Prevalence and clinical relevance of cholelithiasis in cats: A multicenter retrospective study of 98 cases

Audrey Brunet, Cyril Duperrier‐Simond, Suzanne Amoyal, Ghita Benchekroun, Juan Hernandez, Lorris Lecot, Thibaut Lurier, Jean‐Luc Cadoré, Emilie Krafft

Background: Cholelithiasis is an uncommon condition in cats, and its clinical relevance and management are poorly understood. The authors aimed to report the prevalence, clinical presentation, outcome, and risk factors of cholelithiasis in cats.

Study: A retrospective multicenter case series of 98 cats with cholelithiasis diagnosed by ultrasonography. Cholelithiasis was classified as incidental or symptomatic based on clinical and ultrasonographic criteria. Multivariate analysis was used to identify factors associated with clinical expression and survival.

Methods: Data collected from medical records included signalment, clinical signs, laboratory tests, ultrasonographic findings, concurrent diseases, treatments, and outcome. Statistical tests were used to compare variables between incidental and symptomatic cholelithiasis, and to determine risk factors for clinical expression and survival.

Results: The prevalence of cholelithiasis was 0.99% among cats that underwent abdominal ultrasonography. Cholelithiasis was classified as incidental in 41% and symptomatic in 59% of cases. Symptomatic cholelithiasis was frequently associated with another hepatobiliary disease or biliary tract obstruction or both. High body condition score, vomiting, pyrexia, jaundice, increased serum alanine aminotransferase activity, multiple cholelith locations, and biliary tract obstruction were significantly associated with symptomatic cholelithiasis. Survival to discharge was 74% in cats with symptomatic cholelithiasis, and biliary tract obstruction was negatively associated with survival. None of the cats with incidental cholelithiasis developed clinical signs related to cholelithiasis during follow-up.

Limitations: The retrospective design of the study, the missing data in some medical records, the lack of standardized diagnostic and therapeutic protocols, and the short follow-up period for some cats.

Conclusions: Cholelithiasis is uncommon and can be asymptomatic in cats. Symptomatic cholelithiasis frequently is associated with another hepatobiliary disease or biliary tract obstruction or both. Biliary tract obstruction is associated with poorer outcome. Medical treatment can be successful in selected cases. Incidental cholelithiasis rarely progresses to symptomatic cholelithiasis.

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