FINAL   DIAGNOSIS  -   Pancreatic eurytremiasis         

 Signalment:  4-year-old male neutered Domestic shorthair cat

Clinical history:  The cat was presented to the referring veterinarian with an 8-month history of heart murmur, chronic weight loss and diarrhea.  No cardiac abnormalities were observed on ultrasound.

  The reported history indicated that the cat had a good appetite but failed to gain weight.  A day prior to death, the cat had presented with acute onset of severe depression and central blindness.  Chest auscultation revealed only a slight murmur, and no abnormal lung sounds.  Clinical pathology revealed slightly elevated albumin, mild normocytic anemia, neutropenia, lymphopenia and eosinophilia.  The cat was given supportive therapy but died the next day.

Gross Findings:  At necropsy, the pancreas was diffusely atrophic and had extensive loss of normal lobular architecture.  Other gross lesions observed included a thickened left ventricular wall and a pale mottled liver.  The small intestine was dilated and gas-filled.

Histopathologic Findings:  Histologically, the pancreas was markedly atrophied.  The glandular architecture was effaced and replaced by thick bands of fibrous connective tissue that was infiltrated by eosinophils, fewer epithelioid macrophages, and lymphocytes.  Remaining acinar cells were small and lacked acidophilic granules.  Within an enlarged pancreatic duct in the section were several 25x40 microns trematode ova.  Ova had thick brownish-yellow shells, a single operculum, and contained meracidia.  A section of an adult trematode, characterized by a pink tegument, cross sections of a uterus, testis and intestinal tract, was also within the duct.  The ductal wall was hyperplastic and markedly infiltrated by several eosinophils, macrophages and lymphocytes.  Identification of trematodes as  Eurytrema procyonis was made on paraffin-embedded tissues.

Morphologic Diagnosis:

1) Pancreas: Granulomatous, eosinophilic pancreatitis with marked atrophy and fibrosis

2) Pancreatic duct: Granulomatous, eosinophilic inflammation with intraductal trematode and ova (Eurytrema procyonis)

Discussion:  The fluke Eurytrema procyonis was first described in the raccoon pancreas by Denton in 1942 in Houston.  Since then, reports of its occurrence in the pancreatic duct of foxes, cats and other species have appeared.  The primary habitat of these flukes is the medium pancreatic ducts, although they may simultaneously infest the biliary tract.  Infestations of the pancreatic duct causes distention, thickening of the ducts, and chronic interstitial pancreatitis, leading to periductal and acinar fibrosis.

  Significant loss of exocrine pancreatic function as compared to uninfected cats has been demonstrated by functional studies on the pancreas of infected cats.  Impaired bicarbonate and protein secretions were observed in these cats, even in the absence of clinical manifestation of pancreatic insufficiency.  The exocrine pancreas function of the cat in this report, however, was not evaluated.  The slightly elevated albumin observed was most likely a spurious increase resulting from dehydration.  Severe atrophy and fibrosis of pancreas is most likely a result of chronic obstruction and not direct effects of the flukes.

  The life cycle of E. procyonis is believed to involve ingestion of the intermediate host (snail, grasshopper).  Outdoor cats are therefore at a higher risk, especially in rural and semirural areas.

-byVictoria Owiredu-Laast, DVM

   ADDL Graduate Student