Triaditis In Cats
Written by Shula Berg BVSc CertAVP(GSAS) GPAdvCert(SASTS) MRCVS
Clinically reviewed by Elizabeth McLennan-Green BVM&S CertAVP(SAM) MRCVS
Table of Contents
- Overview
- Symptoms
- Diagnosis
- Treatment
- Outlook
Triaditis is the collective name for a combination of conditions specific to cats:
- Cholangitis (inflammation of the gall bladder and bile ducts)
- Pancreatitis (inflammation of the pancreas)
- Enteritis (inflammation of the small intestine)
In cats, the small ducts from the gall bladder and pancreas combine before entering the intestine. It is believed that this anatomical link leads to development of triaditis, possibly due to bacteria ascending from the intestine.
What are the symptoms of Triaditis?
Not all cats will have all three components of triaditis. Typically, pancreatitis and enteritis alone have milder symptoms, while cats with cholangitis are much sicker. However, all three components have very similar symptoms:
Which tests are used to diagnose Triaditis?
Biopsies of the pancreas, liver and intestines are the only test that is 100% specific for triaditis. However, this is almost never justified. Instead, non-invasive tests provide a strong index of suspicion and guide treatment.
Blood tests
Blood tests typically show elevation of liver enzymes and bile acids with cholangitis, as well as an increase in white blood cells. Protein levels may be low with chronic enteritis. Elevated lipase is suggestive of pancreatitis, but additional tests may be needed at an external lab to confirm this.
Ultrasound
Ultrasound provides the best mechanism of viewing the organs involved in triaditis. Changes seen can include distension of the gall bladder and bile ducts, inflammation of the pancreas, and thickening of the intestines, however some cases have no obvious changes. The pancreas is a very small organ, so identifying it on ultrasound can be tricky and takes practise. Ultrasound may be repeated to monitor improvement during the course of treatment.
Bile analysis
Occasionally, a small sample of bile may be taken out of the gall bladder with a fine needle. This allows testing for bacterial infection to confirm diagnosis and guide antibiotic choice.
How is Triaditis treated?
There is no specific cure for triaditis, and treatment is mostly supportive. Depending on the severity of disease, cats may need to be admitted for inpatient care. Treatment typically includes:
Fluids
Many patients are dehydrated, and may be lacking in electrolytes due to vomiting and inappetence. Fluids are usually provided intravenously, using a drip.
Pain relief
Pancreatitis is very painful, which contributes to inappetence. Often strong, opioid based drugs are required to control discomfort.
Supportive care
Depending on the symptoms shown, other medications are used including anti-nausea, gastro-protectants, and hepatic support (if the liver is affected).
Antibiotics
Cholangitis is usually due to bacterial infection. Broad-spectrum antibiotics are used, with bile sampling for culture considered if there is poor response. Antibiotics may need to be given for 4-6 weeks depending on severity.
Feeding
Although most patients don't want to eat, feeding is extremely beneficial to the recovery process. Controlling pain and nausea will help, and in some patients, appetite stimulants are used. In severe cases, a feeding tube may be recommended. Long-term, cats with chronic enteritis may require a prescription diet for management.
Steroids
Some types of cholangitis respond well to anti-inflammatory doses of steroids. This is not the case for all cats, however; your vet will advise if appropriate.
What is the outlook for cats with Triaditis?
The prognosis for triaditis is variable. Mildly affected cats usually make a full recovery, but more severely affected cats may need prolonged hospitalisation. Rarely, severe triaditis can be fatal. Cats who have suffered from triaditis once are prone to repeat episodes.
Disclaimer
Please note that the content made available on this webpage is for general information purposes only. Whilst we try to ensure that at the time of writing all material is up to date and reflects industry standards, we make no representation, warranties or guarantees that the information made available is up to date, accurate or complete. Any reliance placed by yourselves is done so at your own risk.
Page last reviewed: 21st June 2024
Next review due: 21st June 2026