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Diseases of the Bile Duct
Diseases of the Bile Duct in Horses
Introduction
Bile duct diseases are generally characterized by icterus (jaundice), colic, and fever. Icterus occurs when there is a build up of bilirubin in the tissues. Not all of these symptoms are present in every case and these symptoms can be caused by diseases other than bile duct problems. If one of your primary symptoms is icterus but you are uncertain of its significance see Icterus (Jaundice) in Horses. This article is about the diagnosis, treatment, and prognosis of disease of the bile duct.
Symptoms
The symptoms you will see depend largely on the primary cause and degree of obstruction of the bile duct. Most of the serious symptoms of bile duct disease are caused by the secondary hepatitis and liver failure induced by the toxic effects of the back up of bile into the liver. However, there are other complications of excessive bile in the blood (bilirubinemia) and tissues. Deposition into the skin, even when less than can cause icterus, can result in hyper-sensitivity to the sun. With severe bilirubinemia, the kidneys can be injured by excessive bile casts lodging in the kidney's tubules.
Though similar symptoms may be seen, the course of the acute and chronic bile duct disease are very different:
Acute Complete Obstruction
Horses with a rapid onset of complete obstruction of the bile duct become very sick very quickly. They will have a remarkable icterus caused by high levels of conjugated bilirubin and a secondary hepatitis. The secondary hepatitis may lead to liver failure and will have to be differentiated from bile duct disease by careful laboratory analysis and ultrasound. The build up of bile acids or secondary biliary tract infection can cause fever and when stones are present often colic is seen also.
Chronic Obstruction
Chronic obstruction is more common than the acute disease. The severity of the signs will depend on the degree of obstruction but unlike the acute disease which is rapidly progressive, you may see recurring episodes of icterus, colic, and fever. With time a secondary chronic liver disease may occur with loss of appetite, lethargy, non-regenerative anemia, and weight loss occurring.
Causes of Bile Duct Disease
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