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Cholestasis in a feline

Sonopath Forum

Cholestasis in a feline

Jasmine is a 10 year old Feline that belongs to a veterinary technician.

This cat came in jaundiced.

Labs came back:

ALP:  914, ALT: 202, AST: 91, Total Bilirubin: 11.7, Conjugated Bilirubin: 6.8, GGT 7, Bilirubin- unconjugated 4.9.

UA: 3+ Bilirubin, SG 1.012, pH: 7. Sed: clear

CBC: WNL

Jasmine is still eating and is not vomiting. There has been no recent weight loss.

The liver is enlarged and bright. I also thought the texture was a bit coarse in some of the views.

Jasmine is a 10 year old Feline that belongs to a veterinary technician.

This cat came in jaundiced.

Labs came back:

ALP:  914, ALT: 202, AST: 91, Total Bilirubin: 11.7, Conjugated Bilirubin: 6.8, GGT 7, Bilirubin- unconjugated 4.9.

UA: 3+ Bilirubin, SG 1.012, pH: 7. Sed: clear

CBC: WNL

Jasmine is still eating and is not vomiting. There has been no recent weight loss.

The liver is enlarged and bright. I also thought the texture was a bit coarse in some of the views.

I have numerous slides pending. I scanned a couple and lipidosis is present. I want to make sure I am not underestimating some sort or round cell tumor. 

Jasmine is currently getting SQ fluids at home, Mirtazapine, an antibiotic (can’t recall which one) and Prednisolone.

My ?: Do you see any indication of obstruction of the CBD that would account for the elevated hepatic numbers. I am almost paranoid of missing something here.

Thanks for any imput you may give me.

 

 

Comments

EL

Some subtle things that make

Some subtle things that make me think this is lipidosis only:

1) the parenchyma is uniformly hyperechoic… snow on grass scenario as I like to think of it.

2) the GB is normally positioned; no subtle internal mass effects or displacement so the Gb is happy and sitting in its normal spot.

3) see attached image the cbd is barely viisible (which is normal) and not > 0.4 cm which would mean post hepatic obstruction and surgical…. big bili = big cbd in post hepatic obstruction. So the bili issue is parenchymal assuming no anemia from hemolytic disease. LSA can live with lipidosis of course but if no monocellular population mixed in the fat then lipidosis is likely the issue.

randyhermandvm

Thanks EL. I will post the

Thanks EL. I will post the cytology findings.