Toxoplasma ‐related cholangiohepatitis diagnosed by bile cytology in an immunocompetent cat

An 8‐year‐old, male, neutered domestic shorthair cat was presented for investigation of a 2‐week history of hyporexia, lethargy and jaundice. Diagnostic investigations revealed hyperbilirubinaemia, increased liver enzyme activity and thickening of the gall bladder wall with a multilayer appearance. Cytology of the bile and liver identified Toxoplasma tachyzoites, and subsequently, Toxoplasma antibodies were positive. The cat was treated with clindamycin, and a follow‐up visit revealed resolution of hyperbilirubinaemia, gall bladder thickening, and a decrease in liver enzyme activity, although these never fully normalised. This case report describes a cat with Toxoplasma ‐associated cholangiohepatitis diagnosed by identifying Toxoplasma tachyzoites in bile, a novel finding in a cat without any known immunosuppressive conditions. To our knowledge, this is the first report of such a diagnostic pathway in a non‐immunosuppressed cat and highlights the importance of considering toxoplasmosis as a differential diagnosis for immunocompetent cats with signs of cholecystitis.