What is your diagnosis? Bile from a cat

Abstract

A 7-year-old spayed female domestic longhair cat was presented to the University of Florida Veterinary Hospital for evaluation of inappetence and increased serum liver enzyme activities at the referring veterinarian. The cat lived primarily outdoors, was known for catching lizards, and had no travel history outside of Florida. On physical examination, the cat was febrile, with a body temperature of 103.9°F, and was icteric. A CBC (ADVIA 2120 Hematology System; Siemens Healthcare GmbH) revealed a mild leukocytosis (WBC 16.1 K/µL, RI 5.4-15.4) characterized by a mature neutrophilia (13.1 K/µL, RI 2.3-9.8) and mild thrombocytosis (PLT 520 K/µL, RI 160-502). On slide review, most neutrophils contained Döhle bodies, consistent with mild toxicity. A serum biochemistry profile (Beckman Coulter AU480; Beckman Coulter Inc) showed moderate hyperbilirubinemia (8.8 mg/dL, RI 0.1-0.4), markedly increased ALT activity (1277 U/L, 32-83), moderately increased AST activity (294 U/L, RI 13-43), mildly increased ALP activity (211 UL, RI 11-60), and mild hypochloremia (108.8 mEq/L, RI 112-119). On abdominal ultrasound, the gallbladder and common bile duct were mildly distended with mildly thickened walls. Bile was submitted for cytologic evaluation (Figure 1).

Feline Cyst-like Lymphocytic Cholangiohepatitis in a Cat: First Case Report

“…Clinical manifestation of liver fluke infestation can be hepatic cysts. Detection of liver fluke eggs from fecal examination may be missed because of the intermittent egg shedding and low number of eggs in feces [ 25 ]. Cytology of bile aspirate could increase the sensitivity of parasitic egg detection [ 26 ].…”