Gallbladder adenoma in a domestic shorthair cat

Abstract

Case summary A 13-year-old neutered female domestic shorthair rescue cat presented asymptomatically with raised hepatic enzymes following a routine pre-anaesthetic blood test. Cholangitis was suspected, and supportive treatment with 2 weeks of amoxicillin–clavulanic acid and 4 weeks of ursodeoxycholic acid and S-adenosylmethionine was trialled, with no improvement in biochemistry parameters. Clinicopathological investigations also revealed a markedly raised total bilirubin and abnormal bile acid stimulation test. Abdominal ultrasonography revealed pathological changes in the gallbladder, hepatomegaly with increased echogenicity and markedly thickened common bile duct walls. An exploratory laparotomy was performed revealing a grossly abnormal gallbladder with a small rupture at the dorsal fundus, which was managed via cholecystectomy. Pancreatic and hepatic biopsies were collected concurrently. Histopathology from the submitted samples revealed a gallbladder adenoma, chronic neutrophilic cholangitis and nodular hyperplasia of the pancreas. Culture of the gallbladder bile was negative but may be attributable to the initial treatment with antibiosis. At the time of writing, 5 months postoperatively, the cat had recovered well and remained asymptomatic and clinically healthy, but hepatic enzymes and bilirubin were only mildly reduced from the preoperative levels, despite the cat remaining clinically normal. Relevance and novel information To our knowledge, this is the first case of a gallbladder adenoma confirmed histopathologically in a feline patient. Our findings suggest that although gallbladder neoplasia is rare in cats, this benign tumour should be considered a differential diagnosis.

Cholecystectomy in 23 cats (2005‐2021)

“…Previous reports of cholecystectomy in cats are limited to smaller case series and case reports. [1][2][3][4]7,9,10,13 The indication for cholecystectomy in these papers included cholelithiasis, 1,2,3,13 biliary tract rupture, 11 and neoplasia 9,10 involving the gall bladder. As in this study, follow up in those papers was variable, [2][3][4]7,9,10,13 with some cats deteriorating postoperatively and others showing no recurrence of clinical signs at follow up, with up to 6 years follow up reported in one cat.…”

“…[1][2][3][4]7,9,10,13 The indication for cholecystectomy in these papers included cholelithiasis, 1,2,3,13 biliary tract rupture, 11 and neoplasia 9,10 involving the gall bladder. As in this study, follow up in those papers was variable, [2][3][4]7,9,10,13 with some cats deteriorating postoperatively and others showing no recurrence of clinical signs at follow up, with up to 6 years follow up reported in one cat. 13 The current study is the largest study of cholecystectomy in cats and, as far as the authors are aware, the first study to include owner assessed outcomes.…”

“…5 Choleliths have been identified in all parts of the biliary tract including the intrahepatic biliary ducts, cystic duct, CBD, and at the sphincter of Oddi (SOD). 6 Other indications for cholecystectomy include cholecystitis, 7 biliary mucocele, 8 neoplasia of the gall bladder, 9,10 or trauma. 11 Morbidity and mortality rates are considered high following feline extrahepatic biliary tract surgery.…”

“…13 Outcomes of cholecystectomy in cats are limited to single case reports or small case series. [2][3][4]7,9,10,13 In one study, cholecystectomy was performed for obstructive cholelithiasis in 5 cats; 4 survived and were all alive at a mean follow-up time of 22 months. 3 The objectives of this study were to describe the indications, clinical findings, treatments, complications, and outcomes in a larger population of cats undergoing cholecystectomy.…”

“…Outcomes of cholecystectomy in cats are limited to single case reports or small case series 2–4,7,9,10,13 . In one study, cholecystectomy was performed for obstructive cholelithiasis in 5 cats; 4 survived and were all alive at a mean follow‐up time of 22 months 3 …”