Liver disease in cats and gallbladder problems: causes and remedies – A very important organ for our existence is the liver. And as for us, in cats it is fundamental and can get sick. Let’s talk about liver disease in cats.
The liver performs many functions. It has a large memory capacity and functional reserve and is capable of regenerating itself. These properties offer some protection against permanent damage. However, the liver is also susceptible to injury due to its role in metabolizing, detoxifying and storing various toxic compounds. What are liver diseases in cats, and how to recognize their signs and intervene in time to resolve them, obviously together with our trusted veterinarian? Let’s find out together.
- Metabolizes fats, carbohydrates and proteins
- Metabolizes drugs (inactivates them or facilitates body excretion)
- Stores and metabolizes vitamins
- Preserves minerals, glycogen and triglycerides
- It produces proteins necessary for various body functions, such as blood clotting
- It produces the bile acids necessary for digestion
- Detoxifies harmful products manufactured inside the body (such as ammonia) or consumed by the animal (such as poisons)
Treatment of liver disorders
Early treatment is critical for cats with sudden liver failure. The veterinarian will prescribe specific treatment if an underlying cause can be identified. In the case of long-term or end-stage liver disease and in case of sudden liver disease in which no underlying cause has been identified, supportive treatment is aimed at slowing the progression of the disease, minimizing complications and giving the liver time to regenerate and compensate. Supportive treatment may include administration of fluids, drugs to protect the liver and dietary support.
Vitamin deficiencies can occur with liver disease. The prescribed vitamin and mineral supplements may include zinc, B vitamins, vitamin K and vitamin E. It will be essential to follow the vet’s recommendations regarding vitamin supplementation because the overdose of some vitamins can be harmful.
Complications of liver disease
Hepatic encephalopathy is a neurological syndrome caused by liver dysfunction and is observed in various liver diseases. Signs suggesting liver encephalopathy include dullness, going round and round, head pressure, aimless wandering, weakness, poor coordination, blindness, excessive burring, changes in behavior (e.g. aggression), dementia, collapse, convulsions and coma.
Severely affected cats may be in a coma or in a semicomatous state, and should not be fed until their condition improves. Treatment is likely to include intravenous fluids to correct dehydration and electrolyte imbalances (salt). Enema can be used to cleanse the intestines of ammonia and other poisons and to introduce nutrients that help reduce the production of poison. Medicines to influence bacterial populations in the intestine can also be used to reduce the absorption of toxic products.
Ascites is a condition in which fluid collects in the abdomen. In patients with liver disease, ascites is caused by a combination of high blood pressure in the liver and an imbalance in the metabolism of water and salt. Swelling can be controlled by prescribing a diuretic (a drug to increase the amount of water excreted in the urine)by reducing sodium intake, extracting excess liquid with a needle or a combination of these steps.
Clotting defects occur in cats with liver disease because the liver produces many of the proteins responsible for the clotting process. In addition, there may be a reduced absorption of vitamins that help clot from the digestive tract. Clotting problems can be treated using blood or plasma transfusions to provide the necessary clotting factors. Heparin and vitamin K can also be given to reduce or increase the clotting ability. The veterinarian prescribes the most appropriate treatment for the individual animal.
Cats with sudden liver failure and long standing liver disease are sensitive to bacterial infections. The veterinarian is careful about this possibility, because the signs of the liver disease itself (e.g. fever or low blood sugar levels) can be similar to those of the infection. One or more antibiotics may be needed to adequately treat the types of bacteria associated with the infection.
Fibrosis, the formation of fibrous scar tissue in the liver, can eventually lead to liver cirrhosis. Cirrhosis is a serious disease that disrupts liver function. However, fibrosis can sometimes be reversed or reduced through the use of appropriate drugs. The vet can determine, if necessary, which available medications would be helpful for our pet.
Acute liver failure and other common diseases
Acute liver failure causes a sudden loss of liver function, which is often associated with liver encephalopathy and coagulation abnormalities. It can occur due to a sudden injury to a previously healthy liver or an additional insult to an already sick liver.
It is important to seek immediate veterinary treatment to support the liver until it can regenerate and compensate for the insult. Any underlying causes of liver failure must be identified and treated, if any. Be sure to inform the vet of any medications our pet receives, or any access to substances that may have poisoning him. Treatment may include intravenous fluids, vitamin supplementation, dietary changes, antibiotics and some liver medications.
Liver lipidosis is the most common cause of liver disease in cats. Excessive accumulation of fat (triglycerides) in the liver leads to liver failure. The cause is unknown, but the disease is associated with a period of poor appetite (from a few days to several weeks), especially in obese cats.
Factors that can trigger loss of appetite include a change in diet (to start weight loss or to a food that the cat doesn’t like) or other stressful events (such as moving, boarding, introducing a new pet, losing or death of other pets or owners). Liver lipidosis can also be associated with a metabolic disease (such as diabetes mellitus) or a disease of the digestive system that causes loss of appetite.
Treatment is primarily supportive unless the underlying cause can be found. Fluid treatment is used to correct dehydration. Vitamin, mineral and electrolyte deficiencies are common and integration is often required. Additional liver medications may be needed.
Nutritional support is essential. Occasionally, a prescribed appetite stimulant can help if started in the early stages of the pathological process. However, most of the time the appetite stimulants are not effective and the positioning of a feeding tube is necessary. The veterinarian will recommend adequate nutrition, usually a protein-rich, calorie-rich and balanced diet. The recurrence of liver lipidosis is rare in recovering cats.
Inflammatory liver disease is the second most common liver disease reported in cats. The 2 types of inflammatory liver disease in cats are cholangitis / cholangiohepatitis and portal lymphocytic hepatitis.
Cholangitis is an inflammation of the bile ducts (small tubes inside the liver that carry bile to the gallbladder and small intestine). Cholangiohepatitis is an inflammation of the biliary tract that extends into the surrounding liver tissue. The differentiation between cholangitis and cholangiohepatitis depends on the location of the inflammation inside the liver.
Cats with cholangitis or cholangiohepatitis can also have other inflammatory disorders, such as inflammatory bowel disease, pancreatitis and kidney disease (chronic interstitial nephritis). The combination of inflammatory bowel disease, pancreatitis and cholangiohepatitis is often called triaditis.
Other conditions associated with cholangitis / cholangiohepatitis syndrome include bacterial infections, blood poisoning (septicemia), inflammation of the gallbladder, gallstones, liver flows, tumors and malformations or obstructions of the bile ducts. Diagnosis can involve blood tests and ultrasound, but definitive diagnosis requires biopsies taken from different parts of the liver.
Cholangitis / cholangiohepatitis suppurativa (acute) usually causes an obvious and sudden disease in cats. The signs include fever, enlarged liver, abdominal pain, jaundice, lethargy, vomiting, poor appetite and weight loss. The syndrome typically occurs in young or middle-aged adults. Affected cats have an increased risk of digestive tract infections.
Non-suppurative (chronic) cholangitis / cholangiohepatitis usually affects middle-aged or older cats. Affected cats are typically ill for months or even years before diagnosis. The signs include intermittent vomiting and diarrhea, appetite fluctuations, hidden behaviors and jaundice that come and go.
Lymphocytic portal hepatitis is an inflammatory liver disease that does not involve the biliary tract. The cause is uncertain, but it can be related to a reaction to organisms, debris or immune cells that arrive in the liver from the digestive tract. The vet will be able to provide a treatment program based on the most current information.
Poisons affecting the liver
Since the liver is the main organ that metabolizes drugs, some medications can cause liver dysfunction in cats. The specific signs and effects depend on the drug and dosage. In many cases the veterinarian will be aware of the potential for liver disease in the cat when prescribing these drugs and will monitor the kitty for signs of impaired or impaired function.
If our pet has had an accidental overdose of a drug, has had an adverse reaction to a drug (even at the prescribed dosage) or has eaten a poison, you should immediately consult a veterinarian. If necessary, the veterinarian can take steps to minimize the absorption of the drug or poison.
Infectious liver disease
Different types of infections can cause liver disease in cats, including viral, bacterial, fungal and parasitic diseases.
Feline infectious peritonitis is caused by a virus. The infection leads to widespread inflammation, especially in the abdomen (including the liver) and inflammation of the blood vessels (vasculitis). Jaundice, fluid buildup in the abdomen, vomiting, diarrhea and fever are common signs.
Systemic virulent calicivirus is an aggressive form of a common upper respiratory virus in cats (called feline calicivirus). Virus outbreaks usually occur in shelters and farms, resulting in the death of 33-60% of the affected cats. Adult cats are most affected. The signs include fever, loss of appetite, swelling of the limbs and face, jaundice, loss of hair and sores on the nose, lips, ears and feet.
The bacteria Mycobacterium avium they can cause liver infections in young Abyssinian and Somali cats that are born with immune deficiencies. Affected cats often have vague signs, including weight loss despite eating large quantities of food. Lungs can also be affected. The vet can prescribe antibiotics to treat the condition. Relapses may occur and may be due to immune system dysfunction.
Other types of bacterial infections, such as those caused by Clostridium piliforme (Tyzzer disease), can cause liver damage. Infections elsewhere in the body can transfer to liver tissue and cause damage or dysfunction. Since the liver can help protect the body from bacterial infections, cats with liver failure or long-term liver disease are more susceptible to bacterial infections elsewhere in the body.
The most common fungal infections associated with liver dysfunction are coccidioidomycosis and histoplasmosis. If the liver is involved, the signs may include abdominal swelling, jaundice and enlarged liver. Coccidioidomycosis can be treated with long-term use (6 to 12 months) of antifungal drugs. However, relapses sometimes occur. Histoplasmosis is often treated with prescription antifungal drugs. Depending on the level of disease, the prospects for recovery may be poor. Permanent antifungal treatment is necessary for some cats with these diseases.
Toxoplasmosis is a parasitic disease that can cause short-term liver failure due to the death of liver cells. The parasite is a protozoan, Toxoplasma gondii, which is found all over the world. The infection is more common in cats positive for feline immunodeficiency virus and feline leukemia virus. Jaundice, abdominal swelling, fever, lethargy, vomiting and diarrhea are seen, as well as signs of central, pulmonary or ocular nervous system involvement.
Toxoplasmosis can also infect humans and is very likely to cause signs in pregnant women and people with compromised immune systems. Since the parasite is transmitted through the stool, pregnant women and other people at increased risk of infection should avoid contact with cat litters.
Endocrine diseases affecting the liver
Several liver diseases in cats are caused by diseases involving the endocrine glands. These diseases include diabetes mellitus and hyperthyroidism.
Cats with diabetes mellitus have an increased risk of developing liver lipidosis because diabetes mellitus increases lipid metabolism and mobilization. Lipids include any of the groups of water-soluble fats and fat-like chemicals that are sources of fuel for the body. However, when too many lipids are deposited in the liver, the organ’s function is impaired. The replacement of insulin may or may not correct this conservation problem. Diabetic cats also have an increased risk of inflammation of the pancreas (pancreatitis) and bile duct (cholangitis) and bacterial infections of the biliary tract.
Cats with hyperthyroidism have increased levels of some chemicals (enzymes) in the liver and, in rare cases, an excessive amount of bilirubin (a yellow bile pigment). Cats with excess bilirubin may have jaundice. Despite the elevated liver enzyme, liver function is generally normal. Liver enzyme levels almost always return to normal when the underlying causes are treated. However, a drug commonly used to treat hyperthyroidism (called methimazole) can, in rare cases, cause liver disease in the cat.
Hepatocutaneous syndrome is rare, long-term, progressive and generally fatal. Diabetes mellitus is often present at the same time, but some cancers, hormones and medications can also trigger the syndrome. Scabs and abnormalities on the pads, ears, skin around the eyes and pressure points are typical skin changes. Poor appetite, weight loss, excessive thirst and urination and lethargy are also reported.
Liver cysts can be acquired (usually single nodules) or present at birth (usually multiple nodes called polycystic disease). Congenital polycystic liver disease has been reported in Persian cats. The cat with multiple cysts may also have cysts in the kidneys. Cysts are often not diagnosed, but sometimes they enlarge and cause abdominal bloating and other signs such as lethargy, vomiting and excessive thirst. Cats with multiple cysts throughout the liver may have signs of liver dysfunction.
In addition to the liver diseases in the cat that we talked about, there are tumors. Tumors that originate in the liver (called primary tumors) are less common than those caused by spreading to another part of the body (called metastatic tumors). Primary tumors are most often observed in cats over the age of 9 and can be malignant (cancerous) or benign. The most common types of primary tumors are biliary adenomas, biliary adenocarcinomas, lymphomas and other blood cell tumors.
Metastatic (spreading) tumors of the liver are less common in cats than in dogs. Tumors that can spread to the liver include pancreatic, intestinal and kidney cell carcinomas; mast cell tumors; and lymphoma. Metastatic tumors usually occur on multiple sites.
Gallbladder and bile duct diseases
The liver secretes bile, a substance that helps digestion and absorption of fats and the elimination of certain waste products from the body. The bile is stored in the gallbladder and released into the duodenum through the bile duct.
Jaundice (a yellow tinge evident in the skin, mucous membranes and eyes) is often the main sign of gallbladder and bile duct diseases. An exception is gallbladder cancer, which cannot cause jaundice.
Gallstones rarely cause disease. In cats, gallstones are generally associated with inflammation of the bile duct. Most cats with gallstones show no signs or show discomfort only after eating. When viewed, the signs include vomiting, jaundice, loss of appetite, abdominal pain and fever. Bacterial infections are often present.