Bile Duct Inflammation (Cholangitis) in Dogs - Causes, Treatment and Associated Conditions

Key takeaways

Canine cholangitis is a rare inflammation that affects the liver, bile ducts, and gallbladder.

The most common cause of cholangitis is an infection that ascends from the intestinal tract to the liver
Symptoms of cholangitis include vomiting, abdominal pain, diarrhea, excessive thirst, and excessive urination
Diagnosis involves physical examination, blood work, diagnostic imaging, and liver biopsies
Treatment of cholangitis can involve antibiotics, corticosteroids, dietary changes, and surgery
Most episodes of acute cholangitis have a good prognosis with appropriate treatment
Chronic cases of cholangitis require lifelong treatment and may lead to liver failure

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A closer look: Bile Duct Inflammation (Cholangitis) in Dogs

Cholangitis is a rare condition in dogs, but when left untreated it can lead to life-threatening liver cirrhosis and liver failure.

cholangitis can be either acute or chronic. Acute cholangitis has a sudden onset, and is typically associated with an infectious cause. Acute causes can lead to chronic cholangitis if left untreated. Chronic cholangitis can also be caused by immune-mediated disease. Dogs with chronic cholangitis can develop liver cirrhosis and liver failure.

If the inflammation is caused by a bacterial infection, the cholangitis generally presents as consistent.

If the underlying cause of the inflammation is immune-mediated, the cholangitis generally presents as intermittent.

Risk factors

Cholangitis must be treated as an emergency. Dogs showing symptoms of cholangitis require immediate veterinary attention.

Possible causes

Cholangitis is usually caused by an ascending infection in which bacteria from the intestines spread to the liver via the bile duct.

In rare occasions, bacterial infection can be carried into the liver via the bloodstream, leading to cholangitis.

Immune-mediated destruction of the bile ducts can also cause cholangitis. This condition can either occur on its own, or develop after an episode of bacterial infection.

Main symptoms

Testing and diagnosis

Cholangitis in dogs is rare. Ruling out other causes of the symptoms is the first step in the diagnosis.

Dogs presenting with cholangitis require the following diagnostics to determine the best course of treatment:

Physical examination
Blood tests
Urinalysis
Diagnostic imaging, including ultrasound and X-rays
Bile culture
Biopsy or fine-needle aspirate of the liver
Exploratory surgery to examine the liver and take samples

Specific diagnosis of the underlying cause of cholangitis requires a liver biopsy.

Steps to Recovery

Once diagnosed, treatment options include:

Antibiotics
Corticosteroids
Liver-supporting supplements
Dietary changes
Surgery: in severe cases, surgery may be needed to remove the gallbladder

If the dog is suffering from dehydration, hospitalization may be needed to administer IV fluids.

The prognosis for cholangitis varies depending on the stage and severity of the infection.

Dogs with infections that are diagnosed early generally have a good prognosis, recovering fully with proper treatment.

If cholangitis is not diagnosed early, the prognosis is guarded, with recovering dogs often suffering permanent loss of liver function.

Some patients develop immune-mediated cholangitis after an episode of acute cholangitis. These cases generally need life-long medication and constant medical monitoring. Chronic liver inflammation can lead to liver failure over time.

Prevention

Cholangitis is associated with other gastric conditions like inflammatory bowel disease and pancreatitis, but the root cause is often unknown, so there are no specific preventive measures available to avoid it. Annual veterinary checkups and maintaining an appropriate, vet approved diet can help to identify conditions like cholangitis in their early stages, improving health outcomes overall.