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Hepatic Peliosis in Cats - VET SAYS RARE - PLEASE HELP
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Hannah_Vernon posted:
Hi,
I have taken my cat back and forward to the vets for all sorts of tests recently including a liver biopsy (results below). My vet is wonderful but says that he has never seen this disease in cats, it is so rare they have no idea how to help or medicate. He is obviously researching along with pathologist at the practice. I'd be so grateful if anyone has every heard of this in cats, how it can be treated or managed. I love my cat dearly and want the best for him! Hoping you can help!
Thanks!!
Hannah


Brian the cat
Feline: Male
Age: 6


Biopsy Diagnosis: HEPATIC PELIOSIS
Histology:
The sample submission is three portions of liver tissue as biopsies from the cat. Clinically there is mils hepatomegaly with hyperechoic foci on ultrasound. Cat has history of intermittent head tremor.


The sections of the liver samples show recognizable lobular architecture with portal and central vein areas. Some hepatocyte swelling with hydropic change. However, in the subserosal and parenchymal areas there is mutlifocal rough cystic cavity formations as distention of sinusoids, blood filled spaces retaining partial lining of vascular endothelium. There is a minor accumulation of blood derived products in swollen hepatocytes or macrophages. A few clusters of lymphocytes are also noted


Comment:
A histological presentation suggestive of HEPATIC PELIOSIS, a vascular disorder of uncertain aetioligy in cats. Focal obstruction of small branches of portal veins has proposed to initiate this reaction. The functional significance is uncertain and perhaps would depend on how widespread condition throughout the organ.


Other info:
* It was picked up after doing deductive blood tests after taking him to the vets to discuss head tremors that appeared to happen when relaxed - not long lasting, some time just a few seconds but tremors were definitely involuntary.
* First blood tests showed that his liver enzyme levels were normalish (55-66) when starved but over 120 after having eaten (bile acid test), Kidney function appeared normal. Urine tests we're clear.
*The vet commented that when he did the biopsy that his whole liver was very unhealthy and appeared mottled and swollen across the whole surface area. The surgery took an hour longer than anticipated due to having to stop the bleeding on his very damaged liver. However, he has fully recovered from his surgery now and is happy and playful.
* After surgery, PCV tests showed that count was at 24 (normal 26-46), its raised within 4 days after having 4 tests over this period to ensure no internal bleeding. It is currently at 26 still.
* He has a lost a little bit of weight but is eating and drinking normally.
Reply
 
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AMERICAN VETERINARY MEDICAL ASSOCIATION
Drew Weigner, DVM, ABVP responded:
Peliosis of the liver (also called polycystic liver disease) is indeed a rare condition in cats and is usually found as an incidental finding on biopsy. Its cause and significance is unknown. While it's possible for the disease to progress to the point of liver failure, it's also possible for an affected cat to live a normal lifespan with this condition.

The bigger question is if this has anything to do with his head tremor. When searching for the cause of a disease or symptom, it's not unusual to find things that are unrelated. While there's value in knowing your cat has peliosis, don't lose sight of the reason he had a medical workup in the first place. It's unlikely the peliosis is related to his head tremor, so further investigation needs to be done.

While monitoring his liver function and red blood cell count is important to see if the peliosis has progressed, there is no known treatment for this disease.

Drew Weigner, DVM, ABVP
The Cat Doctor
Board Certified in Feline Practice
 
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Hannah_Vernon replied to Drew Weigner, DVM, ABVP's response:
Thank you so much for your response! We are still looking at possible reasons his head tremors, it has been suggested that due reduced liver function and consequent lack of cleansing that toxins may e getting into his brain and causing the tremors; I'll stay ontop if this though as per your recommendation. His PCV has dropped to 23.5% may need to look at a steroid injection also. Your feedback is very much appreciated and has given me more hope than I had yesterday. Hannah


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