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Also known as ''suppurative cholangitis'', ''exudative cholangitis/cholangiohepatitis'' and ''acute cholangitis/cholangiohepatitis''.

Also known as ''suppurative cholangitis'', ''exudative cholangitis/cholangiohepatitis'' and ''acute cholangitis/cholangiohepatitis''.

==Signalment==

==Signalment==

==Description==

==Description==

'''Neutrophilic cholangiohepatitis''' is characterised by infiltration of large numbers of [[Neutrophils - WikiBlood|neutrophils]] into portal areas of the [[Liver - Anatomy & Physiology|liver]] and into the [[Liver - Anatomy & Physiology #Hepatic Duct Systems|bile ducts]].  It results from ascending bacterial infection from the [[Small Intestine - Anatomy & Physiology|small intestines]].  [[Escherichia coli]], [[Staphylococcus spp.]], ''[[Streptococci|Streptococcus]] spp.'', ''[[Clostridium species|Clostridium spp.]]'', ''[[Bacillus species|Bacillus spp.]]'', ''[[Actinomycetes|Actinomyces spp.]]'', ''[[Bacteroides|Bacteroides spp.]]'' and occasionally ''[[Salmonella|Salmonella spp.]]'' have been isolated.  Concurrent biliary tract disease are common in cats, especially [[Pancreatitis - WikiClinical|pancreatitis]] and [[Inflammatory Bowel Disease - WikiClinical|inflammatory bowel disease]].  Other predisposing factors include congenital or acquired abnormalities of the biliary system such as that of anatomic abnormalities of the [[Gall Bladder - Anatomy & Physiology|gall bladder]] or common bile duct, bile duct obstruction caused by inspissated bile, cholelithiasis and cholecystitis.

'''Neutrophilic cholangiohepatitis''' is characterised by infiltration of large numbers of [[Neutrophils - WikiBlood|neutrophils]] into portal areas of the [[Liver - Anatomy & Physiology|liver]] and into the [[Liver - Anatomy & Physiology #Hepatic Duct Systems|bile ducts]].  It results from ascending bacterial infection from the [[Small Intestine - Anatomy & Physiology|small intestines]].  [[Escherichia coli]], [[Staphylococcus spp.]], ''[[Streptococci|Streptococcus]] spp.'', ''[[Clostridium species|Clostridium spp.]]'', ''[[Bacillus species|Bacillus spp.]]'', ''[[Actinomycetes|Actinomyces spp.]]'', ''[[Bacteroides|Bacteroides spp.]]'' and occasionally ''[[Salmonella|Salmonella spp.]]'' have been isolated.  Concurrent biliary tract disease are common in cats, especially [[Pancreatitis - WikiClinical|pancreatitis]] and [[Inflammatory Bowel Disease - WikiClinical|inflammatory bowel disease]].  Other predisposing factors include congenital or acquired abnormalities of the biliary system such as that of anatomic abnormalities of the [[Gall Bladder - Anatomy & Physiology|gall bladder]] or common bile duct, bile duct obstruction caused by inspissated bile, cholelithiasis and cholecystitis.

==Diagnosis==

==Diagnosis==

*[[Liver General Pathology - Pathology|jaundice]]

*[[Liver General Pathology - Pathology|jaundice]]

*dehydration

*dehydration

===Laboratory Tests===

===Laboratory Tests===

*Normally to slightly increased alkaline phosphatase (ALP)

*Normally to slightly increased alkaline phosphatase (ALP)

*Normal to slightly increased total bilirubin concentration

*Normal to slightly increased total bilirubin concentration

===Diagnostic Imaging===

===Diagnostic Imaging===

====Ultrasonography====

====Ultrasonography====

A coarse or nodular texture to the liver can be seen.  However, most have variable or no detectable changes in echogenicity of the liver parenchyma.  More chronic cases may have dilation of the biliary tract.

A coarse or nodular texture to the liver can be seen.  However, most have variable or no detectable changes in echogenicity of the liver parenchyma.  More chronic cases may have dilation of the biliary tract.

===Histopathology===

===Histopathology===

Liver cytology or tissue biopsy is required to differentiate inflammatory liver disease from [[Hepatic Lipidosis - WikiClinical|hepatic lipidosis]] and [[Neoplasia - Pathology|neoplasia]].  Bile samples for cytology is needed for a definitive diagnosis.  It is not adequate to perform liver biopsy alone as the disease tend to be confined to the biliary tract and pathology of the liver can be non specific and  mild.  Cytologically, neutrophilic cholangitis usually shows bacteria and [[Neutrophils - WikiBlood|neutrophils]].  Culture and sensitivity should be performed for appropriate choice of antibiotics.

Liver cytology or tissue biopsy is required to differentiate inflammatory liver disease from [[Hepatic Lipidosis - WikiClinical|hepatic lipidosis]] and [[Neoplasia - Pathology|neoplasia]].  Bile samples for cytology is needed for a definitive diagnosis.  It is not adequate to perform liver biopsy alone as the disease tend to be confined to the biliary tract and pathology of the liver can be non specific and  mild.  Cytologically, neutrophilic cholangitis usually shows bacteria and [[Neutrophils - WikiBlood|neutrophils]].  Culture and sensitivity should be performed for appropriate choice of antibiotics.

==Treatment==

==Treatment==

*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]]

*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.

==Prognosis==

==Prognosis==

Good provided the cats are treated early and appropriately.

Good prognosis provided the cats are treated early and appropriately.