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Liver: cholangiohepatitis
Introduction
- Uncommonly recognized in dogs.
- Hepatitis due to edema and sluggish bile flow may be concurrent.
- Cause: ascending infection.
- Signs: hepatic disease with icterus: pyrexia, anorexia, vomiting and diarrhea, lethargy, weight loss, ascites.
- Diagnosis: biochemistry, ultrasonography, gall bladder aspiration, biopsy.
- Treatment: antibiotics, other supportive measures.
- See also acute hepatic disease Liver: acute disease.
Presenting signs
- Vague, intermittent illness.
- Pyrexia of unknown origin.
Age predisposition
- Generally middle aged to older dogs, although young animals can be affected.
Pathogenesis
Etiology
- Cholangiohepatitis likely occurs due to bacteria ascending from the intestinal tract.
- Clostridium spp Clostridia spp andEscherichia coli Escherichia coli are the most frequently documented bacteria. Others may include salmonella spp Salmonella spp , Campylobacter jejuni Campylobacter jejuni , Klebsiella spp Klebsiella pneumoniae , Bacteroides spp Bacteroides fragilis , Actinomyces spp and Streptococcus spp Streptococcus spp.
- May also occur secondary to bacteremia.
Specific
- Predisposing causes include:
- Bile duct/gall bladder anomalies.
- Intestinal abnormalities such as bacterial overgrowth.
- Other small or large intestinal disorders such as motility disorders, clostridial disease.
- Cholelithiasis.
Pathophysiology
- Ascending bacterial infection → hepatitis → immune-mediated response.
- Role of concurrent cholelithiasis Biliary system: disease (cholestatic disease) , bile duct/gall bladder anomalies, pancreatitis Pancreatitis: acute and inflammatory bowel disease Inflammatory bowel disease: overview in etiopathogenesis unclear.
Timecourse
- Depends on etiology.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- O'Neill E J, Day M J, Hall E J, Holden D J, Murphy K F, Barr F J & Pearson G R (2006) Bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis in four dogs. JSAP 47 (6), 325-335 PubMed.
- Center S A (1999) Chronic liver disease - current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.
- Fuentealba C et al (1997) Chronic hepatitis - a retrospective study in 34 dogs. Can Vet J 38 (6), 365-373 PubMed.
- Forrester S D, Rogers K S, Relford R L (1992) Cholangiohepatitis in a dog. JAVMA 200 (11), 1704-1706 PubMed.
- Neer T M (1992) A review of disorders of the gallbladder and extrahepatic biliary tract in the dog and cat. J Vet Int Med 6 (3), 186-192 PubMed.
Other sources of information
- Willard M D (2005)diseases of the gallbladder and extrahepatic biliary system. In:Textbook of Veterinary Internal Medicine. 6th edn. Eds: S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 1478-1482.
- Center S A (1996)diseases of the gall bladder and biliary tree.In:Strombeck's Small Animal Gastroenterology. 3rd edn. Eds: W G Guildfordet al. W B Saunders, Philadelphia, PA , USA. pp 860-877.