Cholestasis in Cats
Bile is a bitter, high alkaline fluid that is created in the liver and stored in the interconnected gallbladder until food has been ingested. It is then released into the small intestine, both to aid in the digestion of food and to emulsify the food so that it can be used appropriately by the body, or carried out of the body as waste.
Bile duct obstruction, or cholestasis, is a term used to describe obstruction of the bile duct, preventing bile from entering into the intestine. There are a variety of diseases related to the gallbladder, liver, and pancreas that can lead to this problem. Both male and female cats may be affected.
Symptoms and Types
Symptoms may vary depending upon the underlying disease that is responsible for this problem. Following are some of the symptoms related to this disease:
- Progressive tiredness
- Loss of appetite
- Polyphagia (excessive hunger and consumption of food)
- Bleeding disorders
- Weight loss
- Orange, or dark urine
- Pale colored stools
This problem is associated with a number of diseases. Following are a few of the causes that can lead to cholestasis:
- Cholelithiasis (stones in the gallbladder/gallstones)
- Neoplasia – abnormal growth of tissue, may be malignant or benign
- Pancreatitis (inflammation of the pancreas)
- Parasitic infestation (e.g., flukes in cats)
- Polycystic hepatobilary disease (liver and bile duct disease with cysts)
- Cholangitis (inflammation of common bile duct)
- Cholangiohepatitis (inflammation of the liver and common bile duct)
- Blunt trauma
- Side effect of abdominal surgery
You will need to give a thorough history of your cat's health, onset of symptoms, and possible incidents that might have preceded this condition, such as an injury to the body. The history you provide may give your veterinarian clues as to which organs are causing secondary symptoms.
Laboratory tests will include complete blood tests, a biochemistry panel, and a urinalysis. These tests will reveal abnormalities related to the underlying disease, if there is one, as well as abnormalities that are due to the bile duct obstruction itself.
Some patients show anemia and abnormalities related to the obstruction. The levels of waste products found in the blood will be indicative, like high levels of bilirubin in the blood. Bilirubin is a throw-away component of the bile and blood fluids; a reddish colored pigment that detaches from the red blood cells as they degrade. Under normal circumstances, bilirubin is secreted through the bile and discarded from the body as waste, giving feces its characteristic color. Due to the bile duct obstruction, too much bilirubin can remain in the blood, eventually leading to a condition of jaundice. Typically, urinalyses will also show high concentrations of bilirubin in the urine and stool samples will be pale in color.
Liver enzyme values may be elevated due to liver damage, and bleeding disorders are common with liver disease as well.
Any blood that is taken will be evaluated through laboratory evaluations of your cat. Abdominal x-ray and ultrasound imaging can be used to examine the interior of the liver, pancreas, and gall bladder. In some cases, where laboratory testing and other techniques are not helpful for diagnosis, exploratory surgery may be used as a diagnostic tool. Diagnostic surgery also carries the advantage of correcting the problem at the same time if it is found in the course of discovering the underlying issues.
If your cat is found to be suffering from a form of neoplasia, an abnormal growth of tissue that is affecting the functioning ability of the bile duct, your veterinarian will need to determine whether the tissue is benign or cancerous. Further treatment will depend upon that outcome.
Treatment is highly variable and individual, depending upon the underlying cause and severity of the disease in your cat. Dehydrated patients are given fluid therapy along with supportive therapy. In cases with bleeding disorders owing to liver disease, the cause of the bleeding must be addressed before surgery can be performed. Parenteral (by injection) antibiotics will be administered pre-surgery to handle any infection present. Treatment approaches include medical treatment, surgery, or both.
Living and Management
Bile duct obstruction, if not treated in time, can lead to serious complications, including severe damage to the gallbladder and liver. Follow your veterinarian's recommendations for treating and preventing a recurrence of this condition. Your cat will need special dietary restrictions while it recovers, which will be explained to you by your veterinarian. Recovery depends on treatment of the underlying cause of the obstruction, and on the bile duct being made viable for the normal outflow of bile contents. The prognosis is generally good, given that these issues are resolved.
However, in case of neoplasia, overall prognosis for recovery is very poor.