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1.
J Vet Intern Med ; 38(1): 176-186, 2024.
Article in English | MEDLINE | ID: mdl-37921591

ABSTRACT

BACKGROUND: Information is limited regarding the prevalence and importance of hepatic histologic abnormalities in dogs with gallbladder mucocele (GBM). OBJECTIVES: To (a) report prevalence of hepatic histologic abnormalities in dogs with GBM (b) evaluate for association between hepatic abnormalities and outcome in dogs with GBM (c) evaluate whether neutrophil-to-lymphocyte ratio (NLR) differs in dogs with GBM with and without specific hepatic lesions. ANIMALS: Fifty-two dogs with grossly and histologically confirmed GBM. METHODS: Multicenter, retrospective study of dogs with GBM undergoing cholecystectomy with concurrent liver biopsy. Archived histological sections of gallbladder and liver evaluated by investigators blinded to data. Proportions of dogs with each histologic abnormality alive vs deceased at 1, 3, and 12 months post-cholecystectomy compared. Mann-Whitney U performed to determine if NLR differed in dogs with or without selected lesions. RESULTS: 51/52 (98%, 95% CI [89%, 99%]) dogs with GBM had at least 1 hepatic histologic abnormality. Hepatic fibrosis (37/51; 73%, 95% CI [59%, 83%]), biliary hyperplasia (29/52; 56%, 95% CI [42%, 68%]), and portal inflammation (25/52; 48%, 95% CI [35%, 61%]) were most common. The proportion of dogs alive vs dead differed based on the fibrosis score at 1, 3, and 12 (P ≤ .04) months post-cholecystectomy. Dogs with hepatic necrosis (P = .006) and cholangitis/cholangiohepatitis (P = .02) had higher NLRs compared to dogs without these lesions. CONCLUSIONS AND CLINICAL IMPORTANCE: Histologic abnormalities of the liver are common in dogs with GBM. A higher portal fibrosis score might be associated with shortened long-term survival after cholecystectomy for dogs with GBM. An increase in NLR might predict hepatic necrosis and cholangitis/cholangiohepatitis in dogs with GBM.


Subject(s)
Bile Duct Diseases , Cholangitis , Dog Diseases , Gallbladder Diseases , Liver Diseases , Mucocele , Dogs , Animals , Retrospective Studies , Mucocele/complications , Mucocele/veterinary , Prevalence , Gallbladder Diseases/complications , Gallbladder Diseases/surgery , Gallbladder Diseases/veterinary , Liver Diseases/veterinary , Bile Duct Diseases/veterinary , Cholangitis/veterinary , Fibrosis , Necrosis/veterinary , Dog Diseases/pathology
2.
J Am Vet Med Assoc ; 262(2): 1-3, 2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38016276

ABSTRACT

OBJECTIVE: To describe a unique presentation of systemic Listeria monocytogenes infection in a lactating adult Holstein cow. ANIMAL: 3-year-old second-parity female Holstein, 200 days in milk. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: A 3-year-old Holstein dairy cow was presented for decreased appetite, decreased milk production, and pyrexia. Blood work displayed marked abnormalities in liver-associated parameters. A diagnosis of L monocytogenes cholangiohepatitis was made following liver biopsy, histopathology, and bacterial culture. TREATMENT AND OUTCOME: The cow was treated with systemic antimicrobial and antipyretic therapy. The cow was discharged to continue treatment on farm, and at time of last communication with the owner, the cow was doing very well, with full resolution of clinical signs. CLINICAL RELEVANCE: This case report describes a novel presentation of L monocytogenes infection in an adult bovine. L monocytogenes cholangiohepatitis should be considered a rare differential diagnosis in cattle presenting with evidence of pyrexia and liver disease.


Subject(s)
Cholangitis , Listeria monocytogenes , Listeriosis , Cattle , Animals , Female , Lactation , Listeriosis/diagnosis , Listeriosis/drug therapy , Listeriosis/veterinary , Cholangitis/veterinary , Milk , Fever/veterinary
3.
J Vet Diagn Invest ; 35(4): 417-424, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37232550

ABSTRACT

Equine ingesta-associated choledocholithiasis is a rare cause of morbidity and mortality. We describe here the clinical, gross, histologic, and microbiologic features of this condition in 2 horses and compare the features to 2 previous cases. Case 1 was a 4-y-old Thoroughbred mare with colic. Case 2 was an 18-y-old American Paint Horse mare with colic, chronic weight loss, and inappropriate mentation. Both had elevated biochemical markers of hepatocellular injury and cholestasis and were euthanized given a poor prognosis. Case 1 had a well-formed 5-cm choledocholith surrounding a piece of hay, and had chronic neutrophilic cholangiohepatitis, bridging fibrosis, and extrahepatic obstruction. Case 2 had an ill-formed choledocholith with occasional hay fragments, wood stick, and twigs, and had regionally extensive hepatocellular necrosis with mild neutrophilic cholangiohepatitis and bridging fibrosis. Enterococcus casseliflavus and Escherichia coli were isolated in both cases; Clostridium spp. were also isolated from case 2. All 4 reported cases had increased activity of cholestatic enzymes, hyperbilirubinemia, portal inflammation, and bridging fibrosis. Colic, pyrexia, leukocytosis with neutrophilia, and elevated hepatocellular enzyme activity were documented in 3 cases. Foreign material in all 4 cases was plant origin (choledochophytolithiasis), including hay (n = 2), sticks/twigs (n = 2), and grass awns (n = 1). Ingesta-associated choledocholithiasis may be considered as a cause of colic, pyrexia, and elevated cholestatic biomarkers in horses.


Subject(s)
Cholangitis , Choledocholithiasis , Colic , Horse Diseases , Horses , Animals , Female , Choledocholithiasis/veterinary , Choledocholithiasis/complications , Colic/complications , Colic/veterinary , Cholangitis/veterinary , Fibrosis , Fever/complications , Fever/veterinary , Horse Diseases/pathology
4.
J Vet Intern Med ; 36(6): 2177-2180, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36178101

ABSTRACT

A 1-year 11-month intact female Alaskan Malamute fed a raw food diet was referred to the Queen Mother Hospital for Animals for further investigation of hyporexia and increased hepatobiliary enzyme activities. Clinicopathological and imaging findings were consistent with cholangiohepatitis, with coccidial zoites identified on bile cytology. Polymerase chain reaction and amplicon sequencing from the bile identified Hammondia heydorni, a Sarcocytid coccidial protozoa with an obligate 2-host life cycle. The dog was treated with clindamycin, marbofloxacin, ursodeoxycholic acid (UDCA) and S-adenosylmethionine/silybin with complete clinical and biochemical resolution documented after 6 weeks. Infection with Hammondia spp. should be considered in patients receiving raw food diets in which coccidial zoites are identified in the bile, but the pathogenic potential of this organism is unknown and the possibility of its presence as a commensal cannot be discounted.


Subject(s)
Cholangitis , Coccidiosis , Dog Diseases , Sarcocystidae , Dogs , Female , Animals , Coccidiosis/veterinary , Raw Foods , Dog Diseases/drug therapy , Dog Diseases/parasitology , Cholangitis/drug therapy , Cholangitis/veterinary , Diet/veterinary
6.
J Small Anim Pract ; 63(8): 573-589, 2022 08.
Article in English | MEDLINE | ID: mdl-35522164

ABSTRACT

Cholangitis/cholangiohepatitis complex in cats is commonly encountered in clinical practice worldwide. Diagnosis and management of cats with this complex is difficult because of the ambiguity of clinical signs, diagnostic test results and commonality of comorbid disorders. These impediments can delay disease identification and treatment, which can increase morbidity and mortality. ​In this narrative review, we aimed to provide a thorough review of the unique physioanatomic features of the biliary system as well as clinically relevant updates on cholangitis/cholangiohepatitis complex in cats.


Subject(s)
Cat Diseases , Cholangitis , Animals , Cat Diseases/diagnosis , Cat Diseases/therapy , Cats , Cholangitis/diagnosis , Cholangitis/veterinary
7.
Vet Med Sci ; 8(4): 1366-1372, 2022 07.
Article in English | MEDLINE | ID: mdl-35560870

ABSTRACT

Mucocele and cholecystitis were diagnosed in a 10 year-old Shetland-sheepdog presenting aspecific clinical signs. Blood examinations and ultrasonography investigation were performed before to surgical approach, which allowed to collect biopsies and samples for bacteriological analyses. In addition, the patient was subjected to cholecystectomy. A multidrug resistant Enterococcus faecium was isolated from the gallbladder specimens. On the basis of antimicrobial susceptibility test, nitrofurantoin was used. The correct bacteriological diagnosis is necessary to set up effective therapy, influencing the patient's prognosis and improving the recovery time.


Subject(s)
Cholangitis , Cholecystitis , Dog Diseases , Enterococcus faecium , Mucocele , Animals , Cholangitis/veterinary , Cholecystitis/veterinary , Dog Diseases/pathology , Dogs , Mucocele/pathology , Mucocele/surgery , Mucocele/veterinary
8.
J Vet Med Sci ; 84(7): 1010-1014, 2022 Jul 10.
Article in English | MEDLINE | ID: mdl-35613870

ABSTRACT

A geriatric female giant panda developed grave signs of illness and was diagnosed with suspected hepatobiliary tract obstruction or other severe hepatic disease such as advanced cholangiohepatitis. The giant panda was euthanized and post mortem computed tomography was performed prior to necropsy. Common bile duct obstruction at the major duodenal papilla by a mineral attenuating calculus causing dilatation of common bile and gallbladder with concurrent multiple areas of liver abscess were detected by postmortem computed tomography. These were confirmed with gross necropsy. This is the first case report of common bile duct obstruction by mineral calculus with concurrent severe cholangiohepatitis in a giant panda.


Subject(s)
Calculi , Cholestasis , Ursidae , Animals , Autopsy , Calculi/diagnostic imaging , Calculi/veterinary , Cholangitis/complications , Cholangitis/diagnostic imaging , Cholangitis/veterinary , Cholestasis/complications , Cholestasis/diagnostic imaging , Cholestasis/veterinary , Euthanasia, Animal , Female , Hepatitis, Animal/complications , Tomography, X-Ray Computed/veterinary
9.
J Am Vet Med Assoc ; 260(2): 194-211, 2022 01 14.
Article in English | MEDLINE | ID: mdl-34936576

ABSTRACT

OBJECTIVE: To characterize the frequency and type of bacterial infection by culture- and immunohistochemical (IHC)-based methods and determine the impact of infection on clinical features and survival time in cats with suppurative cholangitis-cholangiohepatitis syndrome (S-CCHS). ANIMALS: 168 client-owned cats with S-CCHS (cases). PROCEDURES: Clinical features, bacterial culture results, culture-inoculate sources, and survival details were recorded. Cases were subcategorized by comorbidity (extrahepatic bile duct obstruction, cholelithiasis, cholecystitis, ductal plate malformation, biopsy-confirmed inflammatory bowel disease, and biopsy-confirmed pancreatitis) or treatment by cholecystectomy or cholecystoenterostomy. Culture results, bacterial isolates, Gram-stain characteristics, and IHC staining were compared among comorbidities. Lipoteichoic acid IHC staining detected gram-positive bacterial cell wall components, and toll-like receptor expression IHC reflected pathologic endotoxin (gram-negative bacteria) exposure. RESULTS: Clinical features were similar among cases except for more frequent abdominal pain and lethargy in cats with positive culture results and pyrexia, abdominal pain, and hepatomegaly for cats with polymicrobial infections. Bacteria were cultured in 93 of 135 (69%) cats, with common isolates including Enterococcus spp and Escherichia coli. IHC staining was positive in 142 of 151 (94%) cats (lipoteichoic acid, 107/142 [75%]; toll-like receptor 4, 99/142 [70%]). With in-parallel interpretation of culture and IHC-based bacterial detection, 154 of 166 (93%) cats had bacterial infections (gram-positive, 118/154 [77%]; gram-negative, 111/154 [72%]; polymicrobial, 79/154 [51%]). Greater frequency of bacterial isolation occurred with combined tissue, bile, and crushed cholelith inoculates. Infection and gram-positive bacterial isolates were associated with significantly shorter long-term survival times. CLINICAL RELEVANCE: S-CCHS was associated with bacterial infection, pathologic endotoxin exposure, and frequent polymicrobial infection in cats. Combined tissue inoculates improved culture detection of associated bacteria.


Subject(s)
Bacterial Infections , Cat Diseases , Cholangitis , Animals , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/veterinary , Bile/microbiology , Cat Diseases/drug therapy , Cats , Cholangitis/drug therapy , Cholangitis/veterinary , Endotoxins/therapeutic use , Enterococcus
10.
J Am Vet Med Assoc ; 260(2): 212-227, 2022 01 14.
Article in English | MEDLINE | ID: mdl-34936575

ABSTRACT

OBJECTIVE: To characterize clinical features, comorbidities, frequency of bacterial isolation, and survival time in cats with suppurative cholangitis-cholangiohepatitis syndrome (S-CCHS). ANIMALS: 168 client-owned cats with S-CCHS. PROCEDURES: Data were prospectively (1980 to 2019) collected regarding clinical features, comorbidities, bacterial infection, illness duration, and treatments. Variables were evaluated for associations with survival time. RESULTS: Median age of cats was 10.0 years, with no breed or sex predilection observed. Common clinical features included hyporexia (82%), hyperbilirubinemia (80%), lethargy (80%), vomiting (80%), jaundice (67%), weight loss (54%), and hypoalbuminemia (50%). Comorbidities included extrahepatic bile duct obstruction (53%), cholelithiasis (42%), cholecystitis (40%), and ductal plate malformation (44%) as well as biopsy-confirmed inflammatory bowel disease (60/68 [88%]) and pancreatitis (41/44 [93%]). Bacterial cultures were commonly positive (69%) despite prebiopsy antimicrobial administration in most cats. Of surgically confirmed choleliths, diagnostic imaging identified only 58%. Among 55 cats with "idiopathic pancreatitis," 28 (51%) were documented to have transiting choleliths, and 20 had pancreatic biopsies confirming pancreatitis. Cholelithiasis (with or without bile duct obstruction) and cholecystectomy were associated with survival advantages. Survival disadvantages were found for leukocytosis, ≥ 2-fold increased alkaline phosphatase, and hyperbilirubinemia. Cholecystoenterostomy had no survival impact. Cats with ductal plate malformations were significantly younger at diagnosis and death than other cats. Chronic treatments with antimicrobials, S-adenosylmethionine, and ursodeoxycholic acid were common postbiopsy. CLINICAL RELEVANCE: S-CCHS in cats was associated with bacterial infection and various comorbidities and may be confused with pancreatitis. Surgically correctable morbidities (ie, cholecystitis, cholecystocholelithiasis) and cholecystectomy provided a significant survival advantage.


Subject(s)
Bacterial Infections , Cat Diseases , Cholangitis , Pancreatitis , Animals , Bacterial Infections/veterinary , Cats , Cholangitis/complications , Cholangitis/veterinary , Cholecystectomy/veterinary , Pancreatitis/diagnosis , Pancreatitis/veterinary , Vomiting/veterinary
11.
Article in English | MEDLINE | ID: mdl-34638155

ABSTRACT

A 9-year-old female, neutered European shorthair cat was presented with acute vomiting, obvious jaundice and painful enlargement of the abdomen. Icteric skin and mucous membranes in addition to severe bilirubinaemia (mainly direct bilirubin) and a large increase in liver enzyme activities were the main findings at the initial examination. Radio- and ultrasonographic evaluation revealed a massive fluid-filled structure caudal to the liver displacing abdominal organs, in particular the stomach. As this structure with a diameter of 8-10 cm occupied considerable space in the cranioventral abdomen, a detailed ultrasonographic examination of the liver and the gallbladder, and determination of the structure's association with a particular abdominal organ was initially impossible. Via ultrasound-assisted puncture under general anaesthesia 300 ml of an almost clear fluid could be aspirated. Cytological examination revealed a cyst content-like fluid with cell detritus.Further ultrasonographic and computed tomographic diagnostics followed by abdominal laparotomy finally enabled diagnosis of a cystic dilatation of the entire common bile duct and accumulation of white bile. Histopathological examination after euthanasia (requested by the owner) identified lymphoplasmacytic cholangitis and necrosis of the duodenal papilla. The massive dilatation of the common bile duct complicated its definite diagnosis by diagnostic imaging methods. It was most likely caused by a longer-standing obstruction of the bile flow by lymphoplasmacytic cholangitis with necrosis and granulation tissue formation in the area of the duodenal papilla. An interesting but initially misleading feature was the presence of white bile. The etiology of this extremely rare condition remains obscure but in the described case a manifestation of impaired hepatocyte function secondary to biliary stasis is suspected to be the cause.


Subject(s)
Cat Diseases , Cholangitis , Abdomen , Animals , Cat Diseases/diagnostic imaging , Cats , Cholangitis/veterinary , Female , Tomography, X-Ray Computed , Ultrasonography/veterinary
12.
J Vet Diagn Invest ; 33(4): 782-787, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34027760

ABSTRACT

Choledochal cysts, congenital segmental dilations of the common bile duct, have been reported in few cats, and histologic characterization is lacking. A 20-mo-old spayed female domestic shorthair cat was presented because of vomiting and weight loss. There was progressive elevation of liver enzyme activity (ALT > ALP, GGT) and hyperbilirubinemia. Diagnostic imaging identified focal cystic dilation of the common bile duct, dilation and tortuosity of adjacent hepatic ducts, and a prominent duodenal papilla. A choledochal cyst was suspected, and the animal was euthanized. On postmortem examination, there was a 2-cm, firm, thickened, cystic dilation of the common bile duct, patent with adjacent ducts. Histologically, the cyst wall was expanded by fibroblasts, collagen, and lymphoplasmacytic inflammation. Adjacent bile ducts were markedly dilated and tortuous, with lymphoplasmacytic inflammation and papillary mucosal hyperplasia that extended to the major duodenal papilla. There was chronic neutrophilic cholangitis, suggesting bacterial infection and/or disturbed bile drainage, extrahepatic obstruction, and lymphoplasmacytic pancreatitis with ductular metaplasia. Prominent lymphoid follicles within biliary ducts and duodenum suggested chronic antigenic stimulation. Choledochal cysts can be associated with chronic neutrophilic cholangitis, extrahepatic obstruction, choledochitis, duodenal papillitis, and pancreatitis, and should be a differential for increased hepatic enzymes and hyperbilirubinemia in young cats.


Subject(s)
Cat Diseases/diagnosis , Cholangitis/veterinary , Choledochal Cyst/veterinary , Duodenal Diseases/veterinary , Pancreatitis/veterinary , Animals , Cat Diseases/pathology , Cats , Cholangitis/diagnosis , Cholangitis/etiology , Choledochal Cyst/complications , Duodenal Diseases/diagnosis , Duodenal Diseases/etiology , Female , Pancreatitis/diagnosis , Pancreatitis/etiology
13.
J Feline Med Surg ; 22(11): 1047-1067, 2020 11.
Article in English | MEDLINE | ID: mdl-33100169

ABSTRACT

PRACTICAL RELEVANCE: Feline triaditis describes concurrent pancreatitis, cholangitis and inflammatory bowel disease (IBD). The reported prevalence is 17-39% in ill referral patients. While the aetiology is poorly understood, it is known to include infectious, autoimmune and physical components. What is not known is whether different organs are affected by different diseases, or the same process; indeed, triaditis may be part of a multiorgan inflammatory disease. Feline gastrointestinal tract anatomy plays its role too. Specifically, the short small intestine, high bacterial load and anatomic feature whereby the pancreatic duct joins the common bile duct before entering the duodenal papilla all increase the risk of bacterial reflux and parenchymal inflammation. Inflammation may also be a sequela of bowel bacterial translocation and systemic bacteraemia. DIAGNOSTIC CHALLENGES: Cholangitis, pancreatitis and IBD manifest with overlapping, vague and non-specific clinical signs. Cholangitis may be accompanied by increased serum liver enzymes, total bilirubin and bile acid concentrations, and variable ultrasonographic changes. A presumptive diagnosis of pancreatitis is based on increased serum pancreatic lipase immunoreactivity or feline pancreas-specific lipase, and/or abnormal pancreatic changes on ultrasonography, though these tests have low sensitivity. Diagnosis of IBD is challenging without histopathology; ultrasound findings vary from normal to mucosal thickening or loss of layering. Triaditis may cause decreased serum folate or cobalamin (B12) concentrations due to intestinal disease and/or pancreatitis. Triaditis can only be confirmed with histopathology; hence, it remains a presumptive diagnosis in most cases. EVIDENCE BASE: The literature on feline triaditis, pancreatitis, cholangitis and IBD is reviewed, focusing on histopathology, clinical significance and diagnostic challenges. Current management recommendations are provided. Further studies are needed to understand the complex pathophysiology, and in turn improve diagnosis and treatment.


Subject(s)
Cat Diseases/diagnosis , Cholangitis/veterinary , Inflammatory Bowel Diseases/veterinary , Pancreatitis/veterinary , Animals , Cat Diseases/epidemiology , Cat Diseases/etiology , Cats , Cholangitis/diagnosis , Cholangitis/epidemiology , Cholangitis/etiology , Comorbidity , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/etiology , Pancreatitis/diagnosis , Pancreatitis/epidemiology , Pancreatitis/etiology , Prevalence
14.
Vet Clin North Am Small Anim Pract ; 50(5): 1135-1156, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32682546

ABSTRACT

Clinical findings with triaditis and individual disease components overlap and may include hyporexia, weight loss, lethargy, vomiting, diarrhea, dehydration, icterus, abdominal pain, thickened bowel loops, pyrexia, dyspnea, and shock. A definitive diagnosis of triaditis requires histologic confirmation of inflammation in each organ, but this may not be possible because of financial or patient-related constraints. Evidence-based data indicate that histologic lesions of triaditis are present in 30% to 50% of cats diagnosed with pancreatitis and cholangitis/inflammatory liver disease. Treatment of triaditis is based on the overall health status of the patient and the type and severity of disease in component organs.


Subject(s)
Cat Diseases/diagnosis , Inflammation/veterinary , Animals , Cats , Cholangitis/complications , Cholangitis/diagnosis , Cholangitis/veterinary , Inflammation/diagnosis , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/veterinary , Pancreatitis/complications , Pancreatitis/diagnosis , Pancreatitis/veterinary
15.
J Vet Intern Med ; 32(1): 172-180, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29131399

ABSTRACT

BACKGROUND: Cholangitis in dogs appears to be more common than previously thought, but understanding of the disease remains incomplete. OBJECTIVE: To describe a population of dogs with cholangitis or cholangiohepatitis. ANIMALS: Fifty-four client-owned dogs with cholangitis or cholangiohepatitis. METHODS: Medical records of dogs with cholangitis or cholangiohepatitis confirmed by histopathology between January 2004 and December 2014 were identified using a computer-based search and retrospectively reviewed. RESULTS: Clinical signs included vomiting (72.2%), lethargy (70.4%), and inappetence (64.8%). Most dogs (49/50) had increased liver enzyme activities, hyperbilirubinemia (32/50), and hypercholesterolemia (24/43). Ultrasonographic abnormalities of the hepatobiliary system were seen in 84% of cases. On histopathology, 53 of 54 affected dogs had neutrophilic cholangitis (NC) or cholangiohepatitis, whereas 1 dog had lymphocytic cholangitis. Most cases (42/54) were chronic. Evidence of concurrent biliary disease (46.2%) and biliary tract obstruction (42.6%) was common. Seventeen of 36 biliary and 11 of 25 liver cultures were positive for bacterial growth; Escherichia coli and Enterococcus spp. were most common. Median patient survival was 671 days (95% confidence interval [CI]: 114-1,426). On Cox regression, dogs that did not have a cholecystectomy performed had a 2.1 greater hazard for death (P = 0.037; 95% CI: 1.0-4.3) compared to cholecystectomized dogs. Dogs >13 years old had a 5.0 greater hazard for death (P = 0.001; 95% CI: 1.9-13.2) compared to younger dogs. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Chronic NC or cholangiohepatitis was most common. Cholecystitis and biliary tract obstruction often occurred in conjunction with cholangitis. Cholecystectomized dogs had decreased risk of death; thus, cholecystectomy may improve patient outcome.


Subject(s)
Cholangitis/veterinary , Dog Diseases/pathology , Hepatitis, Animal/pathology , Animals , Cholangitis/diagnosis , Cholangitis/microbiology , Cholangitis/pathology , Cholecystectomy/veterinary , Dog Diseases/diagnosis , Dog Diseases/microbiology , Dogs , Enterococcus/isolation & purification , Escherichia coli/isolation & purification , Female , Hepatitis, Animal/diagnosis , Hepatitis, Animal/microbiology , Male , Retrospective Studies
16.
J Feline Med Surg ; 20(1): 30-37, 2018 01.
Article in English | MEDLINE | ID: mdl-28349721

ABSTRACT

Objectives The aim of the study was to compare the hepatic progenitor cell niche in healthy feline livers and the liver tissue of cats with lymphocytic cholangitis. Methods Immunohistochemical stainings for vimentin, laminin, beta (ß)-catenin and Notch1 intracellular domain (NICD) were used on formalin-fixed liver biopsies from affected (n = 12) and unaffected cats (n = 2). Results All immunohistochemical markers used were expressed in more cells, or more intensely, in the liver tissue of cats with lymphocytic cholangitis than in the liver tissue of unaffected cats. Conclusions and relevance Enhanced expression of vimentin, laminin, cytoplasmic/nuclear ß-catenin and NICD in liver biopsies from cats with lymphocytic cholangitis indicates that the hepatic progenitor cell (HPC) niche is remodelled and activated. HPCs might provide insights into new regenerative treatment options for lymphocytic cholangitis in cats in the future.


Subject(s)
Cat Diseases/pathology , Cholangitis/veterinary , Liver/pathology , Stem Cells/cytology , Animals , Cat Diseases/metabolism , Cats , Cholangitis/metabolism , Cholangitis/pathology , Immunohistochemistry , Liver/cytology , Liver/metabolism
18.
J Vet Intern Med ; 31(3): 922-927, 2017 May.
Article in English | MEDLINE | ID: mdl-28303655

ABSTRACT

BACKGROUND: The signalment, clinicopathologic, bacteriological, histopathological, ultrasonographic characteristics, and the treatment and outcomes of adult cattle with cholangiohepatitis are poorly defined. ANIMALS: Thirteen Holstein cows with cholangiohepatitis. METHODS: Retrospective study of medical records of cattle admitted to the CHUV and the AVC between 1992 and 2012 and 2000 and 2012, respectively, for cattle older than 3 months of age with a histopathological diagnosis of cholangiohepatitis. Cholangiohepatitis was defined as the presence of portal inflammation surrounding or infiltrating bile ducts, with or without epithelial damage, and extending into the adjacent lobules. RESULTS: At the time of diagnosis of cholangiohepatitis, cows had decreased appetite (n = 7) or were anorectic (n = 6), had fever (n = 5), and had tachycardia (n = 8). Icterus was detected in 5 cows. Yellow discoloration was identified on the skin of the udder (n = 3), conjunctiva (n = 2), and vulva (n = 1). There was leukocytosis (n = 6), neutrophilia (n = 9), and hyperfibrinogenemia (n = 8). Alteration in the serum biochemistry profile included hyperglobulinemia (n = 8), hypoalbuminemia (n = 10), increased activity of GGT (n = 12), AST (n = 8), and ALP (n = 10), and hyperbilirubinemia (n = 10). Histopathological diagnosis included mild, subacute, nonsuppurative cholangiohepatitis (n = 4), mild suppurative cholangiohepatitis (n = 4), mild mixed (neutrophilic and lymphocytic) cholangiohepatitis (n = 3), and moderate, chronic, nonsuppurative cholangiohepatitis (n = 1). Six cows were discharged from the hospital, and 7 were euthanized. CONCLUSIONS AND CLINICAL IMPORTANCE: Cholangiohepatitis is a rare condition in adult cattle. Antemortem diagnosis can be challenging because clinical signs are unspecific.


Subject(s)
Cattle Diseases/pathology , Cholangitis/veterinary , Animals , Bile Ducts/pathology , Biopsy/veterinary , Cattle , Cattle Diseases/diagnosis , Cattle Diseases/diagnostic imaging , Cattle Diseases/therapy , Cholangitis/diagnosis , Cholangitis/pathology , Cholangitis/therapy , Female , Liver/pathology , Retrospective Studies , Ultrasonography/veterinary
19.
Vet Clin North Am Small Anim Pract ; 47(3): 703-724, 2017 May.
Article in English | MEDLINE | ID: mdl-28069287

ABSTRACT

Cholangitis is common in felines, including neutrophilic, lymphocytic, and chronic cholangitis (liver fluke). History, physical examination, laboratory testing, and abdominal ultrasound support a diagnosis. Diagnosis using hepatic histopathology and/or bile analysis is ideal but not always practical. Neutrophilic cholangitis is associated with bacterial cholecystitis, pancreatitis, and inflammatory bowel disease. The typical presentation is a short illness with lethargy, inappetence, pyrexia, and jaundice. Lymphocytic cholangitis, suspected to be immune-mediated, can have a prolonged clinical course with weight loss and ascites as the predominant features. The prevalence of liver fluke infestation in cats varies worldwide and clinical manifestations are uncommonly reported.


Subject(s)
Cat Diseases , Cholangitis/veterinary , Animals , Anti-Bacterial Agents/therapeutic use , Biopsy/veterinary , Cat Diseases/diagnosis , Cat Diseases/drug therapy , Cat Diseases/etiology , Cat Diseases/pathology , Cats , Cholangitis/complications , Cholangitis/diagnosis , Cholangitis/drug therapy , Risk Factors
20.
J Vet Intern Med ; 30(4): 1031-45, 2016 Jul.
Article in English | MEDLINE | ID: mdl-27296565

ABSTRACT

BACKGROUND: The term triaditis designates the concurrent presence of idiopathic inflammatory bowel disease (IBD), cholangitis, and pancreatitis in cats. HYPOTHESIS/OBJECTIVES: The histopathology of concurrent, but often subclinical, inflammatory processes in the small intestine, liver, and pancreas of cats is poorly described. We aimed to investigate the frequency of enteritis, cholangitis, pancreatitis, or some combination of these in symptomatic and asymptomatic cats, compare clinicopathological features, and correlate histopathological with laboratory findings. ANIMALS: Domestic cats (27 symptomatic, 20 asymptomatic, and 8 normal). METHODS: Prospective study. Physical examination, laboratory variables (CBC, serum biochemistry profile, serum thyroxine concentration, serum feline trypsin-like immunoreactivity [fTLI], feline lipase immunoreactivity [fPLI, as measured by Spec fPL(®) ], urinalysis, and fecal analysis), imaging, and histopathological examinations were conducted. Feline liver, pancreas, and small intestine were biopsied during laparotomy. RESULTS: Inflammatory lesions were detected in 47 cats (27 symptomatic, 20 asymptomatic). In total, 20 cats had histopathologic lesions of IBD (13/47, 27.7%), cholangitis (6/47, 12.8%), or pancreatitis (1/47, 2.1%) alone, or inflammation involving >1 organ (27/47, 57.4%). More specifically, 16/47 cats (34.0%) had concurrent lesions of IBD and cholangitis, 3/47 (6.4%) of IBD and pancreatitis, and 8/47 cats (17%) of triaditis. Triaditis was identified only in symptomatic cats (8/27, 29.6%). A mild, positive correlation was detected between the severity (score) of IBD lesions and the number of comorbidities (rho = +0.367, P = .022). CONCLUSIONS AND CLINICAL IMPORTANCE: Histopathological evidence of IBD or IBD with comorbidities was detected in both symptomatic and asymptomatic cats. The possibility of triaditis should be considered in symptomatic cats with severe IBD.


Subject(s)
Cat Diseases/pathology , Cholangitis/veterinary , Inflammatory Bowel Diseases/veterinary , Pancreatitis/veterinary , Animals , Cats , Cholangitis/complications , Cholangitis/pathology , Fatty Liver/pathology , Fatty Liver/veterinary , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/pathology , Pancreatitis/complications , Pancreatitis/pathology
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