long-term follow-up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a Somali cat with pyruvate kinase deficiency.
MedLine Citation:
PMID:  17475529     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Andrea M Harvey; Peter E Holt; Frances J Barr; Francesca Rizzo; Séverine Tasker
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2007-05-01
Journal Detail:
Title:  Journal of feline medicine and surgery     Volume:  9     ISSN:  1098-612X     ISO Abbreviation:  J. Feline Med. Surg.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-24     Completed Date:  2007-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897329     Medline TA:  J Feline Med Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  424-31     Citation Subset:  IM    
Affiliation:
Department of Clinical Veterinary Science, Division of Companion Animals, University of Bristol, Langford, Bristol BS405DU, UK. a.m.harvey@bristol.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Animals
Cat Diseases / blood,  diagnosis*,  pathology,  therapy*,  ultrasonography
Cats
Cholestasis, Extrahepatic / complications,  diagnosis,  therapy,  veterinary*
Diagnosis, Differential
Female
Follow-Up Studies
Hyperbilirubinemia / complications,  diagnosis,  therapy,  veterinary*
Pedigree
Pyruvate Kinase / blood,  deficiency*
Chemical
Reg. No./Substance:
EC 2.7.1.40/Pyruvate Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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