Feline Cholangitis/Cholangiohepatitis Syndrome Causes, Symptoms, and Treatment of Feline Cholangiohepatitis Syndrome

Feline Cholangitis/Cholangiohepatitis Syndrome

Feline cholangiohepatitis syndrome (CCHS) is a multifactorial disease that can cause life-threatening complications, including jaundice and liver damage. Learn more about its symptoms and treatment.

Feline Cholangiohepatitis syndrome (CCHS) is a serious and potentially fatal condition that affects the liver and bile ducts in cats. This condition is characterized by inflammation and damage to the liver and bile ducts, which can lead to a number of serious complications, including jaundice, abdominal pain, vomiting, and loss of appetite. 

CCHS is a complex and multifactorial disease, and the exact cause of the condition is not well understood. However, it is believed that a combination of genetic, environmental, and immune-mediated factors may contribute to the development of CCHS. 

Despite the lack of a clear understanding of the cause of CCHS, there are a number of treatment options available for cats with this condition, including medications, dietary changes, and surgery. In this article, we will explore the causes, symptoms, and treatment options for Feline Cholangiohepatitis syndrome.


Cholangitis/Cholangiohepatitis syndrome in cats is a condition characterized by inflammation of the bile ducts and liver. The exact cause of the condition is not well understood, but it is believed to be a combination of immune-mediated and infectious factors. Risk factors include exposure to certain toxins and viral infections (such as feline leukemia and feline immunodeficiency virus). Certain breeds of cats (such as Siamese and Persian cats) may have a genetic predisposition to the condition. Additionally, certain medications and underlying medical conditions, such as diabetes, can also contribute to the development of cholangitis/cholangiohepatitis.

Clinical Signs  

Clinical signs of cholangitis/cholangiohepatitis in cats can vary depending on the severity of the condition and the underlying cause. Some common signs include:

  • Jaundice (yellowing of the skin and whites of the eyes)

  • Loss of appetite

  • Weight loss

  • Vomiting

  • Diarrhea

  • Abdominal pain or discomfort

  • Increased thirst and urination

  • Dehydration

  • Depression and lethargy

  • Itchy skin

Some cats may also have a fever and an enlarged liver or spleen. These clinical signs can be similar to other liver diseases, so proper diagnostic tests like a complete blood count, serum biochemistry, bile acids test, and ultrasound are needed to confirm the diagnosis.


The diagnosis of cholangitis/cholangiohepatitis in cats typically involves a combination of physical examination, laboratory tests, and imaging studies.

  • Physical examination: A thorough physical examination can reveal signs of jaundice, abdominal pain, and an enlarged liver or spleen.

  • Laboratory tests: Blood tests such as a complete blood count (CBC) and serum biochemistry panel can help to evaluate liver function, identify inflammation, and detect the presence of underlying medical conditions. Additional tests such as bile acids test and measurement of blood clotting profile may also be performed.

  • Imaging studies: Imaging studies such as ultrasound or computed tomography (CT) can be used to visualize the bile ducts and liver and may reveal signs of inflammation or obstruction.

  • In some cases, a liver biopsy may be necessary to confirm the diagnosis of cholangitis/cholangiohepatitis and to determine the underlying cause of the condition.

The diagnosis of cholangitis/cholangiohepatitis can be difficult and may require a combination of diagnostic tests and a thorough evaluation of the patient's history and clinical signs.


Treatment for cholangitis/cholangiohepatitis in cats typically involves a combination of medical and supportive care. The specific treatment plan will depend on the underlying cause of the condition and the severity of the inflammation.

  • Medical management: The mainstay of treatment is medical management which includes antibiotics, anti-inflammatory drugs, and immunosuppressive drugs. Broad-spectrum antibiotics are used to treat and prevent bacterial infections, anti-inflammatory drugs are used to reduce inflammation and pain, and immunosuppressive drugs are used to suppress the immune system and prevent further damage to the liver.

  • Supportive care: Cats with cholangitis/cholangiohepatitis may require supportive care such as fluid therapy to help with dehydration, vitamins, and supplements to help support the liver and a special diet that is low in fat and easy to digest.

  • Surgery: In some cases, surgery may be needed to remove any blockages in the bile ducts or to remove a portion of the liver that is damaged.

  • Special care: Close monitoring of the patient's clinical status and laboratory results is crucial to evaluate the efficacy of the treatment and to adjust the therapy accordingly.

Cholangitis/Cholangiohepatitis can be a chronic, progressive condition that may require long-term management. That’s why treatment plans should be tailored to the individual patient and may be adjusted as the patient's condition changes.


The prognosis for cats with cholangitis/cholangiohepatitis can vary depending on the underlying cause of the condition, the severity of the inflammation, and the response to treatment.

In general, cats that are diagnosed early and receive prompt and appropriate treatment have a better prognosis. With prompt treatment, cats can recover completely, but some cats may have a chronic disease that requires long-term management.

Cats that have severe inflammation or significant liver damage may have a poorer prognosis. These cats may require long-term treatment and may have a reduced life expectancy.

Cats that have underlying medical conditions that contribute to the development of cholangitis/cholangiohepatitis, such as feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV), may also have a poorer prognosis.

Your veterinarian would develop a treatment plan that is tailored to your individual cat's needs. The best way to ensure the best outcome is to monitor the cat closely and make adjustments to the treatment plan as necessary.

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