Liver Disease in Cats

Since the symptoms of liver disease are not specific, owners may have difficulty recognizing a potential problem. Any cat who has stopped eating for two to three days or is exhibiting other concerning symptoms should be seen by a veterinarian immediately. Liver disease is serious and can be life-threatening. Early diagnosis and treatment are critical to the likelihood of recovery.

The liver is responsible for many important functions including filtering toxic substances from the blood, digesting nutrients, and storing vitamins and minerals. Its many functions make the liver susceptible to damage, while its ability to regenerate decreases the likelihood that damage will be permanent. Cats with liver disease may experience a neurological syndrome known as hepatic encephalopathy which is indicated by behaviors such as aimless wandering, circling, and head pressing. Loss of appetite and extreme weight loss are also potential signs of the condition. 

Symptoms of liver disease will depend on the underlying cause. Affected cats may experience one or more of the following:

• Decreased appetite
• Weight loss
• Jaundice
• Pale gums
• Excessive thirst
• Vomiting
• Stomach ulcers
• Diarrhea
• Excessive urination
• Dark-colored urine
• Excessive drooling
• Muscle Wasting
• Distended abdomen 
• Buildup of abdominal fluid
• Gastrointestinal bleeding
• Changes in liver size
• Behavior changes
• Lethargy
• Depression 
• Collapse

Types

Common types of liver diseases include:

• Hepatic lipidosis
• Cholangiohepatitis (acute or chronic)
• Lymphocytic Portal Hepatitis

Hepatic Lipidosis

Hepatic lipidosis, or “fatty liver disease”, is the most common severe liver disease found it cats. It is more likely to occur middle-aged cats and those that are extremely overweight. The condition is connected to malnutrition which may be caused by any of the following factors:

• Lack of protein or inability to process protein
• Prolonged Anorexia
• Stress 
• Hormonal disturbances
• Changes in Diet
• Kidney Disease
• Diabetes
• Pancreatitis
• Cancer

Cholangiohepatitis 

Cholangiohepatitis has been linked to the following conditions:

• Bacterial, fungal, or protozoal infection
• Feline infectious peritonitis
• Feline leukemia
• Toxoplasmosis
• Liver flukes

Lymphocytic Portal Hepatitis

Lymphocytic portal hepatitis is thought to be related to an immune or thyroid disorder, though no specific cause has been definitively determined.

The treating veterinarian will begin by reviewing the cat’s medical records and discussing with owners the severity and onset of symptoms. The vet should also be made aware of any preceding events that may have brought about the condition. A standard set of lab tests will be ordered including complete blood count (CBC), biochemistry profile, electrolyte panel, and urinalysis. X-rays or ultrasound may be ordered and a liver biopsy or needle aspiration will be needed to make a definitive diagnosis.

Treatment recommendations will depend on the underlying cause of the liver disease and the severity of symptoms. 

Stabilization

If the cat is suffering from advanced disease or displaying acute symptoms, intensive in-patient care and treatment will likely be necessary to stabilize it before other treatment methods are considered. Electrolytes imbalances will need to be addressed promptly. The cat is likely to receive fluid therapy and supplements of B-complex vitamins, thiamine, and cobalamin. Abdominal swelling will likely be treated with a needle aspiration or prescribed diuretic. 

Nutritional Support

If the cat is malnourished, the vet may prescribe an appetite stimulant. It is often more likely that the cat will require food to be administered through a syringe or feeding tube. This many need to continue for as long as several weeks until the cat is able to consume sufficient calories on its own.

Prescription Drugs

Depending on the underlying cause, the veterinarian may prescribe antibiotics and/or corticosteroids to address any underlying infection and reduce inflammation. In the case of lymphocytic portal hepatitis, immunosuppressant drugs may also be recommended.

Dietary Changes

Once the cat has been released from the hospital, the focus will be on minimizing stress on the liver by reducing the amount of fats, proteins, carbohydrates, and drugs that must be processed. This can be accomplished in part by feeding a high-quality diet that is high in protein, calorie-dense, easy to swallow, easily digested, and low in sodium. The cat will need to frequently be fed small meals to minimize stress on the system. Ongoing dietary supplements may also be prescribed.

If an affected cat is able to survive the first few days of treatment, prognosis improves, and recovery may be expected within three to six weeks. Liver disease is a very serious condition in cats, and it is important that veterinary recommendations are followed and that dietary restrictions are adhered to closely. Follow-up visits will be necessary to ensure proper recovery.

Efforts should be made to ensure that the cat is not stressed, and it should be given a quiet place to rest and recover away from children and other animals. Owners will need to keep a close eye on the cat’s weight, hydration, and overall health and inform the veterinarian promptly of any changes.