Percutaneous, ultrasound‐guided ethanol ablation of a pancreatic cyst in a cat

Abstract A 12‐year‐old, male, neutered Bengal cat was referred for a suspected cranial abdominal mass, diarrhoea and weight loss despite polyphagia. Computed tomography identified a large pancreatic cyst, cholecystoliths and jejunal lymphadenopathy. An inability to visualise the common bile and pancreatic ducts precluded partial pancreatectomy, so the cyst was drained intra‐operatively and omentalised. Incisional biopsies confirmed a non‐neoplastic, epithelial pancreatic cyst and concurrent alimentary lymphoma. Hypocobalaminaemia and low trypsin‐like immunoreactivity were also noted, consistent with exocrine pancreatic insufficiency, but feline‐specific pancreatic lipase was normal. The cyst refilled following intra‐operative and post‐operative percutaneous, ultrasound‐guided drainage. On both occasions, the cat had ultrasonographic evidence of extrahepatic biliary obstruction and progressive hyperbilirubinaemia. When the cyst reformed again, percutaneous, ultrasound‐guided ethanol ablation was performed under a general anaesthetic. The cat recovered uneventfully, and while the cyst refilled within a week, its clinical signs improved. Euthanasia was elected 7 months later.