Canine Cholangeohepatitis in Dogs

This syndrome can be seen after surgery or when bile flow is slowed or stopped completely. There are some signs and symptoms to look for, however, they can be indicative of other disorders as they are general. There are some tests that can be done to determine if cholangiohepatitis is the problem. 

If left untreated, this syndrome can lead to cirrhosis of your dog’s liver. Cholangiohepatitis can be seen alongside duodenitis (inflammation of the duodenum), pancreatitis (inflammation of the pancreas) and cholecystitis (inflammation of the gallbladder) and can therefore be difficult to differentiate without further testing.

Cholangiohepatitis is an inflammation of your dog’s liver, gallbladder and bile ducts. This inflammation can be caused by a bacterial infection somewhere else in your dog’s body. It is rare in dogs and there are few cases that have been studied.

Many of the symptoms are general and can be attributed to many disorders. Some of the general and more specific symptoms below that you can look for in your dog are:

• Anorexia to different degrees
• Weight loss
• Dehydration
• Vomiting
• Diarrhea
• Enlargement of the liver (hepatomegaly)
• Jaundice 
• Fever
• Right sided discomfort upon examination
• Lethargy
• Loss of appetite

Cholangiohepatitis has been shown to be caused by different strains of bacteria which impact the bile duct system in your dog. If a bacterial infection is not the cause of your dog’s cholangiohepatitis, the cause may be due to another condition. 

Bacteria

• Salmonella – Found in raw or undercooked food, easily passed by dogs in their feces and saliva
• Campylobacter jejuni – Found in raw meat and chicken and easily passed in your dog’s feces and anything infected with feces with the bacteria in it
• Coccidiosis – A parasite that lives in your dog’s intestinal walls, acquired by your dog eating dirt infected with coccidia or dog feces that were infected with coccidia 
• Streptococcus spps – Caused by a bacteria found in your dog’s respiratory system that sometimes turns into an infection (similar to strep throat in humans)

Other causes

• Disorders that stop bile flow
• Gallbladder secretions that become too thick to be excreted from your dog
• Gallstones
• Surgery to your dog’s blood vessels from his liver, gallbladder and/or pancreas 

Underlying conditions can result in the bacterial movement in a bile duct

• Inflammatory bowel disease (IBD)
• Cholestasis (bile flow reduction or complete stopping)
• Gallbladder stones
• Chronic pancreatitis
• A suppressed immune system
• Unhealthy gut

If you suspect your dog may be suffering from cholangiohepatitis a visit to your veterinarian will be necessary to determine the cause of his symptoms. Your veterinarian will need to know if your dog has been exposed to anything that is toxic or potentially dangerous to him. Once your veterinarian can rule out any toxicity concerns, he may want to do a physical exam on your dog to determine if there are any areas of discomfort or pain. 

Some testing may be done to better help your veterinarian determine what may be causing the symptoms. Some of those tests can include ultrasounds, CT scans, x-rays, samples taken from liver, bile, and from the blood vessels leading to your dog’s pancreas, liver and gallbladder. 

The ultrasounds, CT scans, and x-rays are done to determine any inflammation of your dog’s gallbladder, liver and pancreas and bile ducts. Your veterinarian will look for any enlargement, growths and more that can be the cause of his symptoms. A liver biopsy will most likely be taken by your veterinarian as well in order to confirm cholangiohepatitis.

Treatment options are going to start with antibiotics, treating symptoms and then possibly moving on to surgery if it is necessary. 

Medications

Antibiotics will be used to treat the actual bacterial infection that is causing your dog’s immediate problem. Some of these antibiotics include ticarcillin which is a type of penicillin, metronidazole which is used to treat bacterial infections that affect your dog’s stomach, skin, and respiratory tract, and enrofloxacin, an antibacterial medication that can be used for a variety of issues including cholangiohepatitis. Oral antibiotics can be given for 1 month to 8 weeks. 

Another medication used may be ursodeoxycholic acid, which will help to correct your dog’s bile levels and encourage the creation of bile acids necessary. S-Adenosylmethionine and Silybin can be combined as a liver supplement to help your dog’s liver function and concerns as well. 

Treating symptoms

Your veterinarian may want to treat symptoms like dehydration, difficulty eating, or keeping food down immediately. Treatment may include IV fluids, reducing his fever and other symptom management options. Your veterinarian will most likely have a goal of balancing your dog’s electrolyte levels via IV solution. If it is needed for your dog to receive nutrition and he is not able to take food by mouth, a feeding tube may be placed temporarily until he is able to eat on his own. 

Surgery

In extreme cases, your dog may require surgery to remove his gallbladder if it is badly damaged enough. Surgery may also be used to remove any gallbladder blocks your dog has. If your dog is experiencing repeated episodes of cholangiohepatitis your veterinarian may want to do some exploratory surgery to better see what is causing his continued symptoms and concerns.

Depending on how your dog reacts to medication and symptoms management, he may have to return to the veterinarian for checkups as needed. However, if he does not respond to the medications checkups, possible surgery discussion may happen. Once your dog is treated you can expect his recovery to begin within 1 week of treatment beginning. While medication management can go on for up to 8 weeks, your dog may return to his normal state sooner.

There is no evidence of any necessary changes made to your dog’s life or lifestyle to support non-reoccurrence of cholangiohepatitis. However regular checkups and keeping an eye on any symptoms you noticed in the past will be beneficial for the long run.