Cat Health Care
Information by Condition or Disease

Courtesy of Pawprints and Purrs, Inc.

Feline Liver Disease

The liver is one of the most important and the largest organs in the body and has a considerable reserve. It regulates the levels of most of the chemicals in the blood. It also produces proteins for the blood plasma, converts waste products of protein-processing into a substance that can be removed from the body by the kidneys, helps regulate the distribution of fats in the body, produces bile to aid digestion, and stores glycogen, which is used as an energy source when needed. In addition, the liver regulates amino acid levels and helps clear the blood of certain toxins. It must be extensively damaged before signs of disease are seen. Because many of its functions are similar to those of other organs in the body, signs of liver disease may resemble disease signs of other organs. Liver disease may also accompany disease processes such as pancreatitis, hyperthyroidism, hypothyroidism, and congestive heart failure.

Disease of the cat's liver is not uncommon, particularly among older cats. It is a serious matter, for without the liver, life is not possible. Symptoms of liver disease are:

•A reduced appetite or complete anorexia (refusal to eat)

•Abdominal swelling

•Jaundice (this symptom is most obvious as a yellowing of eyes, ears, and gums)

•Diarrhea

•Depression

•Vomiting

•Weight loss

•Lethargy and irritability

1. •Epilepsy
   

Ascarids (three- to four-inch roundworms), tapeworm cysts, flukes (a type of worm), and toxoplamosis are among the parasites which can affect the liver. Diabetes mellitus and Cushing's syndrome (an excess of adrenal cortical hormone) cause liver damage. Feline infectious peritonitis, leukemia virus, and feline immunodeficiency virus also can involve the liver.

Because of its numerous functions, many signs are possible with liver disease. Icterus (also called jaundice) is one of the most common. This is a yellow coloration of the mucous membranes, caused by an accumulation of toxins which are no longer removed from the blood by the damaged liver. This causes the white of the eyes to appear yellow. The inside of the ears and the gums also may look yellowish. Another sign of possible liver disease is fluid accumulation in the abdomen, seen as a widening of the lower part of the belly. In some liver diseases, brain and central nervous system abnormalities occur. Some cats have only vague symptoms, including poor appetite, occasional vomiting, weight loss, and depression.

Laboratory tests are usually needed to determine the extent of liver disease. Xrays, ultrasound, and a liver biopsy may be necessary to confirm the diagnosis. Even these may not give a definite diagnosis.

Liver disease is difficult to diagnose and still more difficult to treat. When it is caused by another disease or abnormality, treatment will be aimed at that cause. Very little therapy is available when the liver itself is involved. About all that can be done is try to lessen its work load by providing a diet with high quality protein and carefully balanced vitamins and minerals. Drugs such as choline may be helpful in some cases.

Hepatic lipidosis, also called idiopathic hepatic lipidosis (IHL) or fatty liver syndrone, is a common liver disease in cats in the United States, though unusual in the United Kingdom. Its cause is unknown, but it is more frequent in overweight, middle-aged cats. It may be due to metabolic, toxic, or nutritional causes, or to a lack of oxygen supply to the liver. It can occur with diabetes mellitus, and can be seen in cats who have been stressed by boarding, surgery, illness or being moved to a new home. It is sometimes seen in a cat who has been fed dry dog food. Fatty liver may occur in cats who have upper respiratory tract disease because of a high fever which uses reserves faster than is normal. Also, the cat may be unable to smell food because of his nasal congestion, and may have mouth ulcers which make eating painful.

The lipidosis occurs when an apparently susceptible cat eats little or no food for a couple of days to two or more weeks. It is not known whether the failure to eat causes the lipidosis, or if the lipidosis causes the lack of appetite. Once the liver becomes filled with fat, the cat seems to be unable to metabolize and remove it. The cat also seems unable to use stored body fat in this crisis; thus, his body uses muscle to provide protein. About 35% of cats who have hepatic lipidosis will die.

Signs of fatty liver include lack of appetite, often lasting several weeks, and weight loss, although the cat may still be noticeably overweight. He may be jaundiced, and vomiting, constipation, and intermittent salivation may be seen. The cat may be lethargic, dehydrated, and weak.

Cats with advanced hepatic lipidosis have enough liver damage that they cannot utilize protein and its amino acids. The cat may have little or no appetite, and will need a high protein balanced diet. Your veterinarian may need to place a feeding tube in the cat. He then can be fed a mixture of high quality cat food diluted half and half with water and pushed through the tube with a syringe. Nutrical® also can be used for feeding the cat. Human enteral feeding formulas do not have enough protein for cats, while human baby foods are either lacking in protein or have a severe calcium-phosphorus imbalance for cats. Fluids and electolyte solutions also may be given via the tube, and added taurine may be necessary. The feeding tube will be removed when the cat is feeling better and wants to eat by himself.

Some cats who are supplemented with liquid diets may be unable to cope with the protein in these foods. If no signs of hepatic encephalopathy (i.e., arching the neck backwards, head pressing, and tremor) are seen, then the concentration of the diet can be increased. Be careful not to overfeed the cat with the liquid supplement. It may take three to six weeks of force feeding for the cat's enzyme activity to return to normal and for his appetite to return. If you are willing to persist, there is a fairly good chance your cat eventually will return to normal.

Gallstones are rarely seen in cats, but are sometimes found incidentally when the cat is examined for another disease. A cat who does have symptoms may show icterus and dark yellow or orange urine. It may have poor appetite, weight loss, vomiting, and dehydration. Vomiting and intermittent icterus may occur over a period of several months or years when the stones have been present for a long time. Cats with a blocked bile duct may have clay colored feces. The abdomen may bulge with fluid. Gallbladder problems which persist may eventually cause liver failure.

Some gallstones are diagnosed by radiographs of the abdomen or ultrasound examination. Others are discovered by examining fluid from the abdomen. The majority of cats with gallstones do not have any symptoms. Surgery should not be done on these animals - just keep an eye on the problem and operate if they cause illness in the future.

A resilient organ, the liver has great powers to partially regenerate, and will continue to function even after over half of it has been removed. Managing the cat's diet will help the liver rest while it has a chance to heal. Many cases of hepatitis are acute, and only short-term management is needed. Long-term dietary are measures needed for a cat with chronic hepatitis. Dietary care for a cat with liver disease will include high quality protein. Cats with liver problems should not be given shellfish, organ meat, or foods containing fish meal. These contain purines which metabolize to form uric acid, something the cat's damaged liver cannot process.