Choledochal Stenting for Treatment of Extrahepatic Biliary Obstruction in Cats. Griffin M1, Culp W1, Giuffrida M1, Selmic L2, Denitz J1, Perry J3, Schoelkopf A4, Milovancev M5, Phillips H6, Wallace M7, Steffey M1, Balsa I1, Mayhew P. 1University of California, Davis, School of Veterinary Medicine, Davis, CA; 2The Ohio State University, College of Veterinary Medicine, Columbus, OH; 3Veterinary Cancer & Surgery Specialists, Milwaukie, OR; 4University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA; 5Oregon State University, Carlson College of Veterinary Medicine, Corvallis, OR; 6University of Illinois Urbana-Champaign, College of Veterinary Medicine, Urbana, IL; 7University of Georgia, College of Veterinary Medicine, Athens, GA.
Limited information currently exists regarding the clinical progression of cats that undergo choledochal stenting as a treatment for extrahepatic biliary obstruction (EHBO). Objectives were to describe the clinical characteristics, indications for choledochal stent placement, procedure, and outcomes in a cohort of cats undergoing choledochal stenting and to subsequently evaluate for risk factors associated with survival and recurrence of EHBO. A multi-institutional, retrospective study was performed. Medical records from six academic institutions were reviewed with data collected and analyzed statistically. Twenty-three client-owned cats undergoing choledochal stent placement were included. Clinical signs improved post-operatively in 15/20 (75%) cats. Eighteen (78%) cats survived to discharge with a median survival time of 931 days (range 19-3034). Absence of peritoneal effusion was associated with survival. Recurrence of EHBO was documented in 7/18 (39%) cats that survived to discharge. Cholelithiasis was associated with recurrence of EHBO. Following choledochal stent placement, the majority of cats showed improvement in clinical signs/EHBO and experienced long-term survival. The cause of death was often unknown or not associated with hepatobiliary disease. Recurrence of EHBO appears to be common in cats following choledochal stent placement, though recurrent EHBO can be manageable and may not affect long-term outcome. Important study limitations include the retrospective nature with loss to follow-up of cats, potential selection bias, and inability to determine definitive cause and effect for findings. Choledochal stenting appears to be an effective treatment modality in cats with EHBO with potential for prolonged survival, though a substantial risk for recurrence of EHBO was documented.