Severe Cholestatic Liver Disease Secondary to Liver Fluke (Platynosomum concinnum) Infection in Three Cats

Abstract

Three middle-aged domestic cats were presented for vomiting, lethargy, anorexia, and jaundice. Complete blood counts, serum biochemical profiles, and abdominal ultrasounds were suggestive of extrahepatic biliary obstruction in all of the cats. Infection with the liver fluke Platynosomum concinnum was confirmed by intraoperative bile cytology in three cases and by histopathology in two cases. All three cats were euthanized in the postoperative period because of complications. These cases illustrate the severity of signs and complications that can occur with liver fluke infection in cats.

Feline platynosomiasis: analysis of the association of infection levels with pathological and biochemical findings

“…Gross pathological lesions observed in the livers of infected cats were similar to previous descriptions of lesions in feline platynosomiasis (HANEY et al, 2006;HEADLEY et al, 2012;BASU & CHARLES, 2014;BRAGA et al, 2016). Milder injuries such as jaundice, parasites in the bile duct and gallbladder, and visualization of bile ducts on the hepatic surface were the abnormalities most commonly observed, while bile duct distension was the most remarkable lesion present in 61.1% of livers from infected animals.…”

“…Taylor & Perri (1977) noted extensive fibrous connective tissue in the bile ducts in the chronic stage (6 months after infection or beyond). Herein, we observed that naturally infected stray cats in an endemic region to platynosomiasis did not present severe pathological conditions such as cystic liver disease, severe cholestatic liver disease, cholangitis and cholangiohepatitis, cholangiocarcinoma, mesenteric lymphadenopathy, and hepatomegaly (O'SULLIVAN et al, 1976;HANEY et al, 2006;XAVIER et al, 2007;CARREIRA et al, 2008;ANDRADE et al, 2012;BRAGA et al, 2016). Morover, the intensity of parasitism was not related to the severity of macroscopic or microscopic hepatic injuries.…”

“…As seen in other studies of feline platynosomiasis, serum ALP was within normal values (FOLEY, 1994;TAYLOR & PERRI, 1977;CARREIRA et al, 2008). Usually, increase of ALP is associated with severe cholestasis (ALLISON, 2012), which was observed in low frequency (16.6%), despite this clinical sign having been previously described in association to P. fastosum infection (HANEY et al, 2006;BRAGA et al, 2016).…”

“…The most common microscopic lesions include cholangiectasis, cholangiohepatitis, atrophy of hepatocytes, and hyperplasia of the biliary duct epithelium, which results in thickening of the liver, fatty infiltration of hepatocytes, sections of flukes and/or eggs in the liver, and abundant hepatic infiltration of leukocytes and eosinophils (BASU & CHARLES, 2014). However, most cases of platynosomiasis in cats have been described as incidental findings during necropsies (O'SULLIVAN et al, 1976;HANEY et al, 2006;XAVIER et al, 2007;CARREIRA et al, 2008;LENIS et al, 2009;ANDRADE et al, 2012). Therefore, the present study aimed to describe the macroscopic and microscopic liver injuries associated with natural P. fastosum infection in stray cats in an endemic area of midwestern Brazil, and to investigate an association between parasite burden and pathological and biochemical findings.…”

Liver and biliary tract

“…89,90,93,95 Although trauma-related (diaphragmatic herniation) or other extrabiliary causes (duodenal foreign body) of EHBTO are rare, they have been reported, and if addressed in a timely fashion may lead to successful outcomes for the patient. 94,96 Recently a case series of six cats presented data on obstructive sphincter of Oddi Treatment of cholecystitis also depends on the stage of the disease and the clinical picture of the patient.…”