Introduction
Jaundice is a condition caused by an excess buildup of bilirubin in a cat’s system. Bilirubin is a yellowish pigment produced when red blood cells break down. Normally, the liver filters out bilirubin and it exits the body through bile and stool. But liver disease or dysfunction can impair this process, leading to a buildup of bilirubin that causes yellow discoloration of the skin, gums, and eyes in cats. This is called jaundice.
The liver plays many essential roles, including filtering toxins from the blood, metabolizing nutrients and drugs, producing proteins, and secreting bile. Liver failure occurs when the liver is so damaged that it can no longer perform these vital functions. It has many causes in cats, including infections, cancer, toxins, and lipidosis. Liver failure allows bilirubin to accumulate in the blood, often resulting in jaundice.
Therefore, jaundice in cats is most often a result of severe liver disease or failure. It signifies there is an underlying serious health issue that requires prompt veterinary treatment. Left untreated, liver failure and the resulting jaundice can be fatal for cats. However, the outlook depends on the underlying cause and how quickly treatment begins.
Symptoms of Liver Failure
Loss of appetite, vomiting, and diarrhea are common symptoms of liver disease in cats (1). These gastrointestinal issues can lead to weight loss as the cat is unable to properly digest food and absorb nutrients. Increased thirst and urination may also occur as toxins build up in the body and the liver is unable to remove them efficiently (2).
Other symptoms that may present with liver failure include lethargy, abdominal pain, fever, jaundice (yellowing of the skin and gums), and bleeding disorders (2). As liver function declines, the liver is no longer able to produce the proteins and other substances needed for normal bodily processes. This leads to a wide array of clinical signs that can vary greatly between individual cats.
Causes of Liver Failure
There are several potential causes of liver failure in cats:
Inflammation: Inflammation of the liver, known as hepatitis, can occur due to infections, toxins, or an autoimmune reaction. Feline infectious peritonitis (FIP) is a viral infection that commonly causes hepatitis and liver failure in cats [1].
Infections: Besides FIP, other infections like toxoplasmosis and histoplasmosis can infect the liver and lead to inflammation and liver failure [2].
Toxins: Exposure to toxins like acetaminophen, antidepressants, insecticides, poisonous plants, and blue-green algae can damage liver cells and cause acute liver failure [2].
Cancer: Liver cancer, while less common in cats than dogs, can still occur and damage liver function.
Old Age: Gradual liver degeneration in senior cats that leads to liver failure and dysfunction.
Jaundice Explained
Jaundice, also known as icterus, refers to the yellowish discoloration of the skin, mucous membranes, and whites of the eyes caused by an excess buildup of bilirubin in the body (VCA Hospitals). Bilirubin is a yellow-orange bile pigment produced when old red blood cells are broken down. Normally, the liver filters out bilirubin and it leaves the body in bile. But when the liver is not functioning properly, bilirubin can build up and leak into tissues, causing them to take on a yellowish hue.
The visible yellowing in jaundice starts in the ears, gums, and skin of the belly or inside thighs. As bilirubin levels increase, the whites of the eyes will turn yellow. Other tissues like muscle and brain can also be affected but the yellow color won’t be visible (Kingsdale). In addition to color changes, symptoms of jaundice include lethargy, loss of appetite, and weight loss.
Connection Between Liver Failure and Jaundice
Jaundice is a common symptom of liver failure in cats. When the liver is damaged or diseased, it cannot properly process bilirubin. Bilirubin is a yellow pigment that is produced when old or damaged red blood cells are broken down. Normally, the liver metabolizes and excretes bilirubin from the body. But with liver failure, bilirubin accumulates in the bloodstream and other tissues, causing a yellow discoloration of the skin, gums, and whites of the eyes. This is known as jaundice.
As bilirubin levels rise, it starts depositing in body tissues such as the skin and membranes. This results in the yellowish discoloration associated with jaundice. The extent of jaundice depends on the level of liver damage and bilirubin accumulation. Mild jaundice may be barely noticeable, while severe jaundice can cause distinct yellowing of the cat’s skin, gums, and eyes.
In summary, liver failure inhibits the normal processing and excretion of bilirubin, leading to a buildup of this yellow pigment in tissues and resulting in jaundice. So jaundice is a direct consequence of the liver’s inability to function normally.
Diagnosing Liver Failure
There are several tests veterinarians use to diagnose liver disease and failure in cats:
Blood tests: Bloodwork is usually the first step in diagnosing liver problems. Elevated liver enzymes such as ALT, AST, and GGT often indicate inflammation or damage to the liver. Other abnormalities like decreased albumin, increased bilirubin, and decreased blood glucose can also point to liver issues.[1]
Ultrasound: An abdominal ultrasound allows the veterinarian to visualize the size, shape, and texture of the liver. It can help identify masses, cysts, infections, or other structural problems. Ultrasound can also be used to guide needle biopsies of the liver.[2]
Biopsy: Taking a tissue sample of the liver for examination under a microscope can confirm certain diagnoses like cancer or inflammation. Biopsies are usually done along with ultrasound guidance.[3]
Treating Liver Failure
There are several approaches to treating liver failure in cats, including medications, diet modification, and intravenous fluids. Some medications that may be used to treat liver disease include:
- Antibiotics like metronidazole to treat infection
- Corticosteroids like prednisolone to reduce inflammation
- Ursodeoxycholic acid to improve bile flow
- S-Adenosylmethionine (SAMe) to support liver function
- Milk thistle to help protect liver cells
Changing a cat’s diet is crucial when treating liver issues. The vet will likely recommend a high calorie, highly digestible diet. This provides nutrients and energy while putting less strain on the liver. Fat restricted diets may be prescribed since cats with liver disease have difficulty processing dietary fat.
Intravenous fluid therapy helps counteract dehydration, flush toxins from the body, and improve blood flow to the liver. Fluids can also provide electrolyte balancing and nutrition when a cat is too sick to eat. Hospitalization for several days is usually required for IV fluid treatment.
The specific medications and therapy prescribed will depend on the underlying cause and severity of a cat’s liver failure. With aggressive treatment, there is hope for managing liver disease and extending a cat’s life.
Prognosis
The prognosis for cats with liver failure depends greatly on the underlying cause. In cases of acute liver failure, the prognosis is generally guarded to poor unless the underlying cause can be quickly identified and treated. However, chronic liver diseases like cholangiohepatitis have a more variable prognosis. According to PetMD, early diagnosis and aggressive treatment of liver disease can allow some cats to have a good prognosis and live an otherwise normal life. Unfortunately, once the liver is significantly damaged, the prognosis declines rapidly.
For cats in end-stage liver failure, the prognosis is extremely poor, with mortality rates over 90% according to Cloud9Vets. At this stage, liver function is severely impaired and cannot be reversed. Euthanasia is often recommended when a cat is in end-stage liver failure, as the liver damage leads to numerous complications like fluid buildup, wasting away, and eventually multi-organ failure. The quality of life dramatically declines. Still, some owners opt to provide palliative care measures to keep their cat comfortable for its remaining time.
Overall, while early treatment can allow for a good prognosis, untreated or end-stage liver failure has a very poor prognosis. In the latter cases, euthanasia may be the most humane option to prevent extended suffering.
Prevention
There are several ways to help prevent liver disease in cats:
Get regular veterinary checkups. Annual exams allow vets to run bloodwork and potentially catch liver issues early, before they become more serious. Regular vet visits also ensure cats receive recommended vaccines and preventative care.
Avoid toxins. Keep cats away from toxins like antifreeze, pesticides, moldy foods, poisonous plants, and medications. Store chemicals and cleaners securely and use pet-safe products when possible.
Feed a high quality diet. Choose a balanced commercial diet formulated for cats. Avoid cheap brands with fillers and artificial ingredients. Homemade diets must be nutritionally balanced under a vet’s guidance. Provide plenty of fresh water.
Additional steps like maintaining a healthy weight, managing diseases, avoiding injuries, and reducing stress can also help prevent liver problems in cats.
Conclusion
In summary, liver failure is a serious condition in cats that can often lead to jaundice. Liver failure occurs when the liver loses its ability to function properly due to disease, damage or loss of liver cells. This results in a buildup of waste products in the blood, including bilirubin. Bilirubin causes a yellow discoloration of the skin and mucous membranes known as jaundice.
While jaundice is a common symptom of liver failure in cats, it does not occur in every case. Some cats with liver failure may not develop jaundice if the condition is caught early or if the loss of liver function is gradual. However, significant or sudden liver failure typically does result in jaundice in cats. Other symptoms besides jaundice can include vomiting, diarrhea, decreased appetite, weight loss and lethargy.
If liver failure and jaundice are suspected in a cat, diagnostic tests such as blood work, urinalysis and imaging can help confirm the diagnosis. Treatment focuses on addressing the underlying cause and managing symptoms. Supportive care, nutritional support and medications may help stabilize cats with liver failure. However, the prognosis depends on the severity and cause of the liver damage. With aggressive treatment, some cats can recover from liver failure, but it can be fatal if the liver’s function cannot be restored. Regular veterinary care and monitoring cats for signs of liver disease are key to early detection and prevention of serious liver failure.
