Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats

Abstract

BackgroundThe term triaditis designates the concurrent presence of idiopathic inflammatory bowel disease (IBD), cholangitis, and pancreatitis in cats.Hypothesis/ObjectivesThe histopathology of concurrent, but often subclinical, inflammatory processes in the small intestine, liver, and pancreas of cats is poorly described. We aimed to investigate the frequency of enteritis, cholangitis, pancreatitis, or some combination of these in symptomatic and asymptomatic cats, compare clinicopathological features, and correlate histopathological with laboratory findings.AnimalsDomestic cats (27 symptomatic, 20 asymptomatic, and 8 normal).MethodsProspective study. Physical examination, laboratory variables (CBC, serum biochemistry profile, serum thyroxine concentration, serum feline trypsin‐like immunoreactivity [fTLI], feline lipase immunoreactivity [fPLI, as measured by Spec fPL ®], urinalysis, and fecal analysis), imaging, and histopathological examinations were conducted. Feline liver, pancreas, and small intestine were biopsied during laparotomy.ResultsInflammatory lesions were detected in 47 cats (27 symptomatic, 20 asymptomatic). In total, 20 cats had histopathologic lesions of IBD (13/47, 27.7%), cholangitis (6/47, 12.8%), or pancreatitis (1/47, 2.1%) alone, or inflammation involving >1 organ (27/47, 57.4%). More specifically, 16/47 cats (34.0%) had concurrent lesions of IBD and cholangitis, 3/47 (6.4%) of IBD and pancreatitis, and 8/47 cats (17%) of triaditis. Triaditis was identified only in symptomatic cats (8/27, 29.6%). A mild, positive correlation was detected between the severity (score) of IBD lesions and the number of comorbidities (rho = +0.367, P = .022).Conclusions and Clinical ImportanceHistopathological evidence of IBD or IBD with comorbidities was detected in both symptomatic and asymptomatic cats. The possibility of triaditis should be considered in symptomatic cats with severe IBD.

Aspectos anatomopatológicos e avaliação de agentes infecciosos em 32 gatos com colângio-hepatite

“…Dados semelhantes foram descritos por diversos pesquisadores (Lucke & Davies 1984, Barros 2016. Hepatomegalia é um achado comum na colângio-hepatite, provavelmente decorrente do infiltrado inflamatório e é descrita por Prasse et al (1982), Sherding (2000) e Fragkou et al (2016). O aspecto macroscópico do fígado dos casos de CHE corrobora com o descrito por Ilha et al (2004), sendo caracterizado por diminuição do volume do órgão, firme à palpação e com a superfície capsular irregular, provavelmente causadas pela substituição do parênquima hepático por proliferação de tecido conjuntivo.…”

“…Enterite e pancreatite foram identificadas concomitantemente com a colângio-hepatite. Estes dados estão de acordo com diversas pesquisas semelhantes, onde a frequência de enterite em gatos com colângio-hepatite variou de 34% a 83,3% (Weiss et al 1996, Swift et al 2000, Clark et al 2011, Twedt et al 2014, Fragkou et al 2016) e de pancreatite em 50% a 65,2% (Weiss et al 1996, Swift et al 2000, Clark et al 2011, Twedt et al 2014.…”

“…A formação de tríade também foi identificada. Em outras pesquisas, a frequência dessa condição variou de 29,6% a 55,5% (Weiss et al 1996, Swift et al 2000, Clark et al 2011, Twedt et al 2014, Fragkou et al 2016. Tríade foi observada em todas as classificações histológicas da colângio-hepatite, como descrita por Clark et al (2011).…”

Cholangitis der Katze – Diagnostisches Vorgehen und Therapiemöglichkeiten

“…Cholangitiden, entzündliche Erkrankungen des Gallengangsystems, sind eine häufige Erkrankungsgruppe des hepatobiliären Systems der Katze [1][2][3][4]. Die anatomischen Verhältnisse im proximalen Abschnitt des Magen-Darm-Trakts stellen eine mögliche Erklärung für eine dahingehende Prädisposition bei der Katze dar (▶ Abb.…”

Comparison of laparoscopic‐assisted technique and open laparotomy for gastrointestinal biopsy in cats*

“…Acquiring gastrointestinal biopsies is commonly performed to identify the cause of clinical signs of gastrointestinal disease (including weight loss, anorexia, vomiting, diarrhea, and thickened intestinal wall). Such signs are common in cats and intestinal biopsies are often necessary to differentiate inflammatory from neoplastic disorders . Controversy remains regarding the relative value of partial thickness endoscopic biopsy or full thickness samples, but surgical samples have been shown valuable to establish a definitive diagnosis .…”