Cholangitis

What It Is:

Cholangitis is a condition where the bile ducts and surrounding liver tissue become inflamed, interfering with the liver’s ability to remove waste and aid in digestion. In cats, cholangitis is one of the most common liver disorders, often linked to infections, inflammation, or other digestive diseases.

There are two primary forms: neutrophilic cholangitis, which is usually caused by bacterial infection, and lymphocytic cholangitis, which is thought to be immune mediated.

Cholangitis frequently occurs as part of Triaditis, along with pancreatitis and inflammatory bowel disease.

🐾 Common Symptoms

Cats with cholangitis often show signs of general illness and digestive upset:

• Decreased appetite
• Vomiting
• Weight loss
• Lethargy
• Fever
• Jaundice (yellowing of eyes, ears, or gums)
• Abdominal discomfort
• Dehydration
• Diarrhea (less common)

In early stages, symptoms may be mild and easy to miss. In more advanced cases, cats may become very sick and require hospitalization.

🦠 Causes and Risk Factors

The exact cause depends on the type of cholangitis:

Neutrophilic cholangitis

• Caused by bacteria entering the bile ducts from the intestines
• Often occurs alongside pancreatitis or intestinal inflammation
• Common in acute or sudden illness

Lymphocytic cholangitis

• Believed to be immune mediated
• Progresses slowly and is more common in chronic cases
• Often seen in middle aged or older cats

Other contributing factors may include:

• Triaditis
• Prior digestive infections
• Anatomical design of the feline digestive tract
• Stress or sudden diet changes
• Genetic predisposition

🔍 Diagnosis

Cholangitis is often suspected based on symptoms and bloodwork but requires imaging and sometimes biopsy to confirm.

Diagnostics may include:

• Bloodwork to check liver enzymes, white blood cell count, and bilirubin
• Abdominal ultrasound to examine the liver, gallbladder, and bile ducts
• Liver aspirate or biopsy to determine the type of inflammation
• Bile culture to identify bacterial infection
• FIV and FeLV testing to rule out viral contributors

Diagnosing the exact type of cholangitis is important because treatment varies.

💊 Treatment

Treatment depends on the type of cholangitis and the severity of illness.

For neutrophilic cholangitis:

• Antibiotics targeting bile duct bacteria
• Fluids and supportive care for dehydration or fever
• Pain medication
• Anti nausea medication
• Feeding support if the cat is not eating
• Liver protectants like SAMe or milk thistle

For lymphocytic cholangitis:

• Steroids such as prednisolone to reduce immune system inflammation
• Immunosuppressants in some cases
• Ongoing monitoring and bloodwork
• Liver support supplements and special diet

Cats with cholangitis may also be treated for coexisting conditions like pancreatitis or IBD.

🩺 Prognosis

Prognosis depends on the type and how early treatment begins:

• Neutrophilic cholangitis often responds well to antibiotics and has a good outlook if treated early
• Lymphocytic cholangitis tends to be more chronic and requires long term management, but many cats remain stable for years
• Cats with Triaditis or other chronic illness may need ongoing monitoring and medication

Relapses are possible, so follow up care is important.

💡 Cat Owner Note

The liver is a quiet worker until something goes wrong. If your cat starts eating less, throws up frequently, or starts to look a little yellow, it could be more than a stomach bug. Cholangitis can be serious, but with the right treatment, most cats feel better quickly and stay stable with long term care.

❓ Frequently Asked Questions About Cholangitis

Is cholangitis contagious?
No. It is not contagious between cats or to humans.

Can cholangitis be cured?
Neutrophilic cholangitis can often be cured with antibiotics. Lymphocytic cholangitis is usually managed long term but not cured.

How long will my cat need medication?
That depends on the type. Bacterial cholangitis may require a few weeks of antibiotics. Immune based cholangitis often needs lifelong management.

Is jaundice a sign of cholangitis?
Yes. Yellowing of the skin or eyes can indicate liver dysfunction, including cholangitis.

Can cholangitis come back?
Yes. Some cats have flare ups or relapses and need their treatment plan adjusted.

What should I feed a cat with liver disease?
Your vet may recommend a prescription liver diet or a highly digestible food that supports liver function and reduces inflammation.