Page 386 - Problem-Based Feline Medicine

378 PART 7 SICK CAT WITH SPECIFIC SIGNS

Culture and sensitivity of the liver biopsy should be
CHOLANGIOHEPATITIS**
performed if suppurative cholangiohepatitis suspected.
Classical signs Lymphocytic, plasmocytic cholangiohepatitis occa-
sionally produces a high protein abdominal fluid sim-
● Anorexia.
ilar to that of effusive FIP.
● Vomiting.
● Icterus.
● Dehydration.
● Fever. FELINE IMMUNODEFICIENCY VIRUS
● Weight loss. (FIV)**

See main reference on page 427 for details (The Yellow Classical signs
Cat or Cat With Elevated Liver Enzymes).
● Opportunistic infections.
● Gingivitis.
Clinical signs ● Weight-loss/cachexia.
● Diarrhea.
Clinical signs may be acute, chronic or intermittent.
● Chronic fever.
Typically, there is anorexia and depression together
with icterus or increased bilirubin and liver enzymes See main reference on page 339 for details (The Thin,
on a biochemistry panel. Inappetent Cat).

Vomiting and dehydration may be present.
Fever, especially in the suppurative form occurs in Clinical signs
approximately 38% of the cases.
Clinical signs are primarily due to immunosuppres-
Chronic cholangiohepatitis may lead to end-stage liver sion, i.e., chronic recurring infections that do not
disease and the cat may present with ascites and respond to appropriate therapy.
hepatic encephalopathy.
Gingivitis, stomatitis and peridontitis are more com-
Multiple causes include bacterial, protozoal (T. gondii) mon findings in FIV infections than in FeLV, although
and immune-mediated disease. one study suggests that these signs may be to an effect
of age, rather than a consequence of FIV infection.
Diagnosis Fever is chronic and is related to production of tumor
necrosis factor and/or IL-1 in infected cats.
Complete blood count may show neutrophilia with a left
shift, and mild non-regenerative anemia. Weight loss/cachexia are common in the late stages of
FIV, as in human HIV infections.
Biochemistry panel shows hyperbilirubinemia, ele-
vated liver enzyme activities (ALP, ALT, GGT), +/− Diarrhea resembles a panleukopenia-type syndrome
elevated serum bile acids. that may be due to actual enterocyte infection by the
● Signs of late-stage liver disease are occasionally virus or secondary to inflammation.
present, such as decreased BUN, glucose and albu-
Cats are often thin and scruffy with an unkempt hair-
min concentrations.
coat, and may have miliary dermatitis.
Abdominal ultrasound should be performed to evalu-
ate the gall bladder and bile duct for cholelithiasis, bile
sludging and cholecystitis. Diagnosis
Liver aspirates/biopsy allows for differentiation of Diagnosis may be suspected based on history and clin-
suppurative from non-suppurative forms of cholangio- ical signs, but requires antibody or antigen tests for
hepatitis. confirmation.