Cholangiohepatitis
describes a condition in which there is inflammation in the liver and the
biliary tree (gallbladder and bile ducts). In the cat, this is one of the
most common causes of liver problems.
What causes
cholangiohepatitis?
Bacterial infections that ascend from the intestinal tract are thought to
be one of the common causes of cholangiohepatitis. Bacterial infections
elsewhere in the body that secondarily affect the liver and biliary tree
may also play a role. Unfortunately, at this time it is not known why cats
develop this problem or what measures can be taken to prevent it.
What are the signs
of cholangiohepatitis?
The signs we typically see in these patients are not specific to
cholangiohepatitis. Vomiting, diarrhea, loss of appetite or jaundice are
all symptoms that can be seen with this problem. Signs may be intermittent
or persistent.
How is this disorder
diagnosed?
Aside from the history and the physical examination, blood tests may
provide the first clues as to the presence of a liver problem. Elevations
in the liver values, white cell counts and/or abnormal protein levels are
commonly seen. The next step may be
to perform radiographs (x-rays) of the abdomen to look at the size and
position of the liver. An abdominal ultrasound is also helpful in allowing
visualization of the inside of the liver to assess the texture, look for
an obstruction in the gallbladder or biliary tree, or look for any
discrete masses.
A definitive
diagnosis of cholangiohepatitis requires a biopsy of the liver. This may
be done either surgically, laparoscopically or percutaneously. Your
veterinarian will guide you in selecting the most appropriate method in
each case.In some instances,
an aspirate of the liver may be performed prior to a biopsy. An aspirate
is performed using a small needle to obtain cells from the liver that may
give some insight as to the underlying disease process. Aspirates are not
always diagnostic however so your veterinarian will guide you as to
whether or not this is an appropriate diagnostic procedure for your cat.
How is
cholangiohepatitis treated?
Antibiotics are the treatment of choice for this disorder. Often, these
patients need to stay on antibiotic therapy for 4-6 weeks. If the biopsy
indicates a chronic inflammatory problem, anti-inflammatory medications
may be used as well. In most cases, prompt diagnosis and appropriate
therapy leads to a successful outcome.
