[From Tufts February 2012 Issue]
Bobo’s annual exam performed last July by Linda Ross, DVM, DACVIM, internal medicine specialist and professor at Cummings, was unremarkable – although limited by his unfriendly attitude. The 8-year-old cat seemed healthy, if somewhat overweight, and results of his blood work came back normal.
About a week later, however, Bobo’s owner, Bonnie Boyd of Natick, Massachusetts, noticed that the chubby cat’s appetite had decreased, although his activity level remained the same. After keeping an eye on him for some time, she became concerned that he was losing weight and made another appointment with Dr. Ross. The scale showed that he had lost about a pound, which can be a considerable amount for an animal as small as a cat. Bobo wasn’t especially amenable to handling, and his weight — even though it was down — made it difficult to examine him. Dr. Ross recommended an ultrasound to check for possible abdominal disorders that could be causing the weight loss.
When Dr. Ross returned to the waiting room after the ultrasound, Boyd said she could tell something was wrong. The good news was that the ultrasound had pinpointed the problem. The bad news was that Bobo required immediate surgery.
Diagnosis: Biliary Cyst
Bobo had a biliary cyst: a large fluid-filled growth arising from the bile duct system within the liver.
“We didn’t know for sure that’s why he wasn’t eating, but the cyst was certainly large enough that we thought it could be putting pressure on his stomach and causing some discomfort,” Dr. Ross says.
That was on Sept. 12, 2011. After a chest X-ray showed no evidence of spread to the lungs — always a concern when there is a mass anywhere in the body — surgery was scheduled for Sept. 14 with John Berg, DVM, DACVS, veterinary surgeon and professor who specializes in soft tissue surgery.
“The most common kind of liver mass that we see in a cat is a lesion called a biliary cyst, or hepatobiliary cystadenoma, and they’re benign, meaning that they don’t tend to spread to other places in the body,” explains Dr. Berg. “They’re often not very invasive into the liver, so in many cases, they can be removed with a fairly straightforward surgery.”
One of the risks of any kind of tumor removal from the liver is bleeding, but Bobo’s surgery went well, and the nearly softball-size mass was easily removed.
Bobo’s prognosis was good because the mass was completely removed, but the successful surgery wasn’t the end of his troubles. Boyd had him back at the hospital within 18 hours of taking him home because he was running a fever and didn’t want to eat. Lack of appetite is dangerous for an overweight cat because it can lead to a condition called hepatic lipidosis (see sidebar). The solution was to place a feeding tube that would allow Boyd to ensure that Bobo took in enough nutrition until he recovered.
Feeding Tubes and Biliary Cysts
A feeding tube can be placed very quickly under anesthesia, either through the esophagus or directly into the stomach, usually in as little as 10 to 15 minutes. Owners can then put food into a blender and make a slurry that can be given through the tube.
“An advantage of these types of tubes is that if the cat gets his appetite back, he can eat even with the tube in place,” Dr. Ross says. “At some point, either we start decreasing the feedings through the tube, letting them eat or some cats just tell us it’s time by starting to eat on their own.”
The feeding tube solved the problem. It was removed after six days, and Bobo is now doing well. The cost of his surgery and postoperative care was approximately $6,000, most of which was covered by Bobo’s pet health insurance policy.
Boyd, who has taken her cats to Dr. Ross since 1983, was ecstatic with the care Bobo received and the results of the surgery.
“They were wonderful. If it wasn’t for that team, Bobo would not have made it. They are just fabulous.”
