ISSN 2398-2950      

Liver: cholangitis / cholangiohepatitis


Synonym(s): Cholangiohepatitis


  • 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, immune-mediated inflammation.
  • Signs: hepatic disease - icterus, pyrexia, anorexia, ascites, vomiting and diarrhea, lethargy, weight loss.
  • Diagnosis: biochemistry, imaging, 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 recognizable forms and both correlate to distinct, different clinical presentations that require different management.
Print off the owner factsheet Cholangitis/cholangiohepatitis in cats to give to your client.





Neutrophilic cholangitis/cholangiohepatitis (NC) (suppurative cholangiohepatitis)

  • Ascending bacterial infection, biliary obstruction and bacterial translocation.
  • Neutrophilic inflammation of bile duct which can extend beyond the limiting plate and into hepatic parenchyma. 
  • Role of concurrent cholelithiasis, bile duct/gall bladder anomalies, pancreatitis and inflammatory enteropathy in etiopathogenesis is by association but mechanisms are unclear.
  • Commonly occurs with pancreatitis Pancreatitis/intestinal inflammation (triaditis).
  • Common pancreaticobiliary duct may contribute to risk of infection/inflammation.
  • Biliary obstruction (extrahepatic bile duct obstruction; EHBDO) can occur with NC.

Lymphocytic cholangitis/cholangiohepatitis (LC) (non-suppurative cholangiohepatitis)

  • Immune-mediated inflamation with unknown trigger.
  • Infiltrate of small lymphocytes in portal region with varying degrees of fibrosis and bile duct proliferation.
  • Can occur with inflammatory enteropathy and pancreatitis (triaditis) Pancreatitis.


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Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Jaffey J A (2022) Feline cholangitis/cholangiohepatitis complex. J Small Anim Pract 63 (8), 573-589 PubMed.
  • Center S A, Randolph J F, Warner K L et al (2022) Bacterial culture and immunohistochemical detection of bacteria and endotoxin in cats with suppurative cholangitis-cholangiohepatitis syndrome. JAVMA 15 (2), 194-211 PubMed DOI: 10.2460/javma.20.10.0552.
  • Center S A, Randolph J F, Warner K L et al (2022) Clinical features, concurrent disorders, and survival time in cats with suppurative cholangitis-cholangiohepatitis syndrome. JAVMA 260 (2) 212-227 PubMed.

Other sources of information

  • WSAVA Liver Standardization Group (2006) Standards for Clinical and Histological Diagnosis of Canine and Feline Liver Diseases. Eds: Rothuzien J, Bunch S E, Cullen J M et al. Saunders/Elsevier, UK.

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