Hepatobiliary

Question 1

What are the 2 types of cholangitis in dogs?

Answer 1

Neutrophilic (E. coli or enterococcus)
* Most common
Destructive (ductopenia, cholestasis, cirrhosis)

Question 2

What laboratory abnormalities increase the clinical suspicion for biliary tract disease in the dog?

Answer 2

Hyperbilirubinemia
Inflammatory leukogram
Fever
Abdominal pain

Question 3

Concurrent _______ is very common with cholangitis.

Answer 3

Gallbladder disease
* Cholecystitis
* Gallbladder mucocele

Question 4

Define: Cholangiohepatitis

Answer 4

When cholangitis inflammation spreads beyond the portal tracts

Question 5

What are the top differentials for an icteric dog?

Answer 5

• Gallbladder mucocele
• Cholecystitis
• Cholangitis
• Cholelithiasis
• Intra or extrahepatic cholestasis
• Congenital structural abnormalities
• Neoplasia

Question 6

Hepatocellular enzymes

Answer 6

ALT
AST

Question 7

Cholestatic markers

Answer 7

ALP
GGT
Total-bilirubin

Question 8

What 2 types of cholangitis occur in the cat?

Answer 8

Neutrophilic
Lymphocytic

Question 9

Neutrophilic Cholangitis (Feline)

Answer 9

Younger cat +/- fever
Acute clinical signs
Mild or no icterus
Usually bacterial (e. coli or enterococcus)
Liver values should dramatically improve within 3-4 weeks

Question 10

Lymphocytic Cholangitis (Feline)

Answer 10

Older cat (>9y)
Chronic clinical signs
Severe icterus
Relatively fine, but vomiting and weight loss
No response to several weeks of antibiotics

Question 11

What are the diagnostic steps in working up biliary disease in a cat?

Answer 11

• CBC (inflammation)
• Chemistry
• Abdominal ultrasound (ideal)
• Need biopsy to distinguish between neutrophilic and lymphocytic