Cholecystectomy in 23 cats (2005‐2021)

Abstract

Objective: To describe the clinical presentation, treatments, and long-term outcomes following cholecystectomy in cats.Study design: Clinical retrospective study. Animals: Twenty-three client-owned cats.Methods: Medical records of all cats undergoing cholecystectomy between 2005 and 2021 at a single referral hospital were retrospectively reviewed. No cats were excluded. An owner questionnaire assessed long-term outcomes.Results: Vomiting, jaundice, and abdominal pain were the most common clinical signs; median duration of signs was 4 days (range 1-21). Cholelithiasis was the major indication for cholecystectomy followed by cholecystitis. Intraoperative hypotension and postoperative anemia were commonly encountered. Nine cats required a postoperative blood product transfusion. Cardiopulmonary arrest and death occurred in five cats. Eighteen cats (78.3%) survived to discharge. Long-term follow up (>60 days) was available for 16 cats at a median of 1003 days (range 81-4995). Fifteen cats survived over 6 months with eight cats (44.4%) surviving over 3 years. The most common short-term and long-term postoperative complication was vomiting. Owners assessed postoperative outcome as excellent in all cats and quality of life as excellent or good. Conclusion:The most common indication for cholecystectomy was cholelithiasis. Perioperative complications were commonly encountered. Perioperative mortality rate was 21.7%. Long-term owner evaluation of clinical outcome was considered excellent. Clinical significance: Cats undergoing cholecystectomy for non-neoplastic causes can have a favorable prognosis for recovery and quality of life. Concurrent extrahepatic biliary duct obstruction is not a contraindication for cholecystectomy provided that patency of the common bile duct is restored.

Prevalence and clinical relevance of cholelithiasis in cats: A multicenter retrospective study of 98 cases

“…According to the final model of multivariate analysis, BTO but not surgical management was associated with worse outcome whereas medical treatment was positively associated with survival to discharge. Surgical techniques and outcomes were in accordance with the published literature 14,16,18,21,24,27,38,39 . Recurrent or persistent clinicopathological features of SC after discharge were reported in 19% of cats, which is within the range of values reported by other authors (0%‐38.9%) 18,24,27 .…”

“…Surgical techniques and outcomes were in accordance with the published literature. 14,16,18,21,24,27,38,39 Recurrent or persistent clinicopathological features of SC after discharge were reported in 19% of cats, which is within the range of values reported by other authors (0%-38.9%). 18,24,27 Interestingly, only half of the cats that underwent surgery had signs of BTO based on US and surgical treatment was not performed in some cases with BTO.…”

“…The natural course of incidental cholelithiasis has been reported once in dogs, with <8% developing clinical signs 6 . Several surgical procedures have been described for the management of cholelithiasis including cholecystectomy, cholecystotomy, cholecystoenterostomy, choledochotomy, or temporary bile duct stenting 7,14‐16 . The use of UDCA for cholelith dissolution is poorly described in veterinary medicine, with 1 study reporting complete resolution of cholelithiasis in 4/8 dogs 7,17 .…”

“…6 Several surgical procedures have been described for the management of cholelithiasis including cholecystectomy, cholecystotomy, cholecystoenterostomy, choledochotomy, or temporary bile duct stenting. 7,[14][15][16] The use of UDCA for cholelith dissolution is poorly described in veterinary medicine, with 1 study reporting complete resolution of cholelithiasis in 4/8 dogs. 7,17 Its efficacy in cholelith dissolution has not been reported in cats.…”

“…Several small case series of cholelithiasis in cats have been described, 14,16,[18][19][20][21][22][23][24][25][26][27] but the prevalence of cholelithiasis has never been reported in a large cohort. Because cholelithiasis was mainly associated with biliary tract obstruction (BTO) in prior publications, medical management of cats without obstruction has not been widely investigated.…”