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Helminth Infection and Control / Liver Diseases and Immunity / Gallbladder and Bile Duct Disorders · Journal article
Equine Veterinary Education · September 1, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a descriptive case report of a 20-year-old Camargue pony with severe chronic neutrophilic cholangiohepatitis, massive choledocholithiasis, and hepatolithiasis presenting with hepatic encephalopathy and acute colic. The case illustrates a rare clinical presentation and its fatal course despite supportive care, with postmortem confirmation of biliary obstruction and hepatic fibrosis.
Single case report with clinical examination, laboratory analysis, liver biopsy, and postmortem necropsy and histopathology.. A 20-year-old Camargue pony mare with acute-onset neurological signs and intermittent colic.. Intervention: Intensive supportive therapy (specific interventions not detailed in the abstract).. n = 1.
A single large choledocholith weighing 140 g (11 × 5 cm) was found at necropsy Multiple hepatoliths up to 2 cm were present in the liver Laboratory findings included marked hyperammonaemia, hyperbilirubinemia, severe increases in liver enzymes, hypoalbuminaemia and elevated bile acids
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This case alerts clinicians to consider biliary lithiasis in mature equids with combined hepatic and neurological presentations, and underscores the need for early diagnosis and intervention before irreversible hepatic fibrosis develops. The rarity and fatal outcome illustrate the importance of recognizing this differential diagnosis in equine practice.
A single clinical case report with autopsy findings that illustrates a rare disease presentation; descriptive evidence useful for differential diagnosis but without comparative or interventional data.
As stated by the source record.
Quoted from the source exactly as published.
This case alerts clinicians to consider biliary lithiasis in mature equids with combined hepatic and neurological presentations, and underscores the need for early diagnosis and intervention before irreversible hepatic fibrosis develops. The rarity and fatal outcome illustrate the importance of recognizing this differential diagnosis in equine practice.
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Summary A 20‐year‐old Camargue pony mare was referred for acute‐onset neurological signs and intermittent colic. Clinical examination revealed obtundation, cranial nerve deficits, head pressing, ventral strabismus and ataxia. Laboratory analyses showed marked hyperammonaemia, hyperbilirubinemia, severe increases in liver enzymes, hypoalbuminaemia and elevated bile acids. Liver biopsy demonstrated severe chronic neutrophilic cholangiohepatitis with bridging fibrosis, ductular proliferation and hepatic lipidosis. Despite intensive supportive therapy, the pony developed acute colic accompanied by fever and gastric reflux and was euthanised because of a poor prognosis. Gross necropsy revealed a markedly dilated common bile duct containing a single large choledocholith (140 g; 11 × 5 cm), multiple hepatoliths (up to 2 cm) and a fibrotic liver. Histopathological examination of the brain identified Alzheimer type II astrocytes, consistent with hepatic encephalopathy. This case underscores the importance of considering biliary lithiasis in mature equids presenting with hepatic and neurological signs, and highlights the critical role of early diagnosis before the development of irreversible hepatic fibrosis.
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