Canis ISSN: 2398-2942

Liver: cholangiohepatitis

Introduction

• Uncommonly recognized in dogs.
• Hepatitis due to edema and sluggish bile flow may be concurrent.
• Cause: ascending infection.
• Signs: hepatic disease with icterus: pyrexia, anorexia, vomiting and diarrhea, lethargy, weight loss, ascites.
• Diagnosis: biochemistry, ultrasonography, gall bladder aspiration, biopsy.
• Treatment: antibiotics, other supportive measures.
• See also acute hepatic disease Liver: acute disease.

Pathogenesis

Etiology

• Cholangiohepatitis likely occurs due to bacteria ascending from the intestinal tract.
• Clostridium spp Clostridia spp andEscherichia coli Escherichia coli are the most frequently documented bacteria. Others may include salmonella spp Salmonella spp , Campylobacter jejuni Campylobacter jejuni , Klebsiella spp Klebsiella pneumoniae , Bacteroides spp Bacteroides fragilis , Actinomyces spp and Streptococcus spp Streptococcus spp.
• May also occur secondary to bacteremia.

Specific

• Predisposing causes include:
  • Bile duct/gall bladder anomalies.
  • Intestinal abnormalities such as bacterial overgrowth.
  • Other small or large intestinal disorders such as motility disorders, clostridial disease.
  • Cholelithiasis.

Pathophysiology

• Ascending bacterial infection → hepatitis → immune-mediated response.
• Role of concurrent cholelithiasis Biliary system: disease (cholestatic disease) , bile duct/gall bladder anomalies, pancreatitis Pancreatitis: acute and inflammatory bowel disease Inflammatory bowel disease: overview in etiopathogenesis unclear.

Timecourse

• Depends on etiology.

Diagnosis

Treatment

Outcomes