Difference between revisions of "Cholangitis, Neutrophilic"

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==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 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.
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==Diagnosis==
 
==Diagnosis==
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Acute presentation with pyrexia, abdominal pain, lethargy, jaundice.
 
Acute presentation with pyrexia, abdominal pain, lethargy, jaundice.
  
===Haematology & Biochemistry===
+
*Haematology & Biochemistry
 
Increased segmented and band neutrophils.
 
Increased segmented and band neutrophils.
 
Increased ALT and total bilirubin concentration
 
Increased ALT and total bilirubin concentration
  
===Imaaging===
+
*Imaaging
 
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.
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==Treatment==
 
==Treatment==
  
 
==Prognosis==
 
==Prognosis==

Revision as of 11:58, 6 August 2009

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

Signalment

More common in cats than in dogs. Cats of all breeds and ages can be affected, but often young to middle-aged cats. Male cats are more at risk.

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.


Diagnosis

  • Clinical Signs

Acute presentation with pyrexia, abdominal pain, lethargy, jaundice.

  • Haematology & Biochemistry

Increased segmented and band neutrophils. Increased ALT and total bilirubin concentration

  • Imaaging

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

  • 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.


Treatment

Prognosis