Skip to main content
PMC home page
Wiley - PMC COVID-19 Collection logoLink to Wiley - PMC COVID-19 Collection
. 2006 Feb 10;43(6):247–253. doi: 10.1111/j.1748-5827.2002.tb00067.x

Pathogenesis and outcome of extrahepatic biliary obstruction in cats

P D Mayhew 1, D E Holt 1, R C McLear 1, R J Washabau 1
PMCID: PMC7167133  PMID: 12074289

Abstract

Extrahepatic biliary obstruction (EHBO) was confirmed at surgery or necropsy in 22 cats. Biliary or pancreatic adenocarcinoma was diagnosed by histopathology in six cats and one cat had an undiagnosed mass in the common bile duct. The remaining 15 cats had at least one of a complex of inflammatory diseases including pancreatitis, cholangiohepatitis, cholelithiasis and cholecystitis. The most common clinical signs were jaundice, anorexia, lethargy, weight loss and vomiting. Hyperbilirubinaemia was present in all cases. Distension of the common bile duct and gall bladder was the most commonly observed finding on abdominal ultrasound. Nineteen cats underwent exploratory laparotomy for biliary decompression and diversion. Mortality in cats with underlying neoplasia was 100 per cent and, in those with non‐neoplastic lesions, was 40 per cent. Long‐term complications, in those that survived, included recurrence of cholangiohepatitis, chronic weight loss and recurrence of obstruction. Based on these findings, the prognosis for EHBO in cats must be considered guarded.

References

  1. Alon , U. , Berant , M. , Mordechovitz , D. , Hashmonai , M. & Better , O. S. ( 1982. ) Effect of isolated cholaemia on systemic haemodynamics and kidney function in conscious dogs . Clinical Science 63 , 59 – 64 . [DOI] [PubMed] [Google Scholar]
  2. Baez , J. L. , Hendrick , M. J. , Walker , L. M. & Washabau , R. J. ( 1999. ) Radiographic, ultrasonographic, and endoscopic findings in cats with inflammatory bowel disease of the stomach and small intestine: 33 cases (1990–1997) . Journal of the American Veterinary Medical Association 215 , 349 – 354 . [PubMed] [Google Scholar]
  3. Bailey , M. E. ( 1976. ) Endotoxin, bile salts and renal function in obstructive jaundice . British Journal of Surgery 63 , 774 – 778 . [DOI] [PubMed] [Google Scholar]
  4. Barsanti , J. A. , Higgins , R. J. , Spano , J. S. & Jones , B. D. ( 1976. ) Adenocarcinoma of the extrahepatic bile duct in a cat . Journal of Small Animal Practice 17 , 599 – 605 . [DOI] [PubMed] [Google Scholar]
  5. Bayer , I. & Ellis , H. ( 1976. ) Jaundice and wound healing: an experimental study . British Journal of Surgery 63 , 392 – 396 . [DOI] [PubMed] [Google Scholar]
  6. Bernhoft , R. A. , Pellegrini , C. A. , Broderick , W. C. & Way , L. W. ( 1983. ) Pigment sludge and stone formation in the acutely ligated dog gallbladder . Gastroenterology 85 , 1166 – 1171 . [PubMed] [Google Scholar]
  7. Bjorling , D. E. ( 1991. ) Surgical management of hepatic and biliary disease in cats . The Compendium – Small Animal 13 , 1419 – 1425 . [Google Scholar]
  8. Boothe , H. W. , Boothe , D. M. , Komkov , A. & Hightower , D. ( 1992. ) Use of hepatobiliary scintigraphy in the diagnosis of extrahepatic biliary obstruction in dogs and cats: 25 cases (1982–1989) . Journal of the American Veterinary Medical Association 201 , 134 – 141 . [PubMed] [Google Scholar]
  9. Boyden , E. A. ( 1957. ) The choledochoduodenal junction in the cat . Surgery 41 , 773 – 786 . [PubMed] [Google Scholar]
  10. Center , S. A. ( 1996. ) Diseases of the gallbladder and biliary tree . In : Strombeck's Small Animal Gastroenterology , 3rd edn . Eds Guilford W. G. , Center S. A. , Strombeck D. R. , Williams D. A. and Meyer D. J. W. B. Saunders; , Philadelphia . pp 860 – 888 . [Google Scholar]
  11. Center , S. A. , Castleman , W. , Roth , L. , Baldwin , B. H. & Tennant , B. C. ( 1986. ) Light microscopic and electron microscopic changes in the livers of cats with extrahepatic bile duct obstruction . American Journal of Veterinary Research 47 , 1278 – 1282 . [PubMed] [Google Scholar]
  12. Church , E. M. & Matthiesen , D. T. ( 1988. ) Surgical treatment of 23 dogs with necrotizing cholecystitis . Journal of the American Animal Hospital Association 24 , 305 – 310 . [Google Scholar]
  13. Cornell , K. K. , Jakovljevic , S. , Waters , D. J. , Prostredny , J. , Salisbury , S. K. & DeNicola , D. B. ( 1993. ) Extrahepatic biliary obstruction secondary to diaphragmatic hernia in two cats . Journal of the American Animal Hospital Association 29 , 502 – 507 . [Google Scholar]
  14. Crouch , J. E. ( 1969. ) External and internal anatomy of the esophagus, stomach, duodenum and pancreas. In : Text‐Atlas of Cat Anatomy. Ed Crouch J. E. Lea & Febiger; , Philadelphia . pp 144 – 145 . [Google Scholar]
  15. Dixon , J. M. , Armstrong , C. P. , Duffy , S. W. & Davies , G. C. ( 1983. ) Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients . Gut 24 , 845 – 852 . [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Dixon , J. M. , Armstrong , C. P. , Duffy , S. W. , Elton , R. A. & Davies , G. C. ( 1984. ) Upper gastrointestinal bleeding: A significant complication after surgery for obstructive jaundice . Annals of Surgery 199 , 271 – 275 . [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Fahie , M. A. & Martin , R. A. ( 1995. ) Extrahepatic biliary tract obstruction: A retrospective study of 45 cases (1983–1993) . Journal of the American Animal Hospital Association 31 , 478 – 482 . [DOI] [PubMed] [Google Scholar]
  18. Feldman , B. F. , Strafuss , A. C. & Gabbert , N. ( 1976. ) Bile duct carcinoma in the cat: Three case reports . Feline Practice 1 , 33 – 39 . [Google Scholar]
  19. Finberg , J. P. M. , Syrop , H. A. & Better , O. S. ( 1981. ) Blunted response to angiotensin and sympathomimetic amines in bile‐duct ligated dogs . Clinical Science 61 , 525 – 539 . [DOI] [PubMed] [Google Scholar]
  20. Fossum , T. W. ( 1997. ) Surgery of the extrahepatic biliary system. In : Small Animal Surgery. Ed Fossum T. W. Mosby; , St Louis . pp 389 – 399 . [Google Scholar]
  21. Gibson , K. S. ( 1952. ) Cholelithiasis and choledocholithiasis in a cat . Journal of the American Veterinary Medical Association 121 , 288 – 289 . [PubMed] [Google Scholar]
  22. Green , J. , Beyar , R. , Sideman , S. , Mordechovitz , D. & Better , O. S. ( 1986. ) ‘The jaundiced heart’: a possible explanation for post‐operative shock in obstructive jaundice . Surgery 100 , 14 – 19 . [PubMed] [Google Scholar]
  23. Heidner , G. L. & Campbell , K. L. ( 1985. ) Cholelithiasis in a cat . Journal of the American Veterinary Medical Association 186 , 176 – 177 . [PubMed] [Google Scholar]
  24. Hirsch , V. M. & Doige , C. E. ( 1983. ) Suppurative cholangitis in cats . Journal of the American Veterinary Medical Association 182 , 1223 – 1226 . [PubMed] [Google Scholar]
  25. Hittmair , K. M. , Vielgrader , H. D. & Loupal , G. ( 2001. ) Ultrasonographic evaluation of gallbladder wall thickness in cats . Veterinary Radiology & Ultrasound 42 , 149 – 155 . [DOI] [PubMed] [Google Scholar]
  26. Jenkins , C. C. , Lewis , D. D. , Brock , K. A. , Hager , D. A. & Meyer , D. J. ( 1988. ) Extrahepatic biliary obstruction associated with Platynosomum concinnum in a cat . The Compendium – Small Animal 10 , 628 – 632 . [Google Scholar]
  27. Jorgenson , L. S. , Pentlarge , V. W. , Flanders , J. A. & Harvey , H. J. ( 1987. ) Recurrent cholelithiasis in a cat . Compendium – Small Animal 9 , 265 – 270 . [Google Scholar]
  28. Jubb , K. V. F. , Kennedy , P. C. & Palmer , N. ( 1993. ) The liver and biliary system . In : Pathology of Domestic Animals , 4th edn . Academic Press; , San Diego . pp 360 – 364 . [Google Scholar]
  29. Kirpensteijn , J. , Fingland , R. B. , Ulrich , T. , Sikkema , D. A. & Allen , S. W. ( 1993. ) Cholelithiasis in dogs: 29 cases (1980–1990 ) Journal of the American Veterinary Medical Association 202 , 1137 – 1142 . [PubMed] [Google Scholar]
  30. Lawrence , D. , Bellah , J. R. , Meyer , D. J. & Roth , L. ( 1992. ) Temporary bile diversion in cats with experimental extrahepatic bile duct obstruction . Veterinary Surgery 21 , 446 – 451 . [DOI] [PubMed] [Google Scholar]
  31. Leveille , R. , Biller , D. S. & Shiroma , J. T. ( 1996. ) Sonographic evaluation of the common bile duct in cats . Journal of Veterinary Internal Medicine 10 , 296 – 299 . [DOI] [PubMed] [Google Scholar]
  32. Lewis , D. T. , Malone , J. B. , Taboada , J. , Hribernik , T. N. , Pechman , R. D. & Dean , P. W. ( 1991. ) Cholangiohepatitis and choledochectasia associated with Amphimerus pseudofelineus in a cat . Journal of the American Animal Hospital Association 27 , 156 – 161 . [Google Scholar]
  33. Martin , R. A. ( 1993. ) Liver and biliary system. In : Textbook of Small Animal Surgery , 2nd edn . Ed Slatter D. W. B. Saunders; , Philadelphia . pp 645 – 677 . [Google Scholar]
  34. Martin , R. A. , MacCoy , D. M. & Harvey , H. J. ( 1986. ) Surgical management of extrahepatic biliary tract disease: A report of eleven cases . Journal of the American Animal Hospital Association 22 , 301 – 307 . [Google Scholar]
  35. Matthiesen , D. T. ( 1989. ) Complications associated with surgery of the extrahepatic biliary system . Problems in Veterinary Medicine 1 , 295 – 313 . [PubMed] [Google Scholar]
  36. Meijer , P. & Kimman , T. G. ( 1980. ) Een kat met icterus . Tijdschrift Diergeneeskunde 105 , 240 – 241 . [PubMed] [Google Scholar]
  37. Naus , M. J. A. & Jones , B. R. ( 1978. ) Cholelithiasis and choledocholithiasis in a cat . New Zealand Veterinary Journal 26 , 160 – 161 . [DOI] [PubMed] [Google Scholar]
  38. Newell , S. M. , Selcer , B. A. , Roberts , R. E. , Cornelius , L. M. & Mahaffey , E. A. ( 1996. ) Hepatobiliary scintigraphy in the evaluation of feline liver disease . Journal of Veterinary Internal Medicine 10 , 308 – 315 . [DOI] [PubMed] [Google Scholar]
  39. O'Brien , T. R. & Mitchum , G. D. ( 1970. ) Cholelithiasis in a cat . Journal of the American Veterinary Medical Association 156 , 1015 – 1017 . [PubMed] [Google Scholar]
  40. Pain , J. A. , Cahill , C. J. & Bailey , M. E. ( 1985. ) Perioperative complications in obstructive jaundice: therapeutic considerations . British Journal of Surgery 72 , 942 – 945 . [DOI] [PubMed] [Google Scholar]
  41. Pastor , J. , Majo , N. , Arbona , C. , Garcia , F. , Velarde , R. , Pumarola , M. & Lavin , S. ( 1997. ) Sclerosing adenocarcinoma of the extrahepatic bile duct in a cat . Veterinary Record 140 , 367 – 368 . [DOI] [PubMed] [Google Scholar]
  42. Pitt , H. A. , Cameron , J. L. , Postier , R. G. & Gadacz , T. R. ( 1981. ) Factors affecting mortality in biliary tract surgery . American Journal of Surgery 141 , 66 – 72 . [DOI] [PubMed] [Google Scholar]
  43. Raptopoulos , V. , Fabian , T. M. , Silva , W. , D'Orsi , C. J. , Karellas , A. , Compton , C. C. , Krolokowski , F. J. , Doherty , P. & Smith , E. H. ( 1985. ) The effect of time and cholecystectomy on experimental biliary tree dilatation . Investigative Radiology 20 , 276 – 286 . [DOI] [PubMed] [Google Scholar]
  44. Smith , S. A. , Biller , D. S. , Kraft , S. L. , Goggin , J. M. & Hoskinson , J. J. ( 1998. ) Diagnostic imaging of biliary obstruction . The Compendium – Small Animal 20 , 1225 – 1234 . [Google Scholar]
  45. Stewart , H. L. & Lieber , M. M. ( 1935. ) Ligation of the common bile duct in the cat . Archives of Pathology 19 , 34 – 36 . [Google Scholar]
  46. Thune , A. , Friman , S. , Conradi , N. & Svanvik , J. ( 1990. ) Functional and morphological relationships between the feline main pancreatic and bile duct sphincters . Gastroenterology 98 , 758 – 765 . [DOI] [PubMed] [Google Scholar]
  47. Wardle , E. N. ( 1970. ) Endotoxin and acute renal failure associated with obstructive jaundice . British Medical Journal 4 , 472 – 474 . [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Wardle , E. N. ( 1975. ) Endotoxin and acute renal failure . Nephron 14 , 321 – 332 . [DOI] [PubMed] [Google Scholar]
  49. Weiss , D. J. , Gagne , J. M. & Armstrong , P. J. ( 1996. ) Relationship between inflammatory hepatic disease and inflammatory bowel disease, pancreatitis, and nephritis in cats . Journal of the American Veterinary Medical Association 209 , 1114 – 1116 . [PubMed] [Google Scholar]
  50. Wen Ding , J. , Andersson , R. , Soltesz , V. , Willen , R. & Bengmark , S. ( 1994. ) Obstructive jaundice impairs reticuloendothelial function and promotes bacterial translocation in the rat . Journal of Surgical Research 57 , 238 – 245 . [DOI] [PubMed] [Google Scholar]
  51. Wolf , A. M. ( 1984. ) Obstructive jaundice in a cat resulting from choledocholithiasis . Journal of the American Veterinary Medical Association 185 , 85 – 87 . [PubMed] [Google Scholar]

Articles from The Journal of Small Animal Practice are provided here courtesy of Wiley

RESOURCES