The Netherlands (English)
Feline Pancreatitis Leading to Extrahepatic Biliary Obstruction and Jaundice
Identification and history
- Name: Nazca
- Report and medical history: cat, Common European, spayed male, 8 years old.
The patient presented at our veterinary hospital with dejection, anorexia, vomiting and icterus. On clinical examination, there was depressed sensory status, BCS 3/9 and10% dehydration. The lymph nodes and respiratory rate were normal, as were the auscultation findings. Clinical examination revealed discomfort on abdominal palpation.
Hematochemical tests were performed, in which an increase in ALP and ALT activity, leukocytosis and neutrophilia were observed.
Diagnostics
As X-rays are not very sensitive in detecting hepatobiliary disorders, an abdominal ultrasound scan was performed. An abdominal ultrasound with a linear (Freq 23 MHz) probe showed marked changes consistent with pancreatitis, predominantly affecting the right pancreatic lobe, which appeared thickened and hypoechoic, surrounded by hyperechoic peripancreatic fat.
Thickening of the wall of the descending duodenum and of the major duodenal papilla was also observed, likely secondary to the inflammatory process.
The abdominal ultrasound scan of the liver showed that the liver’s echostructure was normal, but revealed a distended gallbladder, a concurrent dilatation of the common bile duct measuring up to 6 mm in diameter, which is suggestive of extrahepatic biliary obstruction secondary to pancreatic inflammation.
Images were acquired with MyLab™X90 VET
Conclusions and treatment
Due to biliary obstruction, a laparotomywas perfomed, which allowed a choledochal stent to be placed to restore bile flow. Postoperatively, the cat received intensive medical management, including supportive care and early enteral nutrition.
This case highlights the risk of secondary biliary obstruction resulting from severe pancreatitis in cats, underlining the importance of imaging for diagnosis.
Dr Hélène Kolb, Associate Veterinarian / Medical Director of the Atlantia Veterinary Hospital, Member of the AFVAC Imaging Study Group (GEIM), Member of the SNCHV
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