Prevalence and clinical relevance of cholelithiasis in cats: A multicenter retrospective study of 98 cases
Résumé
Background: Cholelithiasis is an uncommon and mainly incidental finding in dogs; current literature on this topic is scarce in cats. Hypothesis: Report prevalence, clinical presentation, management, and outcome of cholelithiasis in cats. Animals: Ninety-eight cats with cholelithiasis. Methods: Retrospective multicenter case series. Electronic databases from 3 hospitals were searched for cats diagnosed with cholelithiasis by ultrasonography (US). Cholelithiasis was classified as incidental (IC) or symptomatic (SC) depending on clinicopathological signs, biliary tract US appearance, and presence of another disease potentially explaining the clinical presentation. Multivariate analysis was used to investigate factors associated with clinical expression of cholelithiasis and, within the SC group, survival. Results: The observed prevalence of cholelithiasis was 0.99% (95% confidence interval [CI], 0.79%-1.19%) among cats that underwent abdominal US. Cholelithiasis was classified as IC in 41% and SC in 59%. Choleliths found in multiple locations within the biliary tract (odds ratio [OR], 8.11; 95% CI, 2.32-34.15; P = .001) or associated with US signs of obstruction (OR, 18.47; 95% CI, 2.13-2413.34; P = .004) were significantly associated with SC. Concurrent hepatobiliary diseases were suspected or confirmed in 83% of cases with SC. Forty-three cats (74%) with SC survived to discharge. Biliary tract obstruction (BTO) was negatively associated with survival (OR, 13.87; 95% CI, 1.54-124.76; P = .001). None of the cats with IC that had available follow-up (47%) developed clinicopathological signs related to cholelithiasis. Conclusions and Clinical Importance: Cholelithiasis is uncommon and can be asymptomatic in cats. Symptomatic cholelithiasis frequently is associated with another hepatobiliary disease or BTO or both. Biliary tract obstruction is associated with poorer outcome.
Mots clés
AICc
Akaike information criterion corrected ALP
alkaline phosphatase ALT
alanine aminotransferase AST
aspartate aminotransferase BCS
body condition score BTO
biliary tract obstruction CBD
common bile duct CCH
cholangitis/cholangiohepatitis CE
chronic enteropathy CI
confidence interval IC
incidental cholelithiasis IQ
interquartile OR
odds ratio SC
symptomatic cholelithiasis UDCA
ursodeoxycholic acid US
ultrasonography cholelith
hepatobiliary disease
obstruction
risk factors
ultrasonography
Akaike information criterion corrected
ALP
alkaline phosphatase
ALT
alanine aminotransferase
AST
aspartate aminotransferase
BCS
body condition score
BTO
biliary tract obstruction
CBD
common bile duct
CCH
cholangitis/cholangiohepatitis
CE
chronic enteropathy
CI
confidence interval
IC
incidental cholelithiasis
IQ
interquartile
OR
odds ratio
SC
symptomatic cholelithiasis
UDCA
ursodeoxycholic acid
US
cholelith
Domaines
Santé publique et épidémiologie
Fichier principal
Veterinary Internal Medicne - 2023 - Brunet - Prevalence and clinical relevance of cholelithiasis in cats A multicenter.pdf (1.17 Mo)
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