Cholelithiasis in Cats
Gallstones are typically made up of calcium or other secreted substances, which form into small stone-like structures within the body. Cholelithiasis is a medical condition that can result from the formation of stones in the gallbladder. Stones in the bile ducts or the gallbladder may be visible on an X-ray, or they may not. Unless there are serious symptoms, surgery is not recommended for gallstones.
Symptoms and Types
There are cases where there are no apparent symptoms. However, if there is an infection in addition to the gallstones, your cat may display vomiting, abdominal pain, fever, and jaundice.
There are several causes for gallstones that may be considered. A failure of the gall bladder to function can interrupt the bile flow, or the bile may be sludging; the bile may be supersaturated with pigment, calcium, or cholesterol; stone formation may be caused by inflammation, an infection, a tumor, or the shedding of cells; or, the stones may bring on inflammation and allow for the invasion of bacteria. In cats, cysts, or inflammation of the bile ducts can lead to failure of the bile to flow normally.
Your veterinarian will need to confirm or rule out diseases of the liver, pancreatitis, inflammation of the bile duct or gallbladder, and distension of the gallbladder from an inappropriate accumulation of mucus.
A complete blood count will be ordered to check for bacterial infection. Other underlying factors that could be causing the symptoms, such as obstruction in the bile duct, will also be considered. X-rays are not usually very effective in looking at the gallbladder, but your veterinarian may want to use ultrasound to perform an internal visual examination. Ultrasound imaging can detect stones, a thickened gallbladder wall, or an over sized bile tract. It can also be used as a guide for collecting specimens for culture. Should surgery be recommended, a thorough examination of the liver before surgery will be necessary.
There is disagreement over whether attempts should be made to medically dissolve the stones if an animal does not seem to be in danger. If intravenous (IV) treatment is indicated, your cat will need to be hospitalized until it is stable. In some cases, exploratory surgery will be the treatment chosen. If this is a chronic problem for your cat, new stones may form even after surgery has been performed to remove the existing ones.
Medications that can be used to treat the stones, and any related complications, will be those that can help to dissolve the stones. Vitamin K1 will be given intravenously if the patient is jaundiced; vitamin E will be prescribed if high liver enzymes or inflammation in the liver and bile duct are diagnosed; and S-Adenosylmethionine (SAMe) may be prescribed to improve liver function and bile production. Antibiotics may also be warranted for treating associated infections, bacterial complications, or for the prevention of an infection when outside intervention is necessary (e.g., IV, surgery, or any treatment that necessitates going into the body).
Living and Management
If your cat had surgery, physical examinations and testing will need to continue every two to four weeks for as long as your veterinarian recommends it. Periodic ultrasound exams to evaluate the ongoing functioning of the liver and bile system will also be called for. In addition, you will need to watch for sudden onset of fever, abdominal pain, or weakness, since it may indicate infection. A fat-restricted, high protein diet is most likely to be prescribed for the long term.
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