Cholangiohepatitis refers to the system that contains bile and that surrounds the liver tissue. In cats, it occurs in the form of biliary cirrhosis, suppurative and nonsuppurative cholangiohepatitis. With the cirrhosis, scarring is seen in the liver and on the biliary system. With the suppurative, white blood cells (neutrophils) are seen in biopsies. With the nonsuppurative, white blood cells referred to as lymphocytes and the plasma cells are also seen on biopsy. Cholangiohepatitis is common in cats and frequent in dogs. All the breeds of cats can be easily affected but not as much as it affects the Siamese, Persian and Himalayan cats. This condition occurs in animals that are middle-aged and the males seem to be at a greater risk of the suppurative form of this disease.
The suppurative form of cholangiohepatitis occurs due to two major reasons. When infections ascend from the intestinal tract. This may be because of other diseases like pancreatitis, parasite and bacterial infection. When infections are carried through the bloodstream like salmonella bacteria, toxoplasmosis parasite and viral infections like peritonitis.
The nonsuppurative cholangiohepatitis occurs due to a disorder in the immune system which is closely associated with the following conditions:
- Inflammation of the gallbladder (cholecystitis).
- Stones present in the gallbladder (cholelithiasis).
- Inflammation of the pancreas (pancreatitis).
- Obstruction of the extra-hepatic biliary.
- Intestinal nephritis.
Symptoms and diagnosis
The symptoms of cholangiohepatitis diseases are fever, dehydration, weight loss, lethargy (collapse), loss of appetite, diarrhea, vomiting, jaundice, seizure, blindness, disorientation and excessive salivation. Identification of cholangiohepatitis can tend to difficult and it may often require use of several diagnostic tests. The veterinarian may need to refer your cat for further evaluation by a specialist. Certain tests are then carried out to determine how severe the disease is. These tests include:
- Complete blood count (CBC), urinalysis and biochemical profile.
- Abdominal ultrasound.
- A coagulogram (clotting profile).
- Abdominal X-rays.
- Serum bile acids.
- Blood tests for toxoplasmosis.
- Liver biopsy.
There are other diseases that appear similar to cholangiohepatitis. These include:
- Feline hepatic lipidosis whereby fat builds up in the liver making it not function normal.
- Porto systemic shunts which occurs at birth.
- Hepatic neoplasia which is cancer of the liver.
- Exposure to hepatotoxins which are drugs or agents that is harmful to the liver. E.g. metals like copper, mercury, arsenic, lead, anti-inflammatory agents like carprofen and steroids, anticonvulsants and sprays.
- Extra-hepatic biliary blockage.
- Inflammation of the pancreas
- Pancreatic neoplasia
- Intestinal inflammation.
There are certain ways to treat this disease:
- Hospitalization and supportive care.
- Antibiotic therapy.
- Treating any other medical disorders.
- Proper Nutrition and dietary management.
- Using Vitamin supplements.
- Using Immune modulation drugs.
- Choler tic drugs for enhancing flow of bile.
- Lactulose for slowing down absorption of ammonia from the colon.
- Diuretics for helping the body eliminate excess abdominal fluid.
There is no preventative measure that is recommended in the patients but control over inflammatory bowel disease may be of much help. Therapy comes in when after many evaluations fail. However, you should give all recommended nutrient supplements and medication as prescribed by your veterinarian. You should also go back for follow-ups evaluations and checkups.
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