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Cholangiohepatitis Cholangitis and cholangiohepatitis are inflammatory and/or infectious diseases affecting the liver and bile ducts. E coli infection can ascend the bile ducts into the liver to cause an infectious cholangiohepatitis, chronic or lymphocytic cholangiohepatitis causes a sterile inflammatory process that may be caused by an abnormal immune response. Cirrhosis is the end-stage of chronic liver disease, resulting in terminal liver failure. It is the least common form because many cats die before the chronic form progresses to cirrhosis. The clinical signs of these disorders are similar. Jaundice, lethargy, inappetance, and vomiting can occur. Fever is common in the acute form. Cats with the chronic form have recurrent episodes of clinical signs interspersed with weeks or months of being apparently healthy. Blood tests to assess liver function are an important aid to diagnosis. Liver biopsy is diagnostic but the procedure does carry a degree of risk. Ultrasound can non-invasively indicate liver abnormalities but is not specific for acute or chronic cholangiohepatitis, and the study may appear normal. Ultrasound is however very useful in determining the presence of biliary obstruction. X-rays may show an enlarged liver, or in cases or cirrhosis and shrunken and fibrous liver. Therapy with intravenous fluids and nutritional support is important in stabilising these cases. Antibiotics are required in cases of acute infectious hepatitis, corticosteroids such as prednisolone are helpful in acute cases and form the mainstay of treatment for chronic cases. Symptomatic therapy for vomiting with antacids will be used if necessary. The prognosis varies with the form of the disease. Most cats with the acute form recover clinically in a few days. The chronic form requires continuous therapy in many cats. Those that respond well have a good prognosis, but those that progress to cirrhosis have a poor prognosis. |
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