Feline cholecystitis and acute neutrophilic cholangitis: Clinical findings, bacterial isolates and response to treatment in six cases

Abstract

Clinicopathological findings from six cats with confirmed cholecystitis or acute neutrophilic cholangitis are presented. Historical findings included lethargy and anorexia or inappetence of up to five days duration. On physical examination all cats were pyrexic and four out of six were jaundiced and had cranial abdominal pain. Bile samples were obtained by cholecystocentesis at exploratory coeliotomy (two cases) or by percutaneous, ultrasound-guided cholecystocentesis (four cases). Gall bladder rupture and bile peritonitis occurred subsequent to ultrasound-guided cholecystocentesis in one case. The most common bacterial isolate was Escherichia coli (four cases); E coli was isolated alone in two cases, in combination with a Streptococcus species (one case) and in combination with a Clostridium species (one case). Streptococcus species alone was isolated from one case, as was Salmonella enterica serovar Typhimurium. The latter is the first reported case of Salmonella-associated cholecystitis in a cat. Concurrent pancreatic or intestinal disease was detected histologically in three cases. All cases were treated with antimicrobials based on in vitro susceptibility results. Treatment was successful in five cases. One cat with concurrent diffuse epitheliotropic intestinal lymphoma was euthanased. Percutaneous ultrasound-guided cholecystocentesis is an effective, minimally-invasive technique enabling identification of bacterial isolates in cats with inflammatory hepatobiliary disease.

Bacterial Culture Results from Liver, Gallbladder, or Bile in 248 Dogs and Cats Evaluated for Hepatobiliary Disease: 1998–2003

“…Our results support previous observations from smaller case series, 3,4,[6][7][8][9][10]12,13 in which the predominant bacteria isolated from the hepatobiliary system of dogs and cats were of enteric origin. Bacteria that were identified as contaminants in this study primarily were those associated with the skin, mostly coagulase-negative staphylococci, and probably were the result of collectionor specimen-handling contamination.…”

“…1,2 In veterinary patients, bacteria have been isolated from cases of suppurative cholangitis, hepatic abscesses, cholecystitis, choledochitis, and choleliths. [3][4][5][6][7][8][9][10][11][12][13] In humans with biliary disease, certain conditions have been associated with a higher incidence of infection, such as cholelithiasis, cholecystitis, previous biliary-tract surgery, or other causes of obstructive jaundice. [14][15][16][17][18] In these studies, the most commonly identified biliary pathogens in human patients are enteric bacteria (Escherichia coli, Enterococcus spp., Klebsiella spp., Bacteroides spp., and Clostridium spp).…”

“…A similar list of bacterial isolates has been compiled from cats and dogs diagnosed with a broader range of hepatobiliary diseases. [3][4][5][6][7][8][9][10][11][12][13] However, the overall prevalence and antimicrobial susceptibility of the different bacterial species cultured has not been evaluated in a large group of cases. Therefore, the purpose of this retrospective study was to characterize the results of biliary and liver cultures from dogs and cats evaluated for hepatobiliary disease at a veterinary teaching hospital, including the prevalence of positive cultures, the identity and antimicrobial susceptibility of common isolates, and clinical predictors of positive bacterial culture results.…”

Cytological Findings of 140 Bile Samples from Dogs and Cats and Associated Clinical Pathological Data

“…In contrast to dogs, cats in our study commonly had a neutrophilic inflammatory response on cytological evaluation, a finding described in a small case series 6. This observation could be associated with the relatively high frequency of cholangitis in cats.…”

“…Findings include presence of single and mixed bacteria in both canine and feline bile samples, with or without cytological evidence of inflammation 5, 6, 7, 8. Fungal organisms9 have rarely been documented in the bile of a dog, parasite eggs have been found in bile of a cat and of cows,10, 11 and a single case report documents the presence of atypical lymphocytes in gallbladder aspirates from a cat with lymphoma 12…”