A six year old castrated male domestic short hair cat presented to Cornell University Hospital for Animals (CUHA) for further work-up of vomiting, anorexia, hiding, and progressive elevations in liver enzymes after failing to respond to three days of medical treatment by his referring veterinarian. The cat had been diagnosed with suppurative lymphoplasmacytic cholangiohepatitis three months prior. On presentation to CUHA, he was febrile and had a tense, painful abdomen. Further examination also revealed hepatomegaly and subtle icterus of the nictitans. Biochemical findings included marked elevations in liver enzymes, hyperbilirubinemia, and bilirubinuria. Abdominal ultrasound showed pronounced dilation of extra- and intrahepatic bile ducts attributable to blockage by a proliferation of tissue at the major duodenal papilla (MDP). The patient was taken to surgery the next day where biliary diversion was performed via a cholecystojejunostomy and a temporary stent was placed in the common bile duct. Bile was aspirated for culture and susceptibility and a multi-drug resistant Enterococcus species was isolated. Histopathology of biopsies characterized the MDP tissue as inflammatory. Cholangiohepatitis in the cat and its relationship with biliary obstruction will be discussed as well as the prognosis for cats undergoing surgical decompression of biliary tree obstruction.