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

Abstract Background Cholelithiasis is an uncommon and mainly incidental finding in dogs; current literature on this topic is scarce in cats. Hypothesis Report prevalence, clinical presentation, management, and outcome of cholelithiasis in cats. Animals Ninety‐eight cats with cholelithiasis. Methods Retrospective multicenter case series. Electronic databases from 3 hospitals were searched for cats diagnosed with cholelithiasis by ultrasonography (US). Cholelithiasis was classified as incidental (IC) or symptomatic (SC) depending on clinicopathological signs, biliary tract US appearance, and presence of another disease potentially explaining the clinical presentation. Multivariate analysis was used to investigate factors associated with clinical expression of cholelithiasis and, within the SC group, survival. Results The observed prevalence of cholelithiasis was 0.99% (95% confidence interval [CI], 0.79%‐1.19%) among cats that underwent abdominal US. Cholelithiasis was classified as IC in 41% and SC in 59%. Choleliths found in multiple locations within the biliary tract (odds ratio [OR], 8.11; 95% CI, 2.32‐34.15; P = .001) or associated with US signs of obstruction (OR, 18.47; 95% CI, 2.13‐2413.34; P = .004) were significantly associated with SC. Concurrent hepatobiliary diseases were suspected or confirmed in 83% of cases with SC. Forty‐three cats (74%) with SC survived to discharge. Biliary tract obstruction (BTO) was negatively associated with survival (OR, 13.87; 95% CI, 1.54‐124.76; P = .001). None of the cats with IC that had available follow‐up (47%) developed clinicopathological signs related to cholelithiasis. Conclusions and Clinical Importance Cholelithiasis is uncommon and can be asymptomatic in cats. Symptomatic cholelithiasis frequently is associated with another hepatobiliary disease or BTO or both. Biliary tract obstruction is associated with poorer outcome.