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Feline Cholangitis

Cholangitis is an inflammation of the ducts that carry bile from the liver to the intestine. It is the most common liver disease in cats after hepatic lipidosis. Bile helps digest fats. When the ducts become inflamed, it flows poorly, accum...

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Definition Signs Causes Diagnosis Treatment Prevention Complications When to see a vet Prognosis FAQ Sources Affected species

What is it?

Cholangitis is an inflammation of the ducts that carry bile from the liver to the intestine. It is the most common liver disease in cats after hepatic lipidosis.

Bile helps digest fats. When the ducts become inflamed, it flows poorly, accumulates and the liver in turn suffers.

Two main forms exist. The acute form, with a bacterial component, occurs suddenly with fever and jaundice: it often requires antibiotic treatment. The chronic form, linked to the immune system, sets in slowly and is treated over the long term.

Key point

Jaundice in a cat is never trivial: it requires a rapid veterinary examination.

Commonly observed signs

These signs are neither exhaustive nor specific. Only a veterinarian can establish a diagnosis.

Related signs — each one links to its page:

Jaundice Loss of appetite Vomiting Fever Reduction Weight loss Dark urine Diarrhea

Jaundice: gums, whites of the eyes and inside of the ears take on a yellow tint. The urine gets darker.

Loss of appetite and depression.

Vomiting, more rarely diarrhea.

Fever in acute form. The chronic form often progresses without fever.

Progressive weight loss in the chronic form, with misleading periods of remission.

Abdominal pain, discreet in the cat, which refuses to be handled.

Stomach sometimes distended when fluid accumulates in the abdomen.

In the chronic form, some cats maintain a good appetite for a long time despite the disease.

When to consult without delay

This list does not replace veterinary advice. It gathers situations that justify a prompt consultation.

Causes and risk factors

In the acute form, bacteria from the intestine travel up the bile duct to the liver. The anatomy of the cat, where the bile duct and the pancreatic duct meet before the intestine, facilitates this ascent.

In the chronic form, it is the immune system which permanently attacks the bile ducts.

Obstruction of the bile duct by bile sludge, a stone, inflammation of the pancreas or a mass aggravates or triggers the disease.

In some regions, parasites of the bile ducts are implicated.

Cholangitis is often associated with pancreatitis and inflammatory bowel disease: this is the picture of feline triaditis.

Cats with inflammatory bowel disease or pancreatitis.

The acute form mainly affects young to middle-aged cats; the chronic form, mainly older cats.

Any condition that slows the flow of bile.

No breed predisposition is firmly established.

Diagnosis and care

Diagnosis is the veterinarian's responsibility, based on clinical examination and laboratory tests. Care is decided case by case.

A blood test highlights liver damage and elevated bile pigments responsible for jaundice; she also looks for infection and assesses coagulation.

An ultrasound of the abdomen examines the liver, gallbladder, size of the bile ducts, pancreas and intestine, and looks for obstruction.

A bile sample by puncture of the gallbladder allows the bacteria in question to be identified and the appropriate antibiotic to be chosen: this is a decisive test in the acute form.

Liver samples confirm the form of cholangitis and guide long-term treatment.

As the three organs often go together in cats, the exploration of the pancreas and the intestine is carried out at the same time.

Treatment

The acute bacterial form is treated with antibiotics, ideally chosen based on analysis of the bile, for a prolonged period set by the veterinarian.

The chronic form with an immune component is mainly based on treatments modulating immunity, led by corticosteroids, with progressive adjustments.

Giving an immunosuppressive anti-inflammatory to a cat that actually has a biliary infection can make the situation worse: this is why the veterinarian seeks to establish the form before treating.

A medication that thins the bile and protects the liver is frequently combined, as are antioxidant supplements.

Infusion, anti-nausea and painkillers support the cat in the acute phase.

Resumption of food is a priority: a cat that no longer eats for two to three days adds hepatic lipidosis to its cholangitis. A feeding tube is placed if necessary.

Obstruction of the bile duct by a stone or mass may require surgical intervention.

Associated diseases of the pancreas and intestine are treated at the same time.

Treatment depends on the cause and the animal's condition: it must be determined by a veterinarian. No self-medication.

Prevention

There is no vaccine or specific prevention.

Treating chronic digestive diseases early limits the infiltration of bacteria into the bile ducts.

Consulting as soon as jaundice appears, even slight, allows treatment before the liver is very damaged.

Regular veterinary monitoring of an already affected cat makes it possible to adapt the treatment and identify relapses.

Never give human medicine to a cat: many are toxic to its liver.

Possible complications

Hepatic lipidosis added if the cat stops eating.

Complete obstruction of the bile duct, which becomes a surgical emergency.

Generalized infection from the bile ducts in the acute form.

Cirrhosis and liver failure in old chronic forms.

Accumulation of fluid in the abdomen and bleeding disorders.

When to see a veterinarian

The gums, the whites of the eyes or the inside of the ears of your cat take on a yellow tint: consult without delay.

His urine is abnormally dark.

He has a fever, is vomiting and refuses to eat.

He is depressed, hiding, seems to have stomach pain.

He slowly lost weight despite his retained appetite.

He has already been treated for pancreatitis or intestinal disease and his condition is deteriorating.

Prognosis

The acute bacterial form often responds well to appropriate and prolonged antibiotic treatment: many cats recover.

The chronic form can be controlled rather than cured; with regular monitoring, many cats live years comfortably.

The prognosis is more guarded in the event of obstruction of the bile duct, established cirrhosis or association with severe pancreatitis.

Premature termination of treatment, often because the cat is getting better, is a classic cause of relapse.

Frequently asked questions

How to spot jaundice in a cat?

Look at the gums, whites of the eyes and inside of the ears in daylight, rather than the fur. A yellow tint, even discreet, warrants a quick consultation.

Why should bile be collected?

Because this identifies the bacteria responsible and allows you to choose the truly effective antibiotic, instead of treating at random. This is what often makes the difference in the acute form.

My cat is getting better, can I stop the antibiotics?

No. Treatment of the bile ducts takes a long time and improvement long precedes recovery. Early cessation promotes relapse and resistance. Only the veterinarian decides whether to stop.

Is this disease transmissible to humans or other cats?

No. Even in the bacterial form, the bacteria involved come from the cat's digestive tract itself. There is no contagion between animals or towards humans.