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Cholangitis / Cholangiohepatitis

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Bile is produced by the liver, stored in the gall bladder, and goes through the bile ducts into the intestines to digest fats.

Cholangitis is inflammation of the bile duct. Cholangiohepatitis is inflammation of the bile ducts, gall bladder and liver. These two conditions usually occur simultaneously and are referred to as CCHS.

When any of these organs become inflamed, bile production decreases and/or the bile cannot go through the ducts.

Left untreated, CCHS will cause liver failure.


CCHS can be classified as suppurative or nonsuppurative.

Suppurative CCHS is caused by a bacterial infection.

Nonsuppurative CCHS causes:

  • Immune-mediated disease: the body attacks the gall bladder and bile ducts
  • Tumors block the bile ducts


Suppurative signs are sudden and severe:

  • Painful abdomen
  • Vomiting
  • Fever
  • Jaundice
  • Lack of appetite
  • Collapse

Nonsuppurative signs are chronic and general:

  • Lethargy
  • Vomiting
  • Lack of appetite, weight loss


Your veterinarian will first test for other diseases that cause similar signs to CCHS. Some tests may include:

  • Thyroid testing for hyperthyroidism
  • Pancreatic testing for pancreatitis

If your veterinarian suspects CCHS, some tests may include:

  • Blood tests
  • Urine tests
  • X-rays: to look for tumors
  • Ultrasound: to look at the gallbladder and liver
  • Fine needle aspiration (using a think needle to take a cell sample) of the gall bladder
  • Biopsy to check the bile
  • Exploratory surgery


Most veterinarians will recommend the following treatments for cats with CCHS:

  • IV fluids: to stabilize the cat
  • Feeding tube
  • Antibiotics
  • Surgery: to remove gallstones or clear the bile duct if it is blocked

The rest of treatment depends on the underlying cause.


If the cause is suppurative, then the best preventative is to avoid bacterial infection.


Suppurative: there is a good prognosis with prompt treatment, usually needed long-term.

Nonsuppurative: the prognosis depends on the severity. If the case is advanced, the prognosis is not so good.

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