The Trinity Of Tummy Troubles: Triaditis In Cats

24 December 2015
 Categories: , Blog


Triaditis, which literally means three inflammations, is a condition that affects only cats. Understanding why this condition is exclusive to cats and how it affects their health can help you to recognize when your cat needs hospital care.

One Duct Spells Trouble for Three Organs

Cats have a unique anatomical design that differs from their canine and human companions. To visualize a clear image of a Y-shaped duct, imagine the lower portion of the letter "Y" connecting to your cat's small intestine. At the junction where the letter branches off into two forks, imagine one of the forks connecting to your cat's liver and the other to your cat's pancreas. This means that when your cat's small intestine is inflamed, fluid from the intestine can creep its way into the liver and the pancreas, causing inflammation in these two organs as well. To make matters worse, cats harbor approximately 100 times the amount of bacteria in their small intestines than dogs do. A high level of bacteria and three organs that share one common duct can be a recipe for trouble. Triaditis is the term used for this disease complex, and it is applied to cats that are diagnosed with the following three concurrent inflammatory conditions:

  • Inflammatory bowel disease
  • Cholangitis
  • Pancreatitis

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) occurs when long-term inflammation results in a thickening of the small intestinal wall. There are several potential causes of IBD, including chronic bacterial infection and intestinal bacterial overgrowth. Symptoms of IBD may include any of the following:

  • Vomiting
  • Diarrhea
  • Decrease or increase in appetite
  • Weight loss

These symptoms can also present with a number of other illnesses. Since the only method for obtaining a definitive diagnosis of IBD is through a tissue biopsy, a presumptive diagnosis can be made through less invasive tests, such as blood work and diagnostic imaging to rule out other illnesses. IBD is incurable, but therapeutic measures can be implemented to control the symptoms and improve the cat's quality of life. Such measures include a change in diet, steroidal drugs to reduce inflammation, antibiotic therapy, probiotics and symptomatic medications.


Cholangitis, also known as cholangiohepatitis, is a form of liver disease, and there are several different types of cholangitis. The type that typically presents with triaditis is called acute neutrophilic cholangitis, and the symptoms include the following:

  • Lethargy
  • Decrease in appetite
  • Vomiting
  • Diarrhea
  • Abdominal discomfort
  • Fever
  • Jaundice
  • Dehydration

Cholangitis can be diagnosed from a blood chemistry profile and complete blood count test results in which bilirubin, liver enzymes and white blood cells are elevated. The treatment for cholangitis includes hospitalization with forced feeding or tube feeding, intravenous fluid therapy and antibiotic therapy. Once recovered, a cat may be placed on lifelong medications and supplements, including s-adenosylmethionine, milk thistle and a choleretic to promote optimal liver health and function.


Pancreatitis occurs when the pancreas becomes inflamed, causing digestive enzymes to overflow and inflict damage to itself and to the liver. The symptoms of pancreatitis in cats include the following:

  • Vomiting
  • Fever
  • Lethargy
  • Decrease in Appetite
  • Dehydration
  • Abdominal pain

Blood tests that reveal the levels of pancreatic and liver enzymes confirm the diagnosis of pancreatitis. An abdominal ultrasound may also be performed to evaluate the pancreas. Left untreated, pancreatitis is fatal. The treatment plan for cats with pancreatitis typically includes hospitalization with intravenous fluid therapy, pain control, antibiotic therapy, anti-inflammatory drugs and medications to combat nausea and vomiting. Even with treatment and complete recovery, there may be future recurrences of pancreatitis.

A study concluded that 83 percent of cats that were diagnosed with cholangitis were also afflicted with IBD, 50 percent of cats that were diagnosed with cholangitis were also stricken with pancreatitis, and 39 percent of cats that were diagnosed with cholangitis had both IBD and pancreatitis. All three conditions are chronic in nature, making triaditis a challenge to control. If your cat exhibits any signs of gastrointestinal upset, schedule an appointment with a veterinary clinic as soon as possible for an evaluation.