Liver: cholangitis

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Sections available in full article Introduction, Presenting signs, Age predisposition, Breed predisposition, Pathogenesis, Etiology, Pathophysiology, Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Standard treatment, Sequelae, Prognosis, Sources, Publications, Vetstream contributor(s),
Contributors Prof Ed Hall MA VetMB PhD DipECVIM MRCVS
Dr Mark W Jackson BSc DVM PhD DACVIM MRCVS
Synonyms Cholangiohepatitis

Introduction

  • A group of inflammatory liver diseases with a spectrum of histological classifications including neutrophilic (suppurative), and inflammatory (lymphocytic and biliary cirrhosis)*.
  • Cause : unknown, ascending infection from gut.
  • Signs : hepatic disease - icterus, pyrexia, anorexia, ascites, vomiting and diarrhea, lethargy, weight loss.
  • Diagnosis : biochemistry, biopsy.
  • Treatment : supportive as for hepatic disease, specific therapy depends on histological type.
  • See also acute hepatic disease  Liver: acute disease  .
  • * From the WSAVA Liver Standardization Group (2006):
    • Neutrophilic cholangitis (acute and chronic).
    • Lymphocytic cholangitis (acute and chronic).
    • Chronic cholangitis (fluke infestation in endemic areas (not UK)).
    • For neutrophilic and lymphocytic cholangitis terminology is descriptive of the major infiltrating cell type but mixed inflammatory reactions can occur. These are the two most clearly recognisable forms and both correlate to distinct, different clinical presentations that require different management.

Diagnosis

Clinical signs

  • Icterus.
  • Mild hepatomegaly.
  • Normal liver size.
  • Variable abdominal pain.
  • Vomiting and diarrhea, especially if concurrent triaditis.
  • Ascites.

Diagnosis

Differential diagnosis

  • Triaditis (cholangiohepatitis and pancreatitis  Pancreatitis  with inflammatory bowel disease  Inflammatory bowel disease: overview  ).
  • FIP - for jaundice and ascites.
  • Neoplasia with extra-hepatic bile ducct obstruction.

Sequelae

Prognosis

  • Variable - some resolve, depends on stage and type of disease.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Weiss D J, Gagne J M & Armstrong P J (1996)Relationship between inflammatory hepatic disease and inflammatory bowel disease, pancreatitis and nephritis in cats.JAVMA209, 1114-1116.

 

Other sources of information

  • Marks S L (2008)Feline hepatic disorders: update on diagnosis and management.Proceedings of the51st BSAVA Congress, pp 201-205.
  • Jackson M W (2008)New developments in liver disease in cats.ESFM Pre-Congress Symposium, 33rd WSAVA Congress.
  • WSAVA Liver Standardization Group (2006). Standards for clinical and histological diagnosis of canine and feline liver diseases.Rothuzien J, Bunch S E, Cullen J M, Charles J A, Desmet V J, Twedt D C, van den Ingh T, van Winkle T, Washabua J (eds), Saunders/Elsevier, Edinburgh.

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