Chloe, an 11 yr female spayed DSH cat, presented with the chief complaint of a broken canine tooth. History included years of infrequent, intermittent vomiting a frothy white to yellow material. Screening bloodwork disclosed increased BUN, globulin, and total bilirubin concentrations, increased ALT, AST, ALP activities, and decreased albumin. An abdominal ultrasound disclosed a small left kidney with central mineralization. No abnormalities were identified that could explain the increased liver enzymes. An ultrasound-guided hepatic fine needle aspirate failed to disclose neoplasia, suppurative inflammation, or fatty vacuolation. At laparoscopy, the liver had a prominent reticular pattern with rounded edges, the pancreas was pale and possibly edematous, and a nest of tortuous vessels were observed at the caudal pole of the right kidney (aquired portosystemic shunts). Biopsies of the liver were collected. Chloe was diagnosed with chronic non-suppurative cholangiohepatitis associated with low-grade small cell T-cell lymphoma.