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Biliary Cirrhosis in Small Animals

By

Sharon A. Center

, BS, DVM, DACVIM, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University

Last full review/revision May 2015 | Content last modified May 2015

Biliary cirrhosis refers to periportal bridging fibrosis associated with marked hepatic architectural remodeling and biliary hyperplasia subsequent to chronic (months) of EHBDO or years of nonsuppurative cholangiohepatitis. However, it is uncommon in cats with cholangitis/cholangiohepatitis, because these animals usually succumb before biliary cirrhosis develops. Biliary cirrhosis is misidentified in cats with ductal plate malformations (a form of polycystic liver disease). Clinical features of biliary cirrhosis include variable inappetence, cachexia, jaundice, variable liver size, and ascites. Liver enzymes may be normal. Hypoalbuminemia, hyperglobulinemia, hyperbilirubinemia, and coagulopathies are common. The liver may be considered large on abdominal radiographs and appears nodular on ultrasonographic evaluation. Biopsies are needed for definitive diagnosis. Coagulation deficits complicate tissue sampling and necessitate vitamin K1 supplementation and fresh frozen plasma transfusions before procedures. Treatment is symptomatic, requiring management of HE, hypoalbuminemia, EHBDO, and ascites. Prognosis is generally poor. Biliary cirrhosis is most commonly seen in animals with chronic EHBDO caused by obstructive neoplasia. Although cholecystoenterostomy or choledochoenterostomy can avert progression of EHBDO to biliary cirrhosis, it introduces recurrent retrograde infection through biliary structures causing chronic or recurrent septic cholangitis.

OTHER TOPICS IN THIS CHAPTER

Hepatic Disease in Small Animals
Overview of Hepatic Disease in Small Animals
Hematology in Hepatic Disease in Small Animals
Coagulation Tests in Hepatic Disease in Small Animals
Enzyme Activity in Hepatic Disease in Small Animals
Other Serum Biochemical Measures in Hepatic Disease in Small Animals
Hepatic Function Tests in Small Animals
Imaging in Hepatic Disease in Small Animals
Cholecystocentesis in Hepatic Disease in Small Animals
Liver Cytology in Small Animals
Liver Biopsy in Small Animals
Pathologic Changes in Bile in Small Animals
Nutrition in Hepatic Disease in Small Animals
Fulminant Hepatic Failure in Small Animals
Hepatic Encephalopathy in Small Animals
Portal Hypertension and Ascites in Small Animals
Portosystemic Vascular Malformations in Small Animals
Acquired Portosystemic Shunts in Small Animals
Other Hepatic Vascular Disorders in Small Animals
Hepatotoxins in Small Animals
Infectious Diseases of the Liver in Small Animals
Feline Hepatic Lipidosis
Biliary Cirrhosis in Small Animals
Canine Cholangiohepatitis
Canine Chronic Hepatitis
Lobular Dissecting Hepatitis in Small Animals
Canine Vacuolar Hepatopathy
Metabolic Diseases Affecting the Liver in Small Animals
Hepatocutaneous Syndrome in Small Animals
Nodular Hyperplasia in Small Animals
Hepatic Neoplasia in Small Animals
Miscellaneous Liver Diseases in Small Animals
Diseases of the Gallbladder and Extrahepatic Biliary System in Small Animals
Cholecystitis in Small Animals
Canine Gallbladder Mucocele
Other Disorders of the Gallbladder in Small Animals
Other Disorders of the Bile Ducts in Small Animals
Extrahepatic Bile Duct Obstruction in Small Animals
Cholelithiasis in Small Animals
Biliary Tree Rupture and Bile Peritonitis in Small Animals
Feline Cholangitis/Cholangiohepatitis Syndrome
Hepatobiliary Fluke Infection in Small Animals
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