Biliary Disorders in Horses

This review will mainly focus on the presentation, diagnosis, and treatment of cholangiohepatitis in adult horses. The condition is often accompanied by some degree of intrahepatic and/or extrahepatic biliary obstruction with "sludgy" bile or actual choleliths. In horses, these calculi are typically composed of calcium bilirubinate, rather than cholesterol. There is a propensity for cholangiohepatitis to become a recurrent, chronic condition and patient management should reflect this. Although much rarer, foreign body obstruction, neoplasia and, in some parts of the world, liver flukes can also be causes of biliary disease in horses, and these will also be discussed.