Cholangitis (inflammation of the bile ducts) and cholangiohepatitis (inflammation of the bile ducts and the liver) are commonly occurring problems in cats. Cats with cholangitismay not appear ill whereas cats with cholangiohepatitis usually appear ill.
Cause – The commonest causes of cholangitis and cholangiohepatitis are bacterial infections, pancreatitis, enteritis or an immune-mediated disease.
Breed/Sex Predisposition – Any breed of cat can be affected, although Himalayan, Persian, and Siamese cats seem to be afflicted more frequently. Male cats seem to suffer from Cholangiohepatitis more frequently.
Signs – The clinical signs are variable. The most common signs include anorexia, fever, depression, vomiting, diarrhoea, and weight loss.
Diagnosis – Diagnosis can be difficult. A presumptive diagnosis can be made following appropriate blood tests, radiographs, and ultrasonography. Liver biopsies are usually required for a definitive diagnosis.
Treatment – Treatment is based on the underlying cause and often includes antibiotics, steroids, and drugs to re-establish the flow of bile (destolit). These drugs may need to be given for weeks to months. Cats with poor appetites may need fluid therapy, nutritional supplements, and dietary changes. The inciting cause will need to be treated at the same time. In some cases if the bile duct is obstructed, it may need to be cleared surgically.
Prevention –There is no way to prevent cholangitis/cholangiohepatitis. If cholangiohepatitis is left untreated, it will eventually cause liver destruction and failure.
Prognosis – Liver disease is always serious. However, many pets with liver disease can be managed successfully. The liver has the capability of regenerating itself and so many pets with liver disease will recover. The prognosis for pets with cholangiohepatitis, treated with the appropriate type of antibiotics and for sufficient time, is good. Although approximately half of the cats die or are euthanised within one year after diagnosis, 40% survive between one and five years, and the rest can be expected to have prolonged survivals beyond five years. The prognosis for pets with immune-mediated disease, particularly if the case is advanced, is not as good.
Cholangiohepatitis is frequently seen in conjunction with pancreatitis and inflammatory bowel disease (IBD) in a condition known as TRIADINITIS. Despite the high incidence of inflammation in the small intestine, diarrhoea is not a frequent finding in cats with cholangiohepatitis.