PMID- 31210959
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2055-1169 (Electronic)
IS  - 2055-1169 (Linking)
VI  - 5
IP  - 1
DP  - 2019 Jan-Jun
TI  - Successful treatment of Yersinia pseudotuberculosis hepatitis in a cat presenting 
      with neurological abnormalities.
PG  - 2055116919853644
LID - 10.1177/2055116919853644 [doi]
LID - 2055116919853644
AB  - CASE SUMMARY: A 3-year-7-month-old female neutered domestic shorthair cat was 
      presented for further investigation of acute-onset neurological abnormalities, 
      including marked decreased mentation, ataxia and abnormal cranial nerve 
      responses, with concurrent marked pyrexia (40 masculineC). Initial blood testing was 
      non-specific with mild-to-moderate increases in alanine aminotransferase (ALT) 
      (194 IU/l; reference interval [RI] 17-62 IU/l), aspartate aminotransferase (AST; 
      150 IU/l [RI 0-51 IU/l]) and total bilirubin (20 micromol/l; RI 0-11 micromol/l), and 
      neutropenia (1.17 x10(9)/l; RI 2.5-12.5 x10(9)/l). Brain MRI and cerebrospinal 
      fluid analysis were unremarkable and Toxoplasma serology was negative. Worsening 
      of hepatic biochemical parameters (ALT 265 IU/l, AST 205 IU/l, total bilirubin 
      42.9 micromol/l) led to further investigations for liver disease, including 
      ultrasound, fine-needle aspirate cytology, histology, fluorescent in situ 
      hybridisation and culture of liver tissue and bile, resulting in a diagnosis of 
      Yersinia pseudotuberculosis hepatitis. The cat was treated with a combination of 
      potentiated amoxicillin (62.5 mg PO q12h), marbofloxacin (5mg PO q24h) and 
      combined s-adenosyl methionine (SAMe)/silybin (90 mg PO q24h), and made a full 
      recovery. Follow-up over 14 months identified a persistent mild increase in ALT, 
      despite no apparent ongoing disease. RELEVANCE AND NOVEL INFORMATION: Yersinia 
      pseudotuberculosis hepatitis should be considered as a differential diagnosis in 
      cats presenting with acute-onset neurological signs, and, when diagnosed, can be 
      successfully treated with a combination of marbofloxacin, potentiated amoxicillin 
      and SAMe/silybin. This is the first such case treated successfully with licensed 
      veterinary antimicrobials and the first instance where Y pseudotuberculosis 
      hepatitis has presented with primarily neurological clinical signs.
FAU - Thompson, Dan
AU  - Thompson D
AD  - Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.
LA  - eng
PT  - Case Reports
DEP - 20190530
PL  - England
TA  - JFMS Open Rep
JT  - JFMS open reports
JID - 101672978
PMC - PMC6545640
OTO - NOTNLM
OT  - Yersinia pseudotuberculosis
OT  - Yersiniosis
OT  - hepatitis
COIS- Conflict of interest: The author declares no potential conflicts of interest with 
      respect to the research, authorship, and/or publication of this article.
EDAT- 2019/06/19 06:00
MHDA- 2019/06/19 06:01
PMCR- 2019/05/30
CRDT- 2019/06/19 06:00
PHST- 2019/06/19 06:00 [entrez]
PHST- 2019/06/19 06:00 [pubmed]
PHST- 2019/06/19 06:01 [medline]
PHST- 2019/05/30 00:00 [pmc-release]
AID - 10.1177_2055116919853644 [pii]
AID - 10.1177/2055116919853644 [doi]
PST - epublish
SO  - JFMS Open Rep. 2019 May 30;5(1):2055116919853644. doi: 10.1177/2055116919853644. 
      eCollection 2019 Jan-Jun.