Pathogenesis and outcome of extrahepatic biliary obstruction in cats

Extrahepatic biliary obstruction (EHBO) was confirmed at surgery or necropsy in 22 cats. Biliary or pancreatic adenocarcinoma was diagnosed by histopathology in six cats and one cat had an undiagnosed mass in the common bile duct. The remaining 15 cats had at least one of a complex of inflammatory diseases including pancreatitis, cholangiohepatitis, cholelithiasis and cholecystitis. The most common clinical signs were jaundice, anorexia, lethargy, weight loss and vomiting. Hyperbilirubinaemia was present in all cases. Distension of the common bile duct and gall bladder was the most commonly observed finding on abdominal ultrasound. Nineteen cats underwent exploratory laparotomy for biliary decompression and diversion. Mortality in cats with underlying neoplasia was 100 per cent and, in those with non‐neoplastic lesions, was 40 per cent. Long‐term complications, in those that survived, included recurrence of cholangiohepatitis, chronic weight loss and recurrence of obstruction. Based on these findings, the prognosis for EHBO in cats must be considered guarded.

[1]  K. Hittmair,et al.  Ultrasonographic evaluation of gallbladder wall thickness in cats. , 2001, Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association.

[2]  M. Hendrick,et al.  Radiographic, ultrasonographic, and endoscopic findings in cats with inflammatory bowel disease of the stomach and small intestine: 33 cases (1990-1997). , 1999, Journal of the American Veterinary Medical Association.

[3]  D. Biller,et al.  Diagnostic imaging of biliary obstruction , 1998 .

[4]  N. Majó,et al.  Sclerosing adenocarcinoma of the extrahepatic bile duct in a cat , 1997, Veterinary Record.

[5]  P. J. Armstrong,et al.  Relationship between inflammatory hepatic disease and inflammatory bowel disease, pancreatitis, and nephritis in cats. , 1996, Journal of the American Veterinary Medical Association.

[6]  D. Biller,et al.  Sonographic evaluation of the common bile duct in cats. , 1996, Journal of veterinary internal medicine.

[7]  S. Newell,et al.  Hepatobiliary scintigraphy in the evaluation of feline liver disease. , 1996, Journal of veterinary internal medicine.

[8]  D. Williams,et al.  Strombeck's Small animal gastroenterology , 1996 .

[9]  R. Martin,et al.  Extrahepatic biliary tract obstruction: a retrospective study of 45 cases (1983-1993). , 1995, Journal of the American Animal Hospital Association.

[10]  R. Willén,et al.  Obstructive jaundice impairs reticuloendothelial function and promotes bacterial translocation in the rat. , 1994, The Journal of surgical research.

[11]  J. Kirpensteijn,et al.  Cholelithiasis in dogs: 29 cases (1980-1990). , 1993, Journal of the American Veterinary Medical Association.

[12]  L. Roth,et al.  Temporary bile diversion in cats with experimental extrahepatic bile duct obstruction. , 1992, Veterinary surgery : VS.

[13]  H. Boothe,et al.  Use of hepatobiliary scintigraphy in the diagnosis of extrahepatic biliary obstruction in dogs and cats: 25 cases (1982-1989). , 1992, Journal of the American Veterinary Medical Association.

[14]  J. Malone,et al.  Cholangiohepatitis and choledochectasia associated with Amphimerus pseudofelineus in a cat , 1991 .

[15]  N. Conradi,et al.  Functional and morphological relationships between the feline main pancreatic and bile duct sphincters. , 1990, Gastroenterology.

[16]  D. Matthiesen Complications associated with surgery of the extrahepatic biliary system. , 1989, Problems in veterinary medicine.

[17]  D. Matthiesen,et al.  Surgical treatment of 23 dogs with necrotizing cholecystitis , 1988 .

[18]  S. Sideman,et al.  The "jaundiced heart": a possible explanation for postoperative shock in obstructive jaundice. , 1986, Surgery.

[19]  B. Tennant,et al.  Light microscopic and electron microscopic changes in the livers of cats with extrahepatic bile duct obstruction. , 1986, American journal of veterinary research.

[20]  J. Pain,et al.  Perioperative complications in obstructive jaudice: therapeutic considerations , 1985, The British journal of surgery.

[21]  C. D'Orsi,et al.  The effect of time and cholecystectomy on experimental biliary tree dilatation. A multi-imaging evaluation. , 1985, Investigative radiology.

[22]  K. Campbell,et al.  Cholelithiasis in a cat. , 1985, Journal of the American Veterinary Medical Association.

[23]  W. R. Kelly CHAPTER 2 – The Liver and Biliary System , 1985 .

[24]  Wolf Am Obstructive jaundice in a cat resulting from choledocholithiasis. , 1984 .

[25]  S. Duffy,et al.  Upper Gastrointestinal Bleeding: A Significant Complication After Surgery for Relief of Obstructive Jaundice , 1984, Annals of surgery.

[26]  A. M. Wolf Obstructive jaundice in a cat resulting from choledocholithiasis. , 1984, Journal of the American Veterinary Medical Association.

[27]  L. Way,et al.  Pigment sludge and stone formation in the acutely ligated dog gallbladder. , 1983, Gastroenterology.

[28]  S. Duffy,et al.  Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients. , 1983, Gut.

[29]  Hirsch Vm,et al.  Suppurative cholangitis in cats. , 1983 .

[30]  V. Hirsch,et al.  Suppurative cholangitis in cats. , 1983, Journal of the American Veterinary Medical Association.

[31]  C. Venkatesan,et al.  The Liver and Biliary System , 1983 .

[32]  M. Berant,et al.  Effect of isolated cholaemia on systemic haemodynamics and kidney function in conscious dogs. , 1982, Clinical science.

[33]  J. Finberg,et al.  Blunted pressor response to angiotensin and sympathomimetic amines in bile-duct ligated dogs. , 1981, Clinical science.

[34]  H. Pitt,et al.  Factors affecting mortality in biliary tract surgery. , 1981, American journal of surgery.

[35]  B. Jones,et al.  Cholelithiasis and choledocholithiasis in a cat. , 1978, New Zealand veterinary journal.

[36]  M. Bailey Endotoxin, bile salts and renal function in obstructive jaundice , 1976, The British journal of surgery.

[37]  R. Higgins,et al.  Adenocarcinoma of the extrahepatic bile duct in a cat. , 1976, The Journal of small animal practice.

[38]  H. Ellis,et al.  Jaundice and wound healing: An experimental study , 1976, The British journal of surgery.

[39]  E. Wardle Endotoxin and acute renal failure. , 1975, Nephron.

[40]  E. N. Wardle,et al.  Endotoxin and Acute Renal Failure Associated with Obstructive Jaundice , 1970, British medical journal.

[41]  O'Brien Tr,et al.  Cholelithiasis in a cat. , 1970 .

[42]  Boyden Ea The choledochoduodenal junction in the cat. , 1957 .

[43]  E. Boyden The choledochoduodenal junction in the cat. , 1957, Surgery.

[44]  Gibson Ks Cholelithiasis and choledocholithiasis in a cat. , 1952 .

[45]  C. L. Oakley,et al.  Ligation of the common bile duct , 1932 .