Bile is an important product of liver that helps in the digestion of food (specifically lipids) during digestion process. This dark green to yellowish brown, bitter testing fluid is produced in liver but stored in gall bladder until food is eaten.
Bile ducts are ducts that convey bile from the liver and the gallbladder to the duodenum whereas intrahepatic ducts are part of the outflow system of exocrine bile product from the liver.
Inflammation of the bile ducts and intrahepatic ducts is referred to as cholangitis whereas inflammation of bile ducts, gall bladder and liver is known as Cholangiohepatitis. The two conditions mostly occure together and are collectively referred to as Cholangitis-Cholangiohepatitis Syndrome (CCHS) which describe inflammation of bile ducts, intrahepatic ducts, gall bladder and liver. When any of these organs become inflamed, bile production decreases and/or the bile cannot go through the ducts, causing liver failure. This potentially fatal condition is rare in dogs.
Certain conditions occur prior to or simultaneos to CCHS; inflammation or clogging of the liver ducts running outside the liver (EHBDO), inflammation of the pancreas, inflammatory bowel disease (IBD), fatty liver disease, or long-term inflammation of kidney tissue.
CCHS is classified into three forms, suppurative, non-suppurative and lyphocytic/lymphoplasmacytic.
suppurative, which has a discharge of fluid within the biliary canal and is often sudden onset, but generally has a good outcome; nonsuppurative, which is reoccurring and has a guarded to poor prognosis; and lymphocytic/lymphoplasmacytic, where lymphocytes and plasma cells invade and surround the liver's portal vein or portal triad (the portal vein, bile duct and artery of the liver), and which has a poor outcome due to its longer lasting chronic nature and tendency to progress to cirrhosis of the liver.
Suppurative CCHS
Fever
Swollen painful abdomen – due to fluid crossing over into the abdomen (ascites)
Yellow skin and yellow whites of eyes
Dehydration
Shock
Nonsuppurative CCHS
Enlarged liver (hepatomegaly)
Lack of energy
Lack of appetite (anorexia)
Vomiting
