VET SPEAK: Prompt treatment of this condition can help your cat's chances of survival
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Pancake was a five-year-old, Persian cat. He was brought into the surgery as he had gone right off his food and he was vomiting, writes ALISON LAURIE-CHALMERS.
He was miserable, his abdomen was painful to touch, and he was rapidly becoming dehydrated. He was given pain-relief and anti-sickness treatments and immediately admitted to the clinic for further tests, which revealed he had Cholangiohepatitis.
Among the many important roles performed by a cat’s liver is its contribution to digestion. This relies on the liver’s efficient manufacture and secretion of bile, which travels from the liver via the biliary system to the gall bladder until required within the intestinal tract. It then travels to the small intestine, where it performs digestive processes.
Among the most common causes of liver disease in cats is Cholangiohepatitis, a condition marked by inflammation of the biliary system, the bile ducts and gall bladder, and of the surrounding liver tissue.
This can be caused by bacterial infection inside the gut, the pancreas or small intestine, which then travels up the biliary tract. This form – referred to as suppurative, pus-forming – tends to respond positively to antibiotics. The other form, non-suppurating Cholangiohepatitis, is more common and is an immune phenomenon caused when the body attacks itself, in this case the tissues of the gall bladder or bile ducts. It tends to be treated with immunosuppressive drugs.
In either case, the secondary inflammation of tissues interferes with the flow of bile. Bile can be caustic, and cause significant tissue damage if its passage is impeded.
The typical signs of Cholangeohepatitis include abdominal pain, loss of appetite, fever, vomiting, and jaundice which causes a yellowing of skin, eyes, gums, and mucous membranes. Non-suppurative cases often have vague symptoms such as lethargy, vomiting, anorexia, and a weight loss.
Because the signs for both types are like those associated with other serious liver disorders, a variety of tests may be needed to reach a diagnosis.
In addition to a full blood work up, and a urinalysis, abdomen imaging with an abdominal ultrasound is also used. An ultrasound-guided fine-needle aspiration and biopsy of the liver and gall bladder and bile may also be done. In some cases, exploratory surgery may be required.
To complicate things, cases can often have an accompanying Triaditis. This is the term used to describe the combination of Cholangiohepatitis, pancreatitis, and inflammatory bowel disease (IBD). Eighty-three per cent of cats with Cholangiohepatitis also were found to have inflammation of their small intestine, and half of cats with it had lesions on their pancreas. An underlying inflammatory bowel disease may cause bacteria in the bowel to infect the bile duct, resulting in pancreatitis and Cholangiohepatitis. In general, the prognosis for feline Cholangiohepatitis is unpredictable. Treatment depends on the clinical signs and underlying cause. If diagnosed early, cats with the suppurative form may respond well to antibiotics and return to normal.
Also, long-term remission is possible in cats effectively treated for the non-suppurative type.
But the prognosis is often poor for cats diagnosed with either type at an advanced stage. In all cases, prompt treatment maximizes chances of success.
Wee Pancake had the suppurative form but responded well to treatments.
If you are concerned about symptoms, contact your vet as soon as possible.
Alison Laurie-Chalmers is a senior consultant at Crown Vets.
