Changes

==Aetiology and Pathogenesis==

==Aetiology and Pathogenesis==

Neutrophilic cholangitis/cholangiohepatitis results from asecending bacterial infection from the small intestines.  ''Escherichia coli'', ''Staphylococcus spp.'', ''Streptococcus spp.'', ''Clostridium spp.'', ''Bacillus'', ''Actinomyces'', ''Bacteroides'' and occasionally ''Salmonella spp.'' have been isolated.  Concurrent biliary tract disease are common in cats, especially pancreatits and inflammatory bowel diesease.  Other predisposing factors include bile duct obstruction, cholelithiasis, cholecystitis.

Neutrophilic cholangitis/cholangiohepatitis results from ascending bacterial infection from the small intestines.  ''Escherichia coli'', ''Staphylococcus spp.'', ''Streptococcus spp.'', ''Clostridium spp.'', ''Bacillus'', ''Actinomyces'', ''Bacteroides'' and occasionally ''Salmonella spp.'' have been isolated.  Concurrent biliary tract disease are common in cats, especially pancreatitis and inflammatory bowel disease.  Other predisposing factors include bile duct obstruction, cholelithiasis, cholecystitis.

Increased ALT and total bilirubin concentration

Increased ALT and total bilirubin concentration

*Imaaging

*Imaging

A coarse or nodular texture to the liver on ultrasonography.  More chronic cases may have dilation of the biliary tract.

A coarse or nodular texture to the liver on ultrasonography.  More chronic cases may have dilation of the biliary tract.

*Cytology and Culture

*Cytology and Culture

Bile samples for cytology is needed for a definitive diagnosis.  Histopathology of the liver alone is not adequate as the disease tend to be confied to the bialiary tract and pathology of the liver can be non speciic and  mild.  Cytology shows bacteria and neutrophils.  Culture and sensitivity should be performed for appropriate choice of antibiotics.

Bile samples for cytology is needed for a definitive diagnosis.  Histopathology of the liver alone is not adequate as the disease tend to be confined to the biliary tract and pathology of the liver can be non specific and  mild.  Cytology shows bacteria and neutrophils.  Culture and sensitivity should be performed for appropriate choice of antibiotics.

==Treatment==

==Treatment==

*Long course, 4-6 weeks, of an appropiate antibiotic following culture and senstitivity should be used.  Amoxicillin at 15-20 mg/kg PO q8hours is a good initial choice.

*Long course, 4-6 weeks, of an appropriate antibiotic following culture and sensitivity should be used.  Amoxicillin at 15-20 mg/kg PO q8hours is a good initial choice.

*Ursodeoxycholic acid at 15 mg/kg q24hours may be given due to its choleretic, which promotes increased fluidity of biliary secretions to treat or prevent sludging, and hepatoprotective (anti-inflammatory, immunomodulatory and antifibrotic effects) properties.

*Ursodeoxycholic acid at 15 mg/kg q24hours may be given due to its choleretic, which promotes increased fluidity of biliary secretions to treat or prevent sludging, and hepatoprotective (anti-inflammatory, immunomodulatory and antifibrotic effects) properties.

*A high protein diet rather than a protein-restricted diet is more appropriate for feeding anorexic cats to prevent the development of hepatic lipidosis

*A high protein diet rather than a protein-restricted diet is more appropriate for feeding anorexic cats to prevent the development of hepatic lipidosis

==Prognosis==

==Prognosis==

Good provided the cats are treated early and appropiately.

Good provided the cats are treated early and appropriately.