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160 Cholangitis, Feline

Propranolol 0.02-0.06 mg/kg slow IV
■ Approximate Methylxanthine Content of Selected Products
to effect Caffeine Theobromine Total Methylxanthines
VetBooks.ir IV bolus over 1-2 minutes followed Type of Chocolate (mg/oz) (mg/oz) (mg/oz) 1.1
Esmolol loading dose 0.05-0.1 mg/kg
■
by a constant rate infusion (CRI) of
0.25
0.85
White chocolate
10-200 mcg/kg/min
○ Ventricular tachyarrhythmias Milk chocolate 58 6 64
Lidocaine (dog) 1-4 mg/kg IV, then Dark chocolate* 138 22 160
■
30-50 mcg/min prn Unsweetened baking chocolate 393 47 440
• Fluid diuresis Cocoa powder 737 70 807
• Vomiting, nausea
○ Maropitant 1 mg/kg SQ q 24h or *If the percent cacao of a dark chocolate is known, the methylxanthine content can be more accurately estimated by using this formula:
○ Ondansetron 0.5-1 mg/kg IV q 8-12h methylxanthines (mg/oz) = 400 × % cacao (reported as a decimal).
Nutrition/Diet
Bland diet in pets with GI upset PEARLS & CONSIDERATIONS in the urinary tract. Patients with large
exposures should have a urinary catheter or
Drug Interactions Comments be walked frequently to keep the bladder
Erythromycin, glucocorticoids, and cimetidine • Emesis is often extremely effective in empty.
decrease methylxanthine clearance rate decontaminating asymptomatic pets and can • Patients with chocolate ingestion can require
be effective up to 6-8 hours after exposure. a high rate of fluids due to losses and osmotic
Possible Complications Onset of clinical signs can be delayed up to pull of fluids into the GI tract. Fluid ins and
Pancreatitis, catecholamine depletion, hyperna- 12 hours for pets ingesting a large amount of outs should be monitored to help ensure
tremia, hyperglycemia, ketoacidosis in diabetic chocolate due to the formation of a bezoar adequate hydration.
patients in the stomach.
• Patients with underlying diabetes mellitus Client Education
Recommended Monitoring are at increased risk of hyperglycemia, The darker the chocolate, the higher the risk
ECG, heart rate, blood pressure, mentation, pancreatitis, and ketoacidosis. of poisoning.
fluid ins and outs • LD50 for theobromine in dogs is
250-500 mg/kg; for cats, 200 mg/kg SUGGESTED READING
PROGNOSIS & OUTCOME Dolder LK: Methylxanthines: caffeine, theobromine,
Prevention theophylline. In Peterson ME, et al, editors: Small
• Prognosis is generally good, especially Keep chocolate away from pets. animal toxicology, ed 3, St. Louis, 2013, Elsevier,
with successful and timely decontamina- pp 647-652.
tion. Technician Tips AUTHOR: Laura Stern, DVM, DABVT
• Prognosis is guarded with large exposures • Methylxanthines are excreted in the urine. EDITOR: Tina Wismer, DVM, MS, DABVT, DABT
or with seizures. They and their metabolites can be reabsorbed

Cholangitis, Feline Client Education
Sheet

Epidemiology ASSOCIATED DISORDERS
BASIC INFORMATION
SPECIES, AGE, SEX Triaditis is the term used for describing the
Definition • Any breed, either sex. Persians overrepre- combination of cholangitis with IBD and
• Cholangitis: inflammation centers on the sented in United Kingdom, Norwegian pancreatitis. IBD or pancreatitis occurs in
bile ducts; it may or may not extend into Forest cats in Netherlands 50%-85% of the cases of cholangitis, with both
the hepatic parenchyma. • Although affected cats range in age from present in up to 40% of cholangitis patients.
• Several distinct forms of cholangitis are < 1 to > 16 years old, most are middle-aged. Cholangitis can also be associated with hepatic
included within a single umbrella term (see lipidosis, or secondary to a variety of other
below). RISK FACTORS diseases/conditions (see Risk Factors).
• Cholangitis is one of the most common feline Extrahepatic biliary obstruction, inflammatory Clinical Presentation
hepatobiliary disorders. bowel disease (IBD), pancreatitis, cholestatic
disease, cholelithiasis, bacterial infection or DISEASE FORMS/SUBTYPES
Synonyms splenic abscess, feline infectious peritonitis • On the basis of histopathologic findings, four
• Feline inflammatory liver disease (FIP), toxoplasmosis, immunodeficiencies, distinct forms of cholangitis exist as defined
• Cholangitis or cholangiohepatitis choledochal stent placement, drugs (diazepam, by the World Small Animal Veterinary
• Acute and chronic neutrophilic cholangitis: tetracyclines, others) Association Liver Diseases and Pathology
suppurative cholangitis Standardization Research Group:
• Chronic lymphocytic cholangitis: lympho- CONTAGION AND ZOONOSIS ○ Neutrophilic, acute or chronic
cytic portal hepatitis Not contagious or zoonotic ○ Lymphocytic

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