Dynamic Bile Acids
| Bile Acids |
2.5 |
umol/l |
0.0 - 15.0 |
| Total Bilirubin |
5.0 |
umol/l |
0.0 - 10.0 |
| Bile Acids post feed |
H 29.7 |
umol/l |
0.0 - 15.0 |
Full Blood Count
| WBC |
6.7 |
x10^9/l |
4.0 - 15.0 |
|
| RBC |
7.41 |
x10^12/l |
5.50 - 10.00 |
|
| Haemoglobin |
8.5 |
g/dl |
8.0 - 15.0 |
|
| PCV |
28.0 |
% |
27.0 - 50.0 |
|
| MCV |
L 37.8 |
fl |
40.0 - 55.0 |
|
| MCH |
L 11.5 |
pg |
13.0 - 17.0 |
|
| MCHC |
L 30.4 |
g/dl |
31.0 - 34.0 |
|
| Platelets |
449 |
x10^9/l |
200 - 600 |
|
| |
% |
Range |
x10^9/l |
Range |
| Neutrophils |
45 |
45 -75 |
3.0 |
2.5 - 12.5 |
| Lymphocytes |
H 52 |
25 -33 |
3.5 |
1.5 - 7.0 |
| Monocytes |
1 |
0 - 4 |
0.1 |
0.0 - 0.8 |
| Eosinophils |
L 2 |
4 -12 |
0.1 |
0.0 - 1.5 |
| Basophils |
0 |
0 -1 |
0.0 |
|
| Film |
Film confirms platelet count |
|
|
| |
Burr cells + |
|
|
| |
Schistocytes + |
|
|
| |
Acanthocytes + |
|
|
| |
Occasional microcyte seen |
|
|
| Total Protein |
64.3 |
g/l |
54.0 - 78.0 |
|
| Albumin |
30.3 |
g/l |
21.0 - 39.0 |
|
| Urea |
7.5 |
mmol/l |
6.0 - 10.0 |
|
| Creatinine |
172 |
umol/l |
80 - 180 |
|
| Total Bilirubin |
5.0 |
umol/l |
0.0 - 10.0 |
|
| ALP |
29 |
u/l@37C |
0 - 40 |
|
| ALT |
H 48 |
u/l@37C |
0 - 20 |
|
| AST |
31 |
u/l@37C |
0 - 69 |
|
| Gamma GT |
2.0 |
u/l@37C |
0.0 - 27.0 |
|
| Calcium |
2.43 |
mmol/l |
1.60 - 3.00 |
|
| Phosphate |
1.72 |
mmol/l |
1.40 - 2.60 |
|
| Sodium |
H 157 |
mmol/l |
120 - 155 |
|
| Potassium |
4.40 |
mmol/l |
3.60 - 5.60 |
|
| Chloride |
122 |
mmol/l |
112 - 129 |
|
| Glucose - Random |
|
No oxf sample receive |
|
| Triglycerides |
0.46 |
mmol/l |
0.22 - 1.24 |
|
| Cholesterol |
2.5 |
mmol/l |
1.9 - 3.9 |
|
|
| HAEMATOLOGY |
| PT |
10 |
secs |
|
| APTT |
17 |
secs |
|
| PKD |
Positive |
|
|
|
| CYTOLOGY |
| Fluid Analysis - from free abdominal fluid |
| Fluid Protein |
39.3 |
g/l |
|
| Fluid Albumin |
18.8 |
g/l |
|
| Fluid Globulin |
20.5 |
g/l |
|
| Fluid Albumin:Globulin |
0.9 |
|
|
| Fluid Specific Gravity |
1.030 |
|
|
| WBC |
0.91 |
|
|
| RBC |
0.01 |
|
|
Abdominocentesis was performed and a straw-coloured fluid
collected for analysis.
The free abdominal fluid was a modified transudate containing non-degenerate
neutrophils and occasional reactive mesothelial cells (see below). |
|
Surgical Exploration
The abdomen was surgically explored under general anaesthesia. The abdomen
contained a significant quantity of straw-coloured free fluid. The liver
was massively enlarged and cystic. |
 Figure 3 |
 Figure 4 |
The left medial and proximal left lateral, quadrate, right
medial lobes and papillary process of the caudate lobe were diffusely affected.
The right lateral lobe, and distal extremity of left lateral lobe had a
more normal appearance, although the liver tissue was firm and had a nodular
appearance.
Both kidneys were identified at surgery and both had cystic changes. The
rest of the abdomen was unremarkable. The stomach was unaffected but was
being compressed by the mass. Two liver biopsies were obtained were sent
for histology. Surgical resection of the mass was not possible, but numerous
cysts were drained resulting in a 30-40% reduction in the size of the liver.
The cat recovered uneventfully from anaesthesia and was discharged 24 hours
later with an S-Adenosyl methionine supplement. |
| One of the liver cysts was aspirated and fluid results
are as follows: |
| Fluid Analysis |
|
|
|
| Fluid Protein |
1.4 g/l |
|
|
| Fluid Albumin |
0.5 g/l |
|
|
| Fluid Globulin |
0.9 g/l |
|
|
| Fluid Albumin:Globulin |
0.6 |
|
|
| Fluid Specific Gravity |
1.010 |
|
|
| WBC |
0.19 x10^9/l |
|
|
| RBC |
0.04 x10^12/l |
|
|
|
| Cytological examination was consistent with a cystic fluid
with evidence of both previous and iatrogenic haemorrhage. |
| Histopathology was consistent with multiple biliary cysts
with some areas of nodular hyperplasia with vacuolar change. There was no
evidence of neoplasia or inflammation in any of the sections. |