Merlin – Unravelling the mystery of Feline Triaditis

Merlin’s history at New Lambton Veterinary Clinic spans a good seven years. He has become a much loved regular resident of our cat hospital facility and his colourful history has included skin complaints, urinary tract issues and most recently the diagnosis of inflammatory bowel disease and pancreatitis.

 

Over the past two years Merlin has presented to the clinic with episodes of being off his food, feeling nauseas and running a high temperature. Despite responding to supportive care and hospitalisation the episodes were becoming more frequent and with minimal findings on blood testing and in house imaging we referred Merlin for a specialist ultrasound. We are so fortunate at New Lambton Vets to be able to offer an in house specialist ultrasound service via Newcastle Veterinary Ultrasound Referrals. Dr Ross Barter is able to bring his expertise and ultrasound skills to our patients so they can be examined in the comfort of the familiar settings here. Another bonus is the patient’s primary care clinicians can be involved in the ultrasound procedure resulting in an invaluable service for our patients.

 

Merlin’s ultrasound showed a very tortuous and dilated pancreatic duct and generalised bowel thickening leading to a tentative diagnosis of Inflammatory Bowel disease and secondary pancreatitis. To make a conclusive diagnosis Merlin would need a general anaesthetic and biopsies of his liver and gastrointestinal tract. It was decided as both these disease processes are relatively common in our feline patients to go with the working diagnosis of Feline Triaditis. This would allow also for the inclusion of a third disease process –cholangiohepatitis.

 

What causes Feline Triaditis?

 

Cholangiohepatitis is thought to be initiated by bacteria ascending through the bile duct and an immune response to bacterial antigens is likely to perpetuate inflammation. The cause of pancreatitis is unknown in most cases and not incited by high fat diets as in dogs. The exact cause of IBD is not known but it is not thought to be due to a genetic predisposition in cats as in humans. It is speculated abnormal interplay between antigenic stimulation (by diet or infectious antigens) and the immune system may lead to IBD. Perhaps in Merlin’s case there is a correlation between his skin disease and IBD? We know that skin disease can be a signalment of IBD in our veterinary patients.

 

All 3 components of triaditis are chronic diseases that are challenging to manage. In Merlin’s case he was managed with intravenous fluid therapy, pain relief, anti-nausea medication, antibiotics and anti-inflammatory medication.

 

Now that he is eating well again we are planning to slowly wean him onto a hypoallergenic diet in an attempt to manage his IBD long term.

 

Merlin’s journey is going to be ongoing and this most recent episode had us all a little concerned that he wasn’t going to pull through…Merlin however is a real trooper and has a huge support network behind him with his mum Brenda and sis Morag at home as well as all of us here at NLVC – his home away from home!

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