Gallbladder and Bile Duct Inflammation in Cats

Inflammation of the gallbladder or bile duct are generally conditions that result from other illnesses. Gallbladder inflammation may be referred to as cholecystitis, while bile duct inflammation is known as cholangitis. A combination of conditions related to the gallbladder, bile duct and liver is called cholangiohepatitis or cholangitis-cholangiohepatitis syndrome (CCHS). If the inflammations and underlying causes aren’t treated, the cat’s quality of life can be affected.

Both the gallbladder and bile duct perform important functions in a cat. If either becomes inflamed, the cat will become noticeably ill, with other parts of the body beginning to suffer. Pancreatic disease may lead to an inflammation of the bile duct, resulting in the cat becoming jaundiced and experiencing several other symptoms. When the cat’s owner notices that the cat has yellowed skin or eyes, they need to get the feline into veterinary care as early as possible. An inflamed gall bladder generally develops because of a bacterial infection within the intestines. Both types of inflammation should be diagnosed and treated as soon as possible for a good outlook.

If bile cannot move into or out of the bile duct, the feline will become visibly ill, with the following symptoms:

• Fever
• Loss of appetite
• Vomiting
• Jaundice

Types

Nonsuppurative Cholangiohepatitis

Nonsuppurative cholangiohepatitis may be the result of an immune-mediated disease and be a chronic condition. Symptoms may be vague and change in severity or duration.

Suppurative Cholangiohepatitis

Suppurative cholangiohepatitis is generally the result of a bacterial infection and symptoms may come on suddenly. In addition to general symptoms, a cat may experience 

• Extreme abdominal pain
• Physical collapse

This form of cholangiohepatitis is more severe, with symptoms appearing unexpectedly. If the cat’s bile ducts are too small, the cat may actually want to eat more because of its inability to properly digest its food.

Cats can develop gallbladder or bile duct inflammation for several reasons, which include:

• Restricted blood supply to wall of the gall bladder
• Poor muscle function in the gall bladder
• Past abdominal surgery and increased abdominal sensitivity
• Bacterial infections moving into the gall bladder
• Abnormal development of the gall bladder
• Gall bladder parasites

Cats with pre-existing illnesses may be more likely to develop cholangiohepatitis:

• Pancreatitis
• Inflammatory bowel disease (IBD)
• Chronic interstitial nephritis (one form of kidney disease)
• Gallstones
• Inflamed bile ducts
• Immune system diseases (causes nonsuppurative disease)
• Liver inflammation
• Tumors (malignant or benign)
• Bile tract disease
• Parasitic infestation
• Liver and bile duct cysts
• Trauma (accidental injury)

After a complete physical exam, vets conduct several tests that help them make the correct diagnosis of cholangiohepatitis. The cat undergoes a complete blood count, blood chemistry analysis, stool analysis and a urinalysis. 

After the blood work is done, the cat goes through abdominal X-rays and an ultrasound so the vet can visualize the cat’s abdomen, including the gallbladder and bile duct.

The cat’s bile will be analyzed and its blood will be tested for clotting ability. The vet orders a test of the cat’s thyroid hormone levels, testing for thyroxine levels so they can rule out an overactive thyroid for the cat’s problems. Other tests include pancreatic function testing (TLI test), folate level, and cobalamin testing to see if the cat has an undiagnosed pancreatitis.

Fine-needle aspiration of the gallbladder and exploratory surgery may also be carried out, especially if the cat’s diagnosis is proving to be elusive. If the vet does suspect CCHS, surgery to correct an obstruction of the bile duct can help restore the cat’s health.

Fast treatment for gallbladder and bile duct inflammation can be beneficial, especially in younger cats. If the cat is older and already weakened by illness, the vet may recommend against surgery, depending on the underlying condition.

Medications and antibiotics can help the cat to recover. The vet may also prescribe vitamin K1 intravenously to help reverse any jaundice the cat may have. Vitamin E can help to bring down liver enzymes that are too high, as well as correcting any inflammation within the bile duct and liver. S-Adenosylmethionine (SAMe) may help correct liver and bile duct function. 

While in the veterinary hospital, the cat may be fed through a feeding tube, especially if it refuses to eat. At home, a high-protein diet may be prescribed. The new food may also be low-fat to help the gallbladder and bile duct to function normally.

If surgery is an option, the vet will remove any scar tissue, abnormal growths and scar tissue that may have developed in the cat’s abdomen. Any tumors removed will be biopsied to test for possible cancer.

It’s not easy for a vet to predict whether a cat will recover from cholangiohepatitis or not. If the cat’s disease was diagnosed early, especially if it has the suppurative form of CCHS, the cat may respond well to medication and, over time, regain its good health. For cats with nonsuppurative CCHS, early treatment may allow the cat to enter a long-term remission.

Cats with advanced CCHS will have a poor recovery outlook. CCHS that has advanced to a late stage can become biliary cirrhosis. In this condition, the cat’s normal bile duct tissue is lost to tough, non-functioning connective tissue.

If the cat’s symptoms aren’t diagnosed and treated early, it can lead to permanent, several gall bladder damage. The outlook is the same for early diagnosis and treatment of bile duct obstruction that is consistently managed by the vet and pet owner. This includes maintaining prescribed dietary restrictions long-term.