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Cystadenoma, Hepatobiliary 232.e3

TREATMENT • Vincristine can cause sloughing of soft tissues • A blood smear should be evaluated in any
if extravasation occurs during intravenous patient with an abnormal platelet concen-
VetBooks.ir Treatment may not be necessary; antibiotic administration to monitor for a neutrophil clumps (could cause a false thrombocytope- Diseases and Disorders
Treatment Overview
injection. CBC is indicated 5-7 days after
tration to rule out the presence of platelet
nia) and to look for intracellular inclusions.
therapy for elimination of infection and sup-
nadir. If neutrophils are less than 1500/mcL,
broad-spectrum antibiotics may be indicated.
• Because granulocytic and monocytic vector-
portive care for thrombocytopenia
borne pathogens can also cause thrombocy-
Acute General Treatment Recommended Monitoring topenia, careful review of all cell types on
• Drugs of choice: doxycycline 5-10 mg/ Repeat CBC every 1-2 weeks (for approxi- blood smear is indicated.
kg PO or IV q 12h for 21 days, or mino- mately 4-6 weeks) to monitor for recurrence
cycline 10 mg/kg PO or IV q 12h for of thrombocytopenia and recovery from any SUGGESTED READING
10-21 days anemia that may have developed. Sainz Á, et al: Guideline for veterinary practitioners
• Rarely required: crystalloid fluids or blood on canine ehrlichiosis and anaplasmosis in Europe.
products, as necessary, depending on severity PROGNOSIS & OUTCOME Parasit Vectors 8:75, 2015.
of hemorrhagic complications
• Rarely used: vincristine 0.02 mg/kg IV once, • Excellent with appropriate treatment and ADDITIONAL SUGGESTED
maximum once weekly induces thrombocy- less pathogenic variants READINGS
tosis by an unknown mechanism • Guarded if rare, but severe secondary Arraga-Alvarado CM, et al: Molecular evidence of
complications (e.g., hemorrhage) occur Anaplasma platys infection in two women from
Chronic Treatment Venezuela. Am J Trop Med Hyg 91:1161-1165,
• Tick control is vital to prevention. PEARLS & CONSIDERATIONS 2014.
Gaunt SD, et al: Experimental infection and
Drug Interactions Comments co-infection of dogs with Anaplasma platys and
• Doxycycline results in less frequent drug Evaluation for other tick-borne diseases is rec- Ehrlichia canis: hematologic, serologic and molecu-
interactions than tetracycline. ommended based on likelihood of co-infection; lar findings. Parasit Vectors 3:33, 2010.
• Many oral drugs and foods can decrease however, treatment (e.g., doxycycline) for many Harvey JW: Thrombocytotropic anaplasmosis. In
Greene CE, editor: Infectious diseases of the dog
absorption of oral tetracyclines: aluminum- of these other pathogens is the same as for and cat, ed 4, Philadelphia, 2012, Saunders.
or calcium-containing antacids, iron, kaolin- A. platys. Lima MLF, et al: Molecular detection of Anaplasma
pectin, bismuth salicylate, milk products platys in a naturally infected cat in Brazil. Braz J
• Theophylline may enhance adverse Prevention Microbiol 41:381-385, 2010.
gastrointestinal side effects. • Testing and treatment of bitches before Qurollo BA, et al: Co-infection with Anaplasma
breeding to prevent vertical transmission. platys, Bartonella henselae, Bartonella koehlerae and
Possible Complications • Tick control is paramount. Control of R. ‘Candidatus Mycoplasma haemominutum’ in a cat
• Gastrointestinal side effects are common with sanguineous often requires extensive treatment diagnosed with splenic plasmacytosis and multiple
myeloma. J Feline Med Surg 16:713-720, 2014.
tetracyclines (vomiting, diarrhea, anorexia). of the local/home environment. Sykes JE, et al: Anaplasmosis. In Sykes JE, editor:
• Doxycycline is irritating to the esophageal Canine and feline infectious diseases, St. Louis,
mucosa and may lead to strictures. Follow Technician Tips 2014, Elsevier, pp 290-299.
administration with water or a small food • Blood smear evaluation in thrombocytopenic
bolus to ensure the medication passes into patients may reveal morulae within platelets AUTHOR: Britton J. Grasperge, DVM, PhD, DACVP
the stomach. and therefore an early positive diagnosis. EDITOR: Joseph Taboada, DVM, DACVIM

Cystadenoma, Hepatobiliary Client Education
Sheet

BASIC INFORMATION Clinical Presentation PHYSICAL EXAM FINDINGS

Definition DISEASE FORMS/SUBTYPES Generally unremarkable. Cranial abdominal
Benign hepatic tumor primarily seen in older • Focal or multifocal cystic hepatic lesions are organomegaly may be noted with very large
cats; may occur as focal or multifocal cystic most common. cystadenomas.
lesions of the liver. The cysts are lined by • Solitary masses are far less common.
cuboidal, occasionally vacuolated, epithelium. Etiology and Pathophysiology
Histogenesis remains uncertain. HISTORY, CHIEF COMPLAINT Cause remains unknown.
• Abdominal enlargement, lethargy, vomiting,
Synonym and polydipsia are possible. DIAGNOSIS
Bile duct adenoma • Many patients may show no overt clinical
signs, with cystadenomas identified as Diagnostic Overview
Epidemiology incidental findings on abdominal palpa- A tentative diagnosis can be made by a
SPECIES, AGE, SEX tion, radiographs, abdominal ultrasound, skilled ultrasonographer; histopathologic evalu-
Primarily cats older than 10 years; no sex or necropsy. ation of a biopsy is required for a definitive
predisposition; rare in dogs diagnosis.

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