Bilirubin Encephalopathy in a Domestic Shorthair Cat With Increased Osmotic Fragility and Cholangiohepatitis.
A 7-month-old female domestic shorthair cat was diagnosed with chronic regenerative hemolytic anemia characterized by increased osmotic fragility of unknown etiology. At 13 months of age, the cat was evaluated for acute collapse. The cat was icteric with severe hyperbilirubinemia but no hematocrit changes. Severe obtundation and lateral recumbency progressed to tetraparesis and loss of proprioception in all 4 limbs, and a cerebellar or brainstem lesion was suspected. Postmortem examination revealed suppurative cholangiohepatitis and acute neuronal necrosis in the nuclei of the brainstem and cerebellum, consistent with bilirubin encephalopathy. This is the first known occurrence of cholangiohepatitis and bilirubin encephalopathy in an adult cat with chronic hemolytic anemia. Although rare, bilirubin encephalopathy should be considered a possible sequela to hyperbilirubinemia in adult patients. It remains unknown whether increased osmotic fragility was related to the cholangiohepatopathy.
Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA elena.contreras@colostate.edu.
E T
ET
Contreras
Section of Medical Genetics, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA.
U
U
Giger
Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
J L
JL
Malmberg
Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
J M
JM
Quimby
Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
P A
PA
Schaffer
D000743:Anemia, Hemolytic / Q000209:etiology / Q000662:veterinary*; D000818:Animals; D001652:Bile Ducts / Q000473:pathology; D002371:Cat Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D002415:Cats; D002761:Cholangitis / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D005260:Female; D006520:Hepatitis, Animal / Q000209:etiology*; D006932:Hyperbilirubinemia; D007647:Kernicterus / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D008099:Liver / Q000473:pathology; D009996:Osmotic Fragility
feline; hemolytic anemia; hereditary disorders; hyperbilirubinemia; kernicterus; liver disease