Cholangitis, Lymphocytic

Also known as lymphocyticplasmacytic cholangitis or cholangiohepatitis, lymphocytic portal hepatitis and nonsuppurative cholangitis or cholangiohepatitis.

Signalment

Young to middle-aged cats.

Description

Lymphocytic cholangitis is a slowly progressive chronic disease characterised by infiltration of the portal areas of the liver with small lymphocytes. Although an immune-mediated aetiology has been postulated, the disease has failed to respond to immunosuppressive medications.

Diagnosis

Clinical Signs

History of chronic waxing and waning low-grade illness. Vague clinical signs which include anorexia, depression, weight loss, intermittent vomiting and diarrhoea, jaundice. Severe illness and pyrexia less likely compared to Neutrophilic Cholangitis. Some cats in the UK are polyphagic and are frequently presented with ascites and/or jaundice.

Haematology & Biochemistry

Over half of the cats have marked hyperglobulinaemia Neutrophilia is less common than with acute cholangitis

Imaging

Radiographic signs are non specific. Hepatomegaly due to enlargement of biliary ducts and ascites in some cases. Ultrasonograpy is more helpful and biliary tract dilation can be seen in all cases. Common bile duct is normally dilated and the gallbladder may also be dilated with "sludge". Main differential is extrahepatic biliary obstruction.

Biopsy

Liver biopsy is important to rule out FIP. It is vital to obtain haemostasis profile prior