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A feline domestic longhair, NM, 13 years was presented for anorexia, vomiting, and dehydration. The patient is on ursodiol. Previous lab work showed elevated ALT, GGT and total bilirubin 1.8, and leukocytosis at 21,000 with neutrophilia. Yesterday ALT 1214 and total bilirubin 4.0
Post hepatic obstruction either tissue proliferation stricture or potential common bile duct infiltrative neoplasia less likely.
Surgical intervention for post hepatic obstruction with bile duct redirection. Pancreatic and hepatic biopsies recommended with cholecystectomy.
Intrahepatic biliary dilation noted. Minor coarse architecture. Gallbladder was significantly turgid with suspended debris, tortuous cystic duct. The common bile duct was dilated at 0.56 cm and was dilated to the level of the duodenal papilla. At the duodenal papilla there was echogenic tissue or bile plug which was conical in shape measuring 0.5cm. Pancreas was hypoechoic, irregular, coarse in architecture, mildly enlarged, serpentine contour with regional hyperechoic surrounding fat primarily at the caudal pole of the left limb. Duct measures 0.15 cm.
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