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

SIMPLE SUMMARY: Cholangitis/cholangiohepatitis is the most common inflammatory disease of the biliary system in cats. A tissue biopsy is crucial for a definitive diagnosis. Lymphocytic cholangitis is one type of cholangitis and is identified through histological findings. Treatment requires a long-term immunosuppressive drug. This article is the first report of multiple cyst-like hepatic lesions with histological findings of lymphocyte infiltration in a cat’s liver. ABSTRACT: A 5-year-old female neutered domestic short-haired cat presented with abdominal enlargement. An abdominal ultrasound revealed that large multiple hepatic cysts with irregular walls, hypoechoic fluid, and internal septations occupied most of the liver parenchyma. Serum liver enzymes, bilirubin, and bile acids concentrations were within normal limits. A fecal examination using simple floatation and formalin-ether sedimentation techniques was negative for liver fluke (Platynosomum fastosum), intestinal protozoa, and other helminth eggs. Praziquantel was prescribed for two distinct courses one month apart without obvious improvement of the hepatic cysts. An abdominal laparotomy and histopathological examination finally enabled diagnosis of cyst-like lymphocytic cholangiohepatitis of the liver tissue. Twelve weeks of oral prednisolone resulted in marked ultrasonographic improvement of the hepatic cysts. The liver parenchyma was heterogeneous and filled with multiple small anechoic cavities. Twenty-three months after ceasing the prednisolone, there was no recurrence of hepatic cysts.