This 15 year old FS DSH cat presented with cranial abdominal pain on palpation, vomiting and decreased appetite. Diagnosed with pancreatitis, some improvement. Phos 2.7.
U/A: protein +1, blood +3, urine culture no growth
This 15 year old FS DSH cat presented with cranial abdominal pain on palpation, vomiting and decreased appetite. Diagnosed with pancreatitis, some improvement. Phos 2.7.
U/A: protein +1, blood +3, urine culture no growth
CT of the abdomen –
The pancreas presents generalized enlargement with irregular contours, non-uniform contrast enhancement, multifocal nodular chnages and dilation of the pancreatic duct at up to 3 mm.mThe common bile duct is dilated at a maximum of 6 mm. The cystic duct and the extra- and intrahepatic biliary tree present dilation as well. There is no evidence of obstructive pathology along the biliary system. The liver presents mild generalized enlargement. The left kidney measures 2.7 cm in length and presents with irregular shape owing to mutifocal surface retraction associated with old renal cortical infarction.The right kidney measures 3.5 cm in length and is mildy irregular in shape with undulating surface as well. There is no evidence of primary or secondary neoplastic disease of the lung parenchyma, mediastinal and abdominal lymph nodes.
Age related nodular hyperplasia of the pancreas is seen as well and considered incidental. The renal excretory behavior is suggestive for a polyuric state. The changes are more advanced on the left side and support end stage renal disease whereas the right kidney appears to present compensatory hyperplasia. The computed tomography was negative for macroscopic neoplastic pathology.
Potential protocol for treatment of cholangitis/triaditis:
Corticosteroids at an immunosuppressive dose in acute flare-ups, antibiotic therapy in combination with ursodeoxycholic acid for its choleretic and anti-inflammatory effect as well as its effect on modulating the bile acid pool and reducing toxic bile acids. Use of antioxidants such as S-Adenosylmethionine or Vitamin E may be considered too. As there is pancreatitis analgetic treatment and dietetic management should be considered as well.
