Hematological and biochemical abnormalities are non-specific (anemia, leukocytosis or leucopenia, changes in biliary enzymes, hyperbilirubinemia, hypercholesterolemia), prerenal azotemia, and hypoalbuminemia. The most common electrolyte abnormalities are hypokalemia and hypocalcemia.
Diagnosis Diagnosis is made with the diagnosis of suppurative cholangitis. Courtesy of Daniel Borrás. Echevarne Laboratory Pathology Anatomy Unit.
Clostridium spp.) In cats with IBD; These changes may be the result of an IBD or precede it.
plasmosis, toxoplasmosis, mycobacteria, Prototheca, Pythium insidiosum, pathogenic bacteria. * Food Allergy. * Inflammation of the small intestine aso -
with other primary gastrointestinal diseases (lymphoma, lymphangiectasia).
Cholangiohepatitis The anatomical conformation of the duct Bile duct, the major pancreatic duct, and the duodenum predispose cats to cholangitis by extension of duodenal bacteria, reflux of pancreatic secretions, or both .
Immunoreactivity Feline pancreatic lipase, with sensitivities and specificities of more than 80%, although both are affected by the severity of the disease, so the results are more accurate in patients with moderate to severe pancreatitis  . If there is peritoneal effusion the fluid can be analyzed. Cats show marked elevations of lipase in their effusion compared to serum levels. Radiological changes: loss of defi -
sibility between 11-67%, although normal abdominal ecography does not rule out pancreatitis. Ulcogenic changes: hypoechoic pancreas -
increased, sometimes with cavitary lesions, peripancreatic and mesenteric hyperechogenic fat, presence of peritoneal effusion, local lymphadenopathy, dilatation of the common bile duct, dilatation of the duct Pancreatic (although older cats have the duct
In cats with inflammatory bowel disease, vomiting is more common than diarrhea.
Clinical and laboratory findings
Pancreatitis It may affect cats of all ages, but some authors claim that the middle to advanced age are more vulnerable. There is no racial predisposition.  The clinical spectrum of pancreatitis in
Cats may include mild, subclinical disease that does not require the care of a veterinarian; severe necrotizing disease for which veterinary care and chronic disease are necessary with signs that may come and go in months or Years.  The signs Are non-specific and
common to other intraabdominal problems. If there is secondary bile duct obstruction
, there will also be jaundice. Cats often have less specific clinical signs such as lethargy and anorexia. Sometimes the cause of the visit to the veterinarian is due to clinical signs associated with intestinal disease (IBD) or liver disease (hepatic lipidosis or cholangitis).
More dilated) in cats with chronic pancreatitis, There may be decreased pancreas size, variable echogenicity, nodular ecotexture, acoustic shadows by mineralization and scarring, as well as irregular enlargement of the pancreatic ducts. The thickness of the intestine is increased in
patients with IBD. Finally, the definitive diagnosis is
Inflammatory bowel disease One of the most common signs is emesis (food vomiting). Stools are often found from soft to watery. With exocrine pancreatic insufficiency pale, steatorreic stools and very malolientes are identified. Animals have a voracious appetite. They may also present anorexia and may increase the risk of secondary hepatic lipidosis. They may develop abdominal distension if there is ascites and jaundice in some cases. 
Clinical and laboratory findings of cholangiohepatitis
P> • More predisposition in male cats, mean age at presentation 5.7 years, no racial predisposition.
• Mean age 9.7 years, no racial predisposition.
• Clinical signs less than one month old. • Fever. • Neutrophilia, sometimes with left shift.
• Hyperbilirubinemia and hyperglobulinemia. • Variable increases in ALT and ALKP.
• Clinical signs present for more than one month. • Mature neutrophilia. • Hyperbilirubinemia and hyperglobulinemia. • Variable increases in ALT and ALKP.
• Age from 6 months to 10 years. In one study, Persian cats were overrepresented. • Signs for more than a month or non-significant medical history. • Anorexia • Lethargy • Weight loss • Vomiting
• Less common neutrophilia. • Hyperbilirubinemia and hyperglobulinemia. • If present, abdominal effusion is high in protein (& # 62; 5 g / dl). • Variable increases in ALT and ALKP.
In some patients,
the region of the affected digestive tract and the nature of the signs. In cats with IBD, vomiting is more common than diarrhea. The presence of blood in vomiting or diarrhea is associated with the severity of the disease. So are weight loss and enteropathy due to protein loss (with hypoproteinemia and ascites); Lymphoplasmacytic enteritis is more frequent in dogs than in cats.
Changes in histology, as well as poor appetite and hair loss, must be corrected because it has systemic metabolic consequences. A biopsy is necessary for the diagnosis, either by endoscopy or by laparotomy .
Cholangiohepatitis The characteristics of this pathology appear in the table.
Other diagnostic findings Pre and postpandal bile acids
abnormal. There may be coagulopathies due to lack of vitamin K absorption or hepatic dysfunction. Ultrasound findings: prominent hepatic veins, abnormal biliary tract, normal splenic appearance, and gan -
In cholangiohepatitis it is highly recommended to take bile samples for cytological study And culture and sensitivity.
Diagnosis Analyzes are of little help in diagnosis, although cases of neutrophilia can occur and only in 30% of cats has been reported elevation In the ALT. With fecal analysis, such parasites are discharged by toxocaras, thuringiens, giardias, and bacterial pathogens. Empirical treatment for giardias is recommended. The folate and the cobala -
mine should be evaluated because they may be decreased in cases of anorexia and intestinal malabsorption. And, at the same time, low cobalamin levels can cause
to do histopathologically. It should be noted that the risk of bleeding after biopsy is poorly correlated with normal coagulation parameters and biopsy should be avoided in cats with evidence of coagulopathy. It is highly recommended to take samples of bile for cytological study and culture and sensitivity. The most frequently isolated bacteria are Escherichia coli, although there may be other aerobic or anaerobic agents. The ideal is to perform biliary cytology and
histopathology. Occasionally hepatic fasciola or protozoa is detected . Or
Bibliography available at www.argos.grupoasis.com/bibliografias/ triaditis162.doc
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