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College of Veterinary Medicine & Biomedical Sciences, Texas A&M University
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When a cat falls ill, the last thing an owner may suspect is that multiple conditions are the culprit. However, the body’s reactionary cues often respond to one another, and when one disease is working in tandem with several others, a cat’s way of life can be severely impacted.
This is especially true for triaditis, a complex condition that occurs when multiple organs in the gastrointestinal system develop problems concurrently.
Dr. Sue Lim, an assistant professor at the Texas A&M College of Veterinary Medicine and Biomedical Sciences, describes the complex factors leading to triaditis in cats and how owners can best support their pets through this disease.
The Culprit: Internal Inflammations
Triaditis is complex because it involves the simultaneous inflammation of the pancreas (pancreatitis), the liver (cholangitis), and/or the intestines (chronic enteropathy).
“It is not necessary for cats to have irritation in all three organs for the condition to arise; it can be a combination of any two of the organs,” Lim said.
Signs & Sypmtoms of Triaditis in Cats
Whether a cat is experiencing inflammation of all three organs or only two, common symptoms include dehydration, lethargy, loss of appetite abdominal pain, and diarrhea.
Symptoms can vary but often include lethargy, poor appetite, dehydration, and diarrhea.
“Clinical signs are pretty vague and non-specific and will vary slightly between patients with specific components of triaditis,” Lim said.
Suspected Factors Causing Triaditis in Cats
It is unclear how inflammation in one organ can affect other organs, according to Lim, but the anatomy of cats may play a role. The close physical connection between the pancreas, liver and intestines is a suspected influence in the rise of triaditis.
“In a dog, the common bile duct, which carries bile from the liver to the intestines, and pancreatic duct empty into the intestines separately,” Lim said. “In a cat, the pancreatic duct and common bile duct join before exiting into the intestines. This makes it easier for any bacterial infection from the intestines to enter the liver or pancreas.”
This anatomical difference is also why dogs are rarely at risk of developing triaditis.
Can You Prevent Triaditis in Cats?
According to Lim, there is nothing an owner can do to prevent this disease.
“We don’t know the risk factors causing triaditis; therefore, specific preventative steps cannot be taken,” Lim said. “We now know that the anatomy of the cat predisposes them to it and there are both good and bad bacteria in the GI tract. The problem arises when these bacteria are no longer confined within the GI tract and gain access to places they are not supposed to be, leading to infection and inflammation.”
Confirming a Diagnosis of Triaditis in Your Cat
Diagnosing triaditis begins by identifying which organs are being affected; to make that determination, Lim recommends a combination of tests:
- Blood and urine tests to rule out other disorders, such as kidney disease, hyperthyroidism, exocrine pancreatic insufficiency that may mimic clinical signs associated with triaditis
- Fecal exams to rule out parasites
- Serum feline pancreatic lipase immunoreactivity (fPLI) — a test that recognizes abnormal levels of pancreatic enzymes in blood
- Diagnostic imaging, such as abdominal ultrasound, to evaluate the pancreas, liver and intestines
If results are still inconclusive, a veterinarian may recommend doing more invasive tests such as sampling the gallbladder to look for infection and conducting biopsies of the intestines, liver and pancreas.
Managing Triaditis in Cats
Once triaditis is diagnosed, management typically includes controlling symptoms and preventing aggravation of other organs.
“Currently there are no specific treatments for triaditis,” Lim said. “We manage each component of triaditis either symptomatically or specifically.”
Supportive therapy options include:
- Fluids
- Pain management
- Control of vomiting/nausea
- Managing complications
- Treating comorbidities, such as diabetes, hepatic lipidosis or exocrine pancreatic insufficiency (EPI)
Specific treatments for each affected organ may include diet trials, antibiotics or immunosuppressive therapy. Unfortunately, there is currently no specific therapy for pancreatitis, but the VMBS continues to present new research findings in the search for beneficial treatment plans.
Because triaditis is a health risk for every breed of cat, it is vital for owners to stay vigilant about their feline friend’s daily well-being. The sooner an organ’s inflammation is managed by a veterinarian, the sooner the pet can feel relief.
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