Feline Cholangitis and Cholangiohepatitis – NAVLE Study Guide

Overview and Clinical Importance

Feline cholangitis/cholangiohepatitis syndrome (CCHS) is the most common acquired inflammatory liver disease in domestic cats and ranks as the second most common hepatobiliary disorder after hepatic lipidosis. Understanding this condition is essential for the NAVLE, as it frequently appears in board examination questions and has significant clinical implications for feline practice.

Cholangitis refers to inflammation of the biliary ducts, while cholangiohepatitis describes inflammation that has extended into the periportal hepatic parenchyma beyond the limiting plate. The unique feline anatomy, where the common bile duct and major pancreatic duct share a common opening at the major duodenal papilla, predisposes cats to concurrent inflammatory disease affecting the liver, pancreas, and intestines, known as triaditis.

Anatomical Considerations

Unique Feline Hepatobiliary Anatomy

The feline biliary system has several unique anatomical features that predispose cats to hepatobiliary disease. The common bile duct (CBD) is long and tortuous, traveling from the liver through the hepatoduodenal ligament to join the duodenum at the major duodenal papilla, located approximately 3 cm caudal to the pylorus.