🧬 Vet Guide to Cholangitis and Cholangiohepatitis in Cats (2025) 🐱🩺

Cholangitis and cholangiohepatitis are among the most common liver conditions in cats, and yet they often leave pet owners puzzled due to vague symptoms and complicated terminology. Whether caused by bacterial infections, immune system disorders, or parasitic flukes, this condition can be treatable when caught early. In this 2025 guide, Dr. Duncan Houston BVSc explains everything you need to know about recognizing, diagnosing, and managing this liver disease in cats. 🧪🐾

🩻 What Is Cholangitis vs. Cholangiohepatitis?

While these terms are often used interchangeably, they technically mean:

• 🔬 Cholangitis: Inflammation of the bile duct system (biliary tree)
• 🧬 Cholangiohepatitis: Inflammation of both the bile ducts and surrounding liver cells

Cholangitis is the more commonly used term today, but your vet may still refer to both, especially when explaining chronic cases. Bile, produced by the liver and stored in the gallbladder, helps digest fats and excrete toxins. Infection or inflammation within this system can have widespread effects on digestion and detoxification. 🦠

🔗 Triaditis: The Three-Organ Syndrome

Cholangitis often occurs alongside two other feline conditions:

• 🔄 Pancreatitis: Inflammation of the pancreas
• 🧠 Inflammatory Bowel Disease (IBD): Immune-driven inflammation of the intestines

This combination—cholangitis, pancreatitis, and IBD—is known as triaditis. Over 50% of cats with cholangitis have at least one of these other conditions, and all three can exacerbate one another. 🐱

🔬 Types of Cholangitis in Cats

1. 🧪 Neutrophilic Cholangitis – Caused by bacteria; often sudden onset; most treatable form
2. 🧫 Lymphocytic Cholangitis – Caused by immune dysfunction; chronic and slower onset
3. 🐛 Fluke-Associated Cholangitis – Caused by parasitic liver flukes (common in tropical climates)

🩺 Symptoms to Watch For

Depending on the form and severity, signs may appear suddenly or develop gradually:

• 🤢 Vomiting and diarrhea
• 🛌 Lethargy and weakness
• 🐟 Loss of appetite and weight
• 🟡 Jaundice (yellow gums, eyes, or skin)
• 🔥 Fever and abdominal pain
• 🚰 Increased thirst and urination
• 📈 Swollen or distended belly

🧪 Diagnosing Cholangitis/Cholangiohepatitis

Your vet may perform several tests to determine if your cat has cholangitis:

• 🧫 Blood Tests – High liver enzymes, bilirubin, white blood cells
• 🩻 Abdominal Ultrasound – Checks liver, gallbladder, bile ducts, and pancreas
• 🧬 Bile Culture – Checks for bacterial infection in bile
• 🔬 Liver Biopsy – Often required for a definitive diagnosis, usually via surgery

💊 Treatment Options

Treatment depends on the form and severity of the disease:

1. 🧫 Antibiotics

• ✅ Used for bacterial cholangitis (neutrophilic form)
• ⏳ Usually needed for 4–8 weeks or longer
• 🧪 Should be selected based on bile culture if possible

2. 🧪 Immune Suppression

• 💊 Prednisolone or prednisone for lymphocytic cholangitis
• 💉 Cyclosporine or chlorambucil for chronic or resistant cases

3. 🔄 Liver Support Supplements

• 🌿 SAMe (S-adenosylmethionine) – Antioxidant liver support
• 🌱 Silymarin – Milk thistle extract, may protect liver cells
• 💊 Ursodiol – Improves bile flow, reduces sludge and inflammation

4. 💉 Hospitalization and Nutritional Support

• 💧 IV fluids, anti-nausea meds, and appetite stimulants
• 🍼 Assisted feeding if appetite is severely reduced
• 🔪 Surgery only if bile duct blockage or gallbladder removal is needed

🐛 Liver Flukes: A Special Case

Liver flukes are parasitic flatworms that invade the bile ducts. Common in tropical areas, they often cause chronic inflammation. 🐌

🔬 Transmission:

• 🦐 Crustaceans or lizards eat snail larvae carrying the flukes
• 🐱 Cats ingest infected lizards or raw fish

✅ Treatment: Praziquantel

The same medication used to treat tapeworms is effective against liver flukes. Prognosis is good with treatment. 💊

📆 Prognosis

• 🧪 Cats with acute neutrophilic cholangitis often recover with antibiotics
• ⚠️ Lymphocytic and chronic forms require long-term medication and monitoring
• 🔁 Relapse is possible; lifelong management may be necessary

📲 Ask A Vet for Expert Support

If your cat has been diagnosed with cholangitis or is showing symptoms like jaundice or vomiting, get answers fast through the Ask A Vet app. Dr. Duncan Houston and our team of licensed veterinarians are ready to guide you through diagnosis, treatment, and follow-up care. 🐱💬

Visit AskAVet.com or download the app today for trusted care at your fingertips. 📱

💬 Final Thoughts

Cholangitis and cholangiohepatitis can seem overwhelming, but early diagnosis and treatment can make all the difference. Whether the cause is bacterial, immune, or parasitic, your cat has options for care and support. 🩺🐾

Dr. Duncan Houston and Ask A Vet are here to help your cat feel better—one liver cell at a time. 🧬❤️