Colecistoduodenostomia para tratamento de obstrução biliar secundária a platinossomose felina / Cholecystoduodenostomy for treatment of biliary obstruction secondary to feline platinossomosis

ABSTRACT

Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection isacquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable.The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. Thetreatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the UberabaVeterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodesof vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased valuesof ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease andsteatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomywere then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described,besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patientwas treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorizedcholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adultform. After four days, a new blood count was done and the animal was still anemic and the blood...