What is triaditis? It’s is a condition in cats in which they are affected with three separate diseases at the same time:  pancreatitis, cholangitis (a form of hepatitis), and inflammatory bowel disease (IBD). 

It is unclear why this happens to cats, especially because cats can have one disease, such as pancreatitis, without having the other diseases.

Triaditis in cats

It may results from how the bilary tract connects to the small intestine, and it is suspected that triaditis starts with gastrointestinal (GI) problems associated with IBD, which then leads to the addition of pancreatitis and cholangitis.

Pancreatitis is inflammation of the pancreas, an organ that produces digestive enzymes to help break down food in the small intestine. It can come on suddenly, known as acute pancreatitis, or it can be a long-term, chronic problem.

Cholangitis is inflammation of the gallbladder and bile ducts. It is sometimes termed cholangiohepatitis when the liver is also inflamed.

The duct that goes to the small intestine connects to the pancreas and the gall bladder and runs through the liver, so when that area of the intestines is inflamed, infected, or diseased, the pancreas and gallbladder have a higher chance of being injured as well.

IBD is a chronic condition of the intestines in which inflammation leads to a poorly functioning GI tract. Causes are numerous and include overactivity by the immune system, food allergies, abnormal bacteria in the gut, and genetics  ̶  often occurring in some combination together.

How is Triaditis Diagnosed?

In cats with triaditis, the most common sign is vomiting or throwing up. Decreased activity level, diarrhea or loose stool, poor appetite, and weight loss are also frequently seen. Occasionally, fever, tummy pain, a yellow tinge to the skin (known as icterus),and swelling of the belly may occur.

Your veterinarian will want to do a thorough physical examination to assess for other causes of these signs. They will also run tests on the cat’s blood, such as a complete blood count (CBC), chemistry panel, and pancreatic lipase immunoreactivity test. Imaging such as an abdominal ultrasound may also be needed to confirm the diagnosis.

To be technical about a diagnosis, a biopsy of the pancreas, intestines, and gallbladder or surrounding liver is needed. Many times, this is treated with a strong suspicion that these three organs are involved based on what has already been imaged and diagnosed.

If a bacterial infection is suspected, a culture and sensitivity may be run on fluid or tissues from the affected organs. All of these tests will help point the veterinarian in the right direction for diagnosing triaditis. 

While this sounds like a lot of tests, keep in mind that triaditis is really three different diseases happening at the same time, so it can be difficult to get the diagnosis right. 

Treating Triaditis

Treating Triaditis
This shows the connecting duct from the gallbladder to the small intestines

In order to treat triaditis effectively, all three diseases will need to be managed together. Pancreatitis treatment may include pain medication, treatment for nausea, and hospitalization and fluid therapy for dehydration and to support pancreatic blood flow.

Triaditis treatment is similar, although liver and gallbladder protective medications such as ursodiol, samE, or Denamarin (a combination of sameE and milk thistle) may be used to help encourage healing. Antibiotics may be given if a bacterial infection is occurring.

IBD treatment includes managing the cause of GI disease. This management can mean a special diet, medications to suppress the intestinal immune system, and vitamin B supplementation when needed.

Additional treatments needed will depend on the complications or effects of triaditis on the pet. Bleeding disorders, gall stones (known as choleliths), severe infections such as abscesses or septicemia, calcium deficiencies, and electrolyte imbalances are some of the complications that may occur, especially if treatment is delayed. For cats that won’t eat, sometimes feeding tubes are necessary.

Triaditis is a complex disease, but your veterinarian will be able to give you a good idea of what is needed for your cat and help you get them back to health. The prognosis can vary depending on the severity of disease. But many cats with triaditis recover well with treatment.

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