Introduction
Liver failure is a serious condition in cats that occurs when the liver is no longer able to perform its vital functions. The liver plays an important role in removing toxins, metabolizing nutrients and drugs, and producing proteins and hormones. When the liver begins to fail, toxins can build up in the bloodstream, metabolic functions are disrupted, and the body loses the ability to clot blood properly.
There are several potential causes of liver failure in cats, including inflammation, obstruction of bile flow, cancer, and lipidosis (fatty liver). Common symptoms include jaundice, weight loss, vomiting, diarrhea, excessive drinking and urination, bloody stool or urine, and behavioral changes. Diagnosis typically involves blood tests, x-rays, ultrasound, and sometimes biopsy of liver tissue.
The key question many cat owners face when their pet is diagnosed with liver failure is – can it be reversed? While some causes of liver damage may potentially be resolved if caught early, the prognosis is generally poor once significant liver failure sets in. However, steps can be taken to support remaining liver function and improve quality of life. This article will explore whether liver failure in cats can be reversed as well as treatments to provide the best care possible.
Causes of Liver Failure in Cats
There are several potential causes for liver failure in cats, including:
Hepatic Lipidosis: Also known as fatty liver disease, hepatic lipidosis is the most common cause of liver failure in cats. It occurs when cats stop eating for an extended period, causing fat to accumulate in the liver and prevent it from functioning properly. This is especially common in overweight cats. [1]
Cholangitis/Cholangiohepatitis: These are conditions characterized by inflammation of the bile ducts, often caused by bacterial infections. The inflamed bile ducts prevent proper bile flow and lead to liver damage. [2]
Toxins: Exposure to certain toxins like acetaminophen, antifreeze, or poisonous plants can damage the liver and lead to acute liver failure in cats. [3]
Cancer: Feline lymphoma and other cancers affecting the liver or bile ducts can impair liver function and lead to failure. [1]
Hepatitis: Inflammation and infection of the hepatic cells in the liver, often caused by infectious agents like feline leukemia virus or bacteria. This impairs the liver’s ability to function properly. [2]
Symptoms
The most common symptoms of liver failure in cats include loss of appetite, vomiting, diarrhea, weight loss, increased thirst, and jaundice (yellowing of the skin and gums) Liver Diseases in Cats – VCA Animal Hospitals.
Loss of appetite is one of the first signs of liver disease. Cats with liver failure often lose interest in food as the disease progresses. This leads to weight loss over time.
Vomiting is another common symptom, as the liver loses its ability to process toxins. Cats may vomit repeatedly or have sporadic episodes of vomiting.
Some cats develop diarrhea due to changes in bile secretion and digestion. The diarrhea may be intermittent or persistent.
Increased thirst and urination can occur as the liver is less able to regulate body fluids. Toxins in the blood can also irritate the kidneys.
Jaundice causes yellowing of the skin, gums, and eyes. It happens when bilirubin (a waste product) builds up in the blood as the liver fails to process it.
Diagnosis
Veterinarians use several diagnostic tests to determine if a cat has liver disease and the cause, including:1
Physical exam – The veterinarian will check for clinical signs that point to liver issues, such as jaundice, weight loss, or an enlarged abdomen. They will also listen to the cat’s heart and abdomen for abnormalities.
Blood tests – Bloodwork can detect elevated liver enzymes, bilirubin levels, low albumin, and other abnormalities that indicate liver disease. Blood tests can also help determine the underlying cause. 2
Ultrasound – Abdominal ultrasound allows the veterinarian to visualize the size, shape, and texture of the liver. It can detect masses, inflammation, or other structural changes. 3
Biopsy – Taking a tissue sample of the liver for biopsy can confirm liver disease and determine the cause through histopathology. This is considered the most definitive diagnostic test.
Conventional Treatment
The conventional treatment for liver failure in cats often involves hospitalization and intensive care. According to the Merck Veterinary Manual, treatment typically consists of the following:
Hospitalization – Cats with liver failure usually need to be hospitalized so they can receive intensive around-the-clock medical care and monitoring. Hospitalization allows for regular blood tests, fluid therapy, and nutritional support under veterinary supervision.
Fluid therapy – Fluid therapy is administered intravenously to help combat dehydration, maintain blood pressure, promote kidney function, and remove toxins from the bloodstream. Fluids also provide electrolyte support.
Vitamins – Vitamin supplements, especially B-complex and K, may be given to cats with liver disease to support metabolism and improve blood clotting.
Nutritional support – According to the International Cat Care organization, nutritional support is a critical part of treating liver failure in cats. Cats are often fed highly digestible commercial diets or specially prepared liver support diets to provide balanced nutrition. Feeding small, frequent meals is recommended.
In severe cases, more aggressive treatments like anabolic steroid therapy, antibiotics, and lactulose may be used. However, the core conventional approach involves hospitalization, intravenous fluids, vitamins, and nutritional support.
Source: Merck Veterinary Manual
Can Liver Failure Be Reversed?
If liver failure is caught early, some of the underlying causes may be reversible with prompt veterinary treatment. For example, if a toxin or medication caused the liver failure, stopping exposure and providing supportive care may allow the liver to recover over time.
However, advanced or end-stage liver failure is generally not reversible, even with aggressive treatment. Once significant liver architecture and function is lost, the damage cannot be undone.
According to the American College of Veterinary Internal Medicine, treatment for liver failure focuses on “managing the complications of liver failure and giving supportive care, allowing the body to regenerate liver cells when possible.” This involves fluid therapy, medications, nutritional support, and careful monitoring.
While advanced liver failure itself cannot be reversed, the right care can sometimes prolong and improve quality of life for some time. But cats with chronic or end-stage liver failure typically have a grave long-term prognosis.
Supportive Care
There are several ways to provide supportive care for cats with liver failure to help manage their condition, improve quality of life, and potentially extend survival time. Some of the main aspects of supportive care include:
Nutritional support – Providing adequate calories, proteins, vitamins and minerals is crucial. Cats with liver disease often have reduced appetite so getting nutrition through feeding tubes or assisted feeding may be necessary. Low protein or hepatic diets are sometimes recommended. Vitamin supplements like B12, K and thiamine may also help.
Reducing toxin exposure – Limiting exposure to drugs, chemicals or toxins that further stress the liver is important. Medications may need adjustment and home/environmental toxins should be removed. Ammonia binds in the gastrointestinal tract so diarrhea management and antibiotics for infection can help.
Treating secondary infections – Liver disease reduces immunity so antibiotics are often needed for urinary, respiratory, skin or other infections that commonly occur. Antiemetic drugs can help with nausea and vomiting.
Managing fluid levels – Fluid retention or dehydration are common concerns. Diuretics, IV fluids or electrolytes may be given to maintain balance. Draining accumulated abdominal fluid can also provide relief.
While these supportive measures cannot cure liver failure, they can significantly improve a cat’s wellbeing and may provide more time if the underlying condition can eventually be treated.1
Prognosis
The prognosis for liver failure in cats depends greatly on the underlying cause. If caught early, some causes like infections or toxins can often be successfully treated or managed with a good prognosis. However, according to Cloud9Vets, once advanced liver failure sets in, the prognosis is generally poor.
For cats with end stage liver disease or acute liver failure, the prognosis is grave. According to WagWalking, cats with acute liver failure have a survival rate of less than 20%. However, if the cat can survive the first few critical days of treatment, they may make a full recovery within 3-6 weeks.
Overall, the prognosis depends on how quickly liver disease is caught and treated. But once advanced liver failure sets in, most cats will sadly succumb to the disease eventually without a liver transplant, which is not readily available for cats.
Prevention
There are some steps cat owners can take to help prevent liver failure in cats:
Prevent obesity – Obesity is a major risk factor for fatty liver disease in cats. Keeping your cat at a healthy weight through proper diet and exercise can help prevent liver problems.
Limit toxin exposure – Things like chemicals, plants, and medications can be toxic to a cat’s liver. Keeping your home free of toxins and being careful with medications can reduce toxin exposure.
Vaccinate for infectious diseases – Diseases like FIV and feline leukemia virus can damage the liver. Keeping your cat up-to-date on core vaccines can help prevent liver infections.
Regular vet checkups are also recommended to monitor your cat’s liver health. With early detection, treatment may help prevent irreversible liver failure.
Conclusion
In summary, liver failure in cats can have many causes including toxins, cancer, viral infections, and even congenital issues. Symptoms often include loss of appetite, vomiting, diarrhea, and jaundice. Getting an accurate diagnosis typically requires a combination of blood tests, imaging, and biopsy. While there are some conventional treatments like steroids and antibiotics that may help manage symptoms, liver failure itself is, unfortunately, difficult to reverse in cats. The prognosis depends on the cause and how advanced the condition is. However, with supportive and palliative care such as IV fluids, vitamins, antioxidants, and a special diet, quality of life can often be improved significantly. Prevention through limiting exposure to toxins and prompt treatment of infections is key. Though liver failure presents daunting challenges for cats and their owners, focusing on compassionate symptom management and remaining dedicated to your feline companion’s comfort can make a big difference. With dedication and care, it is possible for cats to live happily for some time even with chronic liver disease.