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US and CYT- Cholangiohepatitis and lipidosis in a 11 year old FS DSH cat with severe icterus

Case Study

US and CYT- Cholangiohepatitis and lipidosis in a 11 year old FS DSH cat with severe icterus

This 11 year old FS DSH cat presented for ADR. On physical exam she was severely icteric.

CBC: HCT 37.6, TP 8.3, platelet count 324,000

Chem: ALT 693, ALKP 235, Tbili 24.3, BUN 89, Crea 11.2 (was 1.2 48 hours prior), Phos 17.9

This 11 year old FS DSH cat presented for ADR. On physical exam she was severely icteric.

CBC: HCT 37.6, TP 8.3, platelet count 324,000

Chem: ALT 693, ALKP 235, Tbili 24.3, BUN 89, Crea 11.2 (was 1.2 48 hours prior), Phos 17.9

Sonographic Differential Diagnosis

cholangiohepatitis, occult lymphoma, lipidosis

Image Interpretation

The liver in this patient was mildly hyperechoic to the falciform fat. The gallbladder
was mildly thickened. This is consistent with cholecystitis pattern. Age related renal changes.

DX

cholangiohepatitis, lipidosis, toxicity, occult lymphoma

Outcome

Recommendations are treatment for cholangiohepatitis and hepatic toxicity along with evauation
of the cytology. No complications were noted post sampling. The cause of azotemia is
unclear in this patient unless acute episodes such as thrombosis or sepsis is an issue.

Sampling

FNA/cytology of the liver: hepatocelluar vacuolization, granularity and lipidosis

Patient Information

Patient Name : Seoul Brown/Newton
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes

Clinical Signs

  • "Not Doing Right"

Exam Finding

  • Icterus

Images

screen_shot_2016-04-30_at_1screen_shot_2016-04-30_at_1screen_shot_2016-04-30_at_1

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • ALT (SGPT), High
  • BUN high
  • Creatinine, High
  • Phosphorus, High
  • Total Bilirubin, High

Clinical Signs

  • "Not Doing Right"