Hepatic cyst in a 16 year old FS DSH cat

Case Study

Hepatic cyst in a 16 year old FS DSH cat

A 16-year-old FS DSH cat with a long history of hyperthyroidism presented for progressive weight loss, vomiting, partial anorexia, and abdominal distension. Physical examination confirmed these findings and revealed a low body condition score. Blood chemistry profile revealed only a mildly elevated ALT with mildly prolonged PT and mildly prolonged aPTT on the coagulation profile.

A 16-year-old FS DSH cat with a long history of hyperthyroidism presented for progressive weight loss, vomiting, partial anorexia, and abdominal distension. Physical examination confirmed these findings and revealed a low body condition score. Blood chemistry profile revealed only a mildly elevated ALT with mildly prolonged PT and mildly prolonged aPTT on the coagulation profile.

DX

Hepatic cyst with serosanguinous fluid with mixed low-grade inflammation.

Sonographic Differential Diagnosis

Absence of distal enhancement supports a cellular component within the fluid. Diagnosis: Hepatic cyst/abscess.

Image Interpretation

The sonogram demonstrates a large space-occupying ovoid anechoic hepatic cyst with an echogenic and mildly thickened wall. The cyst is deviating and compressing the gallbladder. After drainage, there is a moderate reduction in cyst size, and tension has reduced the degree of gallbladder deviation and compression. Fluid analysis demonstrated serosanguineous fluid with mixed low-grade inflammation and a 1.020 specific gravity. No cytologic neoplasia was visible. Aerobic and anaerobic cultures were negative.

Outcome

The patient had not been administered antibiotic prior to the procedure. The patient was lost to follow-up, so return of the cyst could not be assessed.

Clinical Differential Diagnosis

Liver pathology: hepatitis, neoplasia; GI pathology: IBD, GI obstruction; Pancreatic pathology: pancreatitis

Sampling

45 mL of light-brown fluid was drained by US-guided centesis with a 20-gauge endovenous catheter.

UA Specific Gravity Range

1.020

Patient Information

Patient Name : Sheba D
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 03_00050

Clinical Signs

  • Abdominal Distension
  • Anorexia
  • Vomiting
  • Weight loss

History

  • Azotemia
  • Hypothyroidism
  • Vomiting
  • Weight Loss

Exam Finding

  • Abdominal Distension
  • Weight loss

Images

SHEBADAVIEHEPATICCYST_2an1_04232009041439SHEBADAVIEHEPATICCYST_1an2_04232009041737

Blood Chemistry

  • Alkaline Phosphatase (SAP), High

Clinical Signs

  • Abdominal Distension
  • Anorexia
  • Vomiting
  • Weight loss

Special Testing

  • PT Prolonged
  • PTT Prolonged
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