Liver problems in cats are fairly common. We see
both primary liver problems like hepatitis and liver cancer and
also secondary liver problems like fatty degeneration resulting
from prolonged inappetance. Diagnosing liver disease can be difficult
from a physical exam alone. The symptoms of liver disease are often
non-specific – inappetance and lethargy. Occasionally, a cat
with liver and gall bladder problems will appear yellow [jaundiced]
on physical exam, but usually blood tests are required to diagnose
feline liver disease. This is why blood tests can be invaluable
when the physical exam doesn’t reveal a cause for malaise,
vomiting or inappetance.
Sometimes a urine sample will lead us toward liver disease because
of the presence of bilirubin in the urine. X-Rays may indicate an
enlarged or abnormal liver. There are five enzymes in our Serum
Chemistry Profile, which are associated with liver and gall bladder
function. The pattern of their elevation or depression can tell
us something about the liver disease- especially it’s severity,
but they rarely reveal the succinct cause of the problem, which
could be . . .
-Viral or bacterial hepatitis
-Fatty degeneration or other metabolic problems
-Tumors, benign or malignant
-Toxic hepatopathy like Excedrin
-Obstructive disease like gallstones
-Parasitic problems like Toxoplasmosis
It is often necessary to go further with diagnostics. These procedures
might include, bile acid testing, specific viral tests, x-rays,
fecal tests and others. Commonly, ultrasound is a useful, albeit
costly, ancillary test. Ultrasound is really medical sonar and is
painless for your cat. By imaging the liver, gall bladder and bile
ducts, a definitive diagnosis may be made. If the ultrasound is
ambiguous, sometimes a small core biopsy will be taken guided by
the ultrasound image. This may require short, mild anesthesia. Sometimes
a very fine needle can be used to aspirate liver tissue. Both of
these samples are then sent to consulting pathologists for diagnosis
with 2-4 day turnaround time.
Once a diagnosis is achieved, more specific treatment can be started.
We begin to treat all liver patients with a general liver protocol
involving antibiotics, antiiflammatories, vitamins, amino acids
and drugs to promote the normal movement of bile through the liver.
In some cases, exploratory surgery and biopsy might be a better
route to consider than ultrasound, especially if we expect involvement
of other organs or if bile duct obstruction is suspected.
Once a diagnosis is achieved, we will treat specifically and often
recheck the serum chemistry frequently, as the change in liver values
can be rapid [hours to days], this helps us determine if the treatment
is successful or needs modification.
Liver diseases in the cat run the gamut from readily reversible
to untreatable. Without thorough diagnostics it is hard to tell
which cats will respond well, so complete testing is mandatory with
feline liver disease.