Case Study

Biliary calculi with chronic inflammatory hepatopathy pattern in a 7 year old MN DSH cat

A 7-year-old MN DSH was presented for evaluation of vomiting after eating, icterus, and lethargy. Abnormalities on serum biochemistry were elevated ALP (92) and ALT (1177) activity and total bilirubin (3.4) and mild hypokalemia (3.5).

Sonographic Differential Diagnosis

Biliary calculi. Common bile duct, cystic duct and gallbladder with mild chronic inflammatory hepatopathy pattern. Concurrent chronic active pancreatitis pattern.

Image Interpretation

The common bile duct was dilated and embedded with multiple calculi to the level of the duodenal papilla, which was slightly thickened likely from passing calculi periodically. There was no evidence of neoplasia. Lobar biliary calculi and gallbladder calculi were also noted. Concurrent inflammatory hepatopathy pattern was present.

DX

Biliary calculi and chronic inflammatory pattern

Outcome

None

Clinical Differential Diagnosis

Liver – toxins, abscessation, cholangio-hepatitis complex, lipidosis, neoplasia, FIP
Gall bladder – cholecystitis, obstruction (lith, neoplasia, pancreatic/duodenal disease)
Pancreas – pancreatitis, neoplasia