Biliary cirrhosis refers to periportal bridging fibrosis associated with marked hepatic architectural remodeling and biliary hyperplasia subsequent to chronic (several months) EHBDO or chronic (years) cholangiohepatitis. However, it is uncommon in cats with cholangitis/cholangiohepatitis because these animals usually succumb before it develops. 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.
Last full review/revision March 2012 by Sharon A. Center, DVM, DACVIM