Changes

**A long course, 4-6 weeks, of an appropriate antibiotic should be given in light of bacterial culture and sensitivity results.

**A long course, 4-6 weeks, of an appropriate antibiotic should be given in light of bacterial culture and sensitivity results.

**Selected antibiotic should be excreted in the bile in active form, and should be active against aerobic and anaerobic intestinal coliforms.   

**Selected antibiotic should be excreted in the bile in active form, and should be active against aerobic and anaerobic intestinal coliforms.   

**Amoxicillin potentiated with clavulanic acid is a good initial choice.

**[[Penicillins|Amoxicillin]] potentiated with clavulanic acid is a good initial choice.

**Metronidazole may be added to extend the spectrum of anaerobes and coliforms.

**[[Nitroimidazoles|Metronidazole]] may be added to extend the spectrum of anaerobes and coliforms.

*Surgery is warranted if discrete choleliths or complete biliary obstruction is identified.   

*Surgery is warranted if discrete choleliths or complete biliary obstruction is identified.   

**In cases of complete extrahepatic biliary obstruction, surgical decompression and cholecystoduodenostomy or cholecystojejunostomy should be performed.

**In cases of complete extrahepatic biliary obstruction, surgical decompression and cholecystoduodenostomy or cholecystojejunostomy should be performed.

*Ursodeoxycholic acid may be given.

*[[Liver Drugs|Ursodeoxycholic acid]] may be given.

**It has hepatoprotective (anti-inflammatory, immunomodulatory and antifibrotic effects) properties and choleretic effect.  The latter promotes increased fluidity of biliary secretions for treating or preventing sludging.

**It has hepatoprotective (anti-inflammatory, immunomodulatory and antifibrotic effects) properties and choleretic effect.  The latter promotes increased fluidity of biliary secretions for treating or preventing sludging.

*Aggressive supportive care is required due to severe illness.

*Aggressive supportive care is required due to severe illness.

**Fluid and electrolyte derangements should be corrected.

**Fluid and electrolyte derangements should be corrected.

**Vitamin K1 may be given if bleeding diatheses develop.

**Vitamin K1 may be given if bleeding diatheses develop.

*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 - WikiClinical|hepatic lipidosis]]

*Monitor response to treatment with serial complete haematology and biochemistry.

*Monitor response to treatment with serial complete haematology and biochemistry.