Liver Disease in Cats
Written by Small Door's medical experts
Liver disease is an umbrella term for conditions affecting the liver that typically cause damage or inflammation. Live disease can be primary or caused secondarily by another condition, infection, or toxicity. If left untreated, liver disease can have serious health consequences for your cat. Knowing the signs and symptoms of liver disease and when to seek appropriate medical care from your veterinarian can be vital in your cat’s recovery.
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Often referred to as the powerhouse organ of the body, the liver performs multiple functions. For starters, it aids in blood clotting, digestion, and the filtration and removal of toxins and waste products. Because it does so much work filtering substances in the body, it’s very sensitive to what your cat’s body is exposed to, and it can become damaged or injured, affecting its function. However, the liver is also a special organ that has the ability to repair itself and regrow.
Liver disease is most commonly an infection or inflammation affecting the liver. Liver disease in cats can either be short-term (acute) or long-term (chronic).
Types of feline liver disease
Hepatic lipidosis: Hepatic lipidosis (“fatty liver”) is what refers to a large buildup of fat within the liver, and as the Merck Veterinary Manual states, it’s the most common liver disease in cats. Lipidosis can occur when a larger or overweight cat suddenly stops eating (which can occur due to a multitude of reasons, ranging from an underlying disease process to behavioral causes), which then causes the body to begin metabolizing their fat stores. This breakdown of a cat’s peripheral fat storage essentially causes a flooding of fat cells to enter the liver, which makes it difficult for a cat’s liver to do its normal filtration functions.
Hepatitis/cholangitis/cholangiohepatitis: These conditions refer to inflammation of the biliary tract, gallbladder, and liver tissue. It may be associated with inflammatory bowel disease or pancreatitis, or other conditions or infections. There are many causes of hepatitis, including exposure to poisons or toxins, certain medications, bacterial infections, viruses, or fungal infection.
Cirrhosis: Cirrhosis is an advanced-stage accumulation of liver scar tissue, usually caused by chronic hepatitis.
Portosystemic shunt (PSS): A PSS, or liver shunt, is when a cat’s venous blood from the stomach, pancreas, spleen, and intestines bypasses the liver. This causes a buildup of toxins within the body due to the liver being unable to filter blood. This condition can be present from birth (congenital) or acquired later in life due to other issues (such as cirrhosis and hypertension). Untreated shunts can lead to acute liver failure.
Hepatic neoplasia: Hepatic neoplasia (cancer) can originate in the liver or be metastatic, which is when cancer originates from another location within the body and then spreads to the liver.
Liver cysts: These cysts may be present at birth or develop soon after. Multiple cysts can cause liver dysfunction.
Fulminant hepatic liver failure: Fulminant hepatic liver failure is a syndrome characterized by an abrupt loss of liver function.
If your cat is showing any of the following symptoms, consult your veterinarian immediately:
Neurologic signs/hepatic encephalopathy (seizures, disorientation, staring into space, circling)
Increased thirst and urination
Jaundice (yellowing of the skin, gums, eyes)
Ascites (a visible swelling or distention of the abdomen due to an accumulation of fluid)
Pale-colored bowel movements/feces
Liver disease can have many different causes, ranging from bacterial and viral infections to poison and toxin exposure to congenital defects and endocrine disorders.
Some infectious diseases that can lead to liver disease in cats include:
Feline infectious peritonitis (FIP): A viral infection, FIP causes body-wide inflammation, jaundice, ascites (fluid accumulation in the abdomen), fever, vomiting, diarrhea, and vasculitis (inflammation of the blood vessels).
Toxoplasmosis: Toxoplasmosis is a parasitic infection caused by a single-celled organism called a protozoan. This infection will often cause liver failure and is also transmissible to humans.
Systemic calicivirus: This is a more aggressive form of the common upper respiratory virus within cats known as feline calicivirus.
Coccidiomycosis: This is a fungal infection, also known as Valley fever, which can cause liver enlargement, jaundice, and abdominal swelling.
Some examples of endocrine diseases that can affect the liver are:
Hyperthyroidism: This is a condition where the thyroid is overactive and produces more thyroid hormone than is normal.
Diabetes mellitus:Diabetes can increase the risk of hepatic lipidosis because it increases the body’s metabolization of lipids.
Typically, the first step your veterinarian will take to diagnose liver disease will be blood work, but it is likely that additional diagnostics will also be recommended.
Blood work your veterinarian may recommend may include:
Blood chemistry test: A blood chemistry test analyzes the function of your cat’s organs. Specifically, your veterinarian will be looking for abnormalities within your cat’s liver enzymes such as alanine aminotransferase (ALT) and alkaline phosphatase (ALP), as well as other enzymes that can also indicate a liver issue, such as albumin, bilirubin, blood urea nitrogen (BUN), creatinine, glucose, and cholesterol.
Complete blood count (CBC): This blood test measures your cat’s red and white blood cells and platelets (anemia can be a symptom secondary to liver disease).
Coagulation profile: Prothrombin time (PT) and activated partial thromboplastin time (APTT) will show your cat’s ability to form blood clots and detect bleeding risk.
Additional diagnostics that your veterinarian may recommend may also include:
Urinalysis: A urinalysis will check your cat’s urine for protein, blood, infection, crystals, and pH levels.
Radiographs: Radiographs of your cat’s abdomen can allow your veterinarian to view your cat’s liver and surrounding organs. This will help your veterinarian determine whether the border of the liver appears irregular, if it is enlarged, or if there are any masses present.
Computed tomography: A computed tomography (CT) scan can be a useful tool in identifying mass lesions or abnormalities of the veins and arteries attached to the liver.
Ultrasonography: Ultrasounds of the abdomen are used to view the liver and biliary system (the bile ducts and gallbladder). Ultrasonography is a helpful diagnostic tool, as this offers a different perspective from radiographs and allows your veterinarian to obtain additional information. Some things an ultrasound can show that radiographs cannot are:
Measurements of the thickness and dimensions of an organ
Lymph node enlargement
The ability to identify an accumulation of mucus (also known as a mucocele) within the liver or gallbladder
Lymph node enlargement
An accumulation of free fluid (effusion) in the abdomen
Abnormalities within the veins and arteries attached to the liver
It should be noted that there are also several specialized diagnostics to test for certain diseases that can lead to liver disease, such as coccidiomycosis, toxoplasmosis, and hyperthyroidism.
Liver biopsy in cats
A biopsy can help your veterinarian to identify the presence of any cellular abnormalities and diseases, such as cancer. A liver biopsy is when a small collection of tissue and cells are obtained from an organ (in this case, the liver), which are then studied under a microscope, also known as histopathology. Biopsy samples may also be cultured to check for bacterial infection.
The biopsy itself can be performed through different methods, including:
Ultrasound-guided needle biopsy: Performed with or without sedation/anesthesia, your veterinarian will use an ultrasound probe to locate the liver and then aspirate (take) a small portion of cells using a syringe and needle. This method does not involve any surgical incisions.
Wedge biopsy: Performed under anesthesia, a small wedge is taken from the liver during either an abdominal exploratory or laparoscopic surgery.
Treatment of liver disease can vary depending on the underlying cause or severity of symptoms.
Treatment of hepatitis: For a cat with hepatitis, your veterinarian may recommend supportive care to help reduce liver inflammation and scarring (cirrhosis), which can include:
Intravenous (IV) or subcutaneous (SQ) fluids
Supplements (such as Denamarin, a combination of SAMe and silybin)
It should be noted that sometimes immunosuppressive drugs or dietary changes are also needed.
Treatment of portosystemic shunts: Portosystemic shunts can be surgically repaired in most cases, which is a curative treatment.
Treatment of liver cancer: In cases of liver cancer, treatment can include surgical excision of any masses and chemotherapy. Surgery and chemotherapy in these cases can help your cat to feel better, but may not always provide long-term survival.
Is there a cure for feline liver disease?
The success of treatment for liver disease is dependent on the underlying cause of disease. In most cases, a portosystemic shunt can be surgically repaired, which can be curative. Liver disease can often be managed in cats, and if caught in the early stages, most cats will recover without permanent damage to their liver.
Is liver disease in cats contagious for humans or other pets?
Liver disease itself is not contagious to other humans or pets. However, the underlying cause of liver disease can be transmissible. The following are contagious through cat-to-cat transmission:
Feline infectious peritonitis
As far as being transmissible to humans, toxoplasmosis can infect humans.
What is the cost of treating liver disease in cats?
The cost of treating liver disease in cats can vary depending on the severity of symptoms and what treatment is needed. It may cost about $150 for the initial basic examination and medications to upward of hundreds to thousands of dollars more if further testing and supportive care is needed.
Diet for liver disease in cats
Diet is very important in cats with liver disease. Your veterinarian will want to make sure your cat is staying hydrated, has an appropriate electrolyte balance, and is eating well/has a good appetite. Your veterinarian will work with you to recommend an appropriate diet that addresses your cat’s specific needs based on their clinical symptoms.
Supplementing vitamins within your pet’s diet is also important, as liver disease can cause vitamin deficiencies. Vitamins your veterinarian may recommend supplementing can include B vitamins, vitamins E and K, and zinc.
If your cat is not eating on their own, an esophageal tube may need to be placed to provide your cat with a high-protein and calorie-dense diet.
Feline liver disease life expectancy
The life expectancy of cats with liver disease is usually good if diagnosed early and they receive all the necessary treatment and therapeutic support.
Often, there are many things that cause liver disease that are not preventable. However, being aware of which toxic food and non-food items to keep your cat away from (such as human medications, certain plants, and flowers) can help to reduce the risk of exposure to things that may lead to liver damage. Ask your veterinarian to discuss what potential risks may be within your home that could harm your cat. Also, following your veterinarian’s recommendations for annual preventive wellness lab work or medication-monitoring lab work can also help monitor for any early development of liver disease in your cat.
Is there a vaccine for liver disease in cats?
Calicivirus, which is a virus that can lead to liver disease, is a component of your cat’s distemper (FVRCP) vaccine. While vaccines may not prevent infection, they will minimize the severity of symptoms should your cat contract calicivirus.
While liver disease can be fatal, if caught early enough within the disease process, your cat could make a full recovery. Treatment and supportive care to allow the liver to rest and heal will give your cat the best chance of recovery. Exercising preventative measures under the guidance of your veterinarian and being aware of the signs and symptoms of liver disease can help keep your cat happy and healthy.