What is jaundice in cats?
Jaundice, also known as icterus, is a condition that causes a yellow discoloration of a cat’s skin, gums, and eyes due to an excess buildup of bilirubin in the bloodstream (1). Bilirubin is a yellow pigment produced when old red blood cells break down. Normally, the liver filters out bilirubin so it can be excreted from the body. But when the liver is not functioning properly or there is an obstruction preventing bilirubin from leaving the body, it builds up and causes the yellowing effect known as jaundice (2).
Some key facts about feline jaundice:
- Jaundice causes yellowing of the skin, gums, and whites of the eyes
- It is caused by excess bilirubin buildup due to liver dysfunction or bile obstruction
- Jaundice indicates an underlying health problem that requires veterinary diagnosis and treatment
- Common causes include liver disease, hemolytic anemia, and bile duct obstruction
In summary, jaundice refers to the yellow discoloration seen in cats when bilirubin accumulates abnormally high in the blood and tissues rather than being properly excreted by the liver and bile ducts (3). Determining and treating the underlying cause is important.
What causes jaundice in cats?
There are several potential causes of jaundice in cats, including:
Liver disease
Liver disease is one of the most common causes of jaundice in cats. Conditions like hepatitis, cirrhosis, or liver cancer can impair the liver’s ability to remove bilirubin from the blood, leading to a buildup of bilirubin and yellowing of the skin and eyes (1). Chronic inflammation of the liver or toxins can damage liver cells over time.
Bile duct obstruction
A blockage or narrowing of the bile ducts can prevent the normal flow of bile, causing bilirubin to back up into the bloodstream. Gallstones, inflammation of the pancreas, trauma, or cancer may cause bile duct obstruction (2). This is a serious condition and requires urgent veterinary care.
Hemolytic anemia
Hemolytic anemia results from premature red blood cell destruction. The hemoglobin released from destroyed cells is converted to bilirubin. If this exceeds the liver’s capacity to conjugate and excrete bilirubin, jaundice can occur (3). Diseases like autoimmune hemolytic anemia or blood parasites can trigger hemolysis in cats.
Early diagnosis and treatment of the underlying cause is important for jaundiced cats. Consult a veterinarian if your cat has yellowing of the skin, gums, or eyes.
Liver Disease
Liver disease is one of the most common causes of jaundice in cats. There are several types of liver disease that can lead to jaundice, including:
Hepatitis: This is inflammation of the liver, usually caused by infections from viruses like feline infectious peritonitis (FIP), feline leukemia virus (FeLV), or feline immunodeficiency virus (FIV). Bacterial and parasitic infections can also cause hepatitis. With hepatitis, the liver cells become damaged and are not able to function properly. This leads to a buildup of bilirubin that causes jaundice. Hepatitis treatment focuses on addressing the underlying infection and providing supportive care (PetMD).
Liver Cancer: Cancerous growths in the liver crowd out healthy tissue and impair liver function. Tumors obstruct bile flow leading to jaundice. Unfortunately liver cancer carries a poor prognosis in cats. Treatments like surgery, chemotherapy, and radiation therapy may help prolong life but are not curative (VCA Hospitals).
Cirrhosis: This chronic, progressive condition results in scarring and loss of function in liver cells. It is often caused by long-term hepatitis infections. The buildup of fibrous tissue obstructs bile flow leading to jaundice. Treatment focuses on slowing the progression of liver damage with medications, nutritional support, and addressing complications as they arise (Kingsdale Veterinary Hospital).
Bile duct obstruction
Bile duct obstruction, also known as cholestasis or jaundice, occurs when bile flow from the liver to the small intestine is blocked. This prevents bilirubin, a yellow pigment, from being excreted and leads to a buildup of bilirubin in the bloodstream and tissues. Bile duct obstruction is a common cause of jaundice in cats.
There are several potential causes of bile duct obstruction:
- Gallstones – Gallstones, which form in the gallbladder, are a frequent cause of bile duct obstruction in cats. Gallstones can pass from the gallbladder and lodge in the bile ducts, physically blocking the flow of bile.
- Inflammation – Inflammation of the bile ducts, known as cholangitis, can cause thickening and obstruction of the ducts. Inflammation may occur due to bacterial infections, pancreatitis, or other causes.
- Tumors – Tumors within the liver, gallbladder or pancreas can compress or invade the bile ducts, resulting in partial or complete bile obstruction. These may include primary liver tumors or metastatic tumors that have spread from elsewhere in the body.
- Trauma – Physical trauma to the abdomen may damage the bile ducts and cause leakage or obstruction. This may occur due to blunt trauma, such as being struck by a car.
Jaundice is often the first noticeable sign of bile duct obstruction in cats. Yellowing of the skin and mucous membranes occurs as bilirubin accumulates. Other symptoms may include lack of appetite, vomiting, weight loss, lethargy and fever. Diagnosis involves blood tests, imaging such as ultrasound or CT scans, and sometimes biopsy. Treatment depends on the underlying cause but may include surgery, stenting of the bile ducts, or medications to manage symptoms and complications.
Cats with a bile duct obstruction have a guarded to poor prognosis depending on the severity and cause. However, prompt veterinary care can improve quality of life and longevity.
Hemolytic Anemia
Immune-mediated hemolytic anemia (IMHA) is one of the most common causes of jaundice in cats. In IMHA, the cat’s immune system mistakenly attacks its own red blood cells, leading to hemolysis and an increase in bilirubin. IMHA is diagnosed through blood tests showing anemia, a positive Coombs test, and evidence of red blood cell destruction. Treatment involves immunosuppressive medications like prednisone to stop the immune system from attacking red blood cells (1).
Toxins like onions, garlic, and acetaminophen can also damage red blood cells in cats, leading to hemolytic anemia and jaundice. Exposure to blood parasites like Mycoplasma haemofelis can also cause red blood cell breakdown. In these cases, treatment involves stopping exposure to the toxin or parasite and providing supportive care while new red blood cells regenerate (2).
Hemolytic anemia, whether immune-mediated or due to toxins/parasites, can be life-threatening if severe. With treatment, cats have a fair to good long-term prognosis. Preventing access to toxins and regular parasite control can help reduce risk (3).
Diagnosing jaundice
There are several diagnostic tests veterinarians use to confirm jaundice in cats and determine the underlying cause:
Physical exam: Vets will check for visible signs of jaundice like yellowing of the skin, gums, and eyes during a physical exam. They may also feel the abdomen to check for enlarged organs like the liver or gallbladder. According to VCA Hospitals [1], jaundice is easier to detect in cats with light fur or skin pigment.
Blood tests: Bloodwork like a complete blood count (CBC) and serum biochemistry panel can help identify conditions causing jaundice like liver disease, infections, and hemolytic anemia. Elevated liver enzymes like ALT, AST, and bilirubin indicate liver damage or blockage. Vets may also test levels of albumin, clotting factors, and electrolytes [2].
Imaging: X-rays, ultrasounds, or CT scans of the abdomen allow vets to visualize the liver, gallbladder, and bile ducts. These imaging tests help locate gallstones, tumors, inflammation, or other obstructions preventing bile flow [3].
With diagnostics, vets can pinpoint the underlying cause of jaundice in a cat to guide appropriate treatment.
[1] https://vcahospitals.com/know-your-pet/icterus-or-jaundice-in-cats
[2] https://todaysveterinarypractice.com/gastroenterology/the-yellow-cat-diagnostic-therapeutic-strategiesce-article/
[3] https://www.petmd.com/cat/conditions/digestive/c_ct_jaundice
Treating jaundice
The main goals when treating jaundice in cats are to diagnose and address the underlying cause and to provide supportive care. The specific treatment will depend on what’s causing the jaundice.
If there is an obstruction in the bile ducts, surgery may be needed to remove the obstruction and allow bile to flow normally again. Obstructions can be caused by gallstones, inflammation, tumors, or other abnormalities of the bile ducts. Surgery carries risks but can be life-saving if bile flow is completely obstructed (vcahospitals.com).
In cases of liver inflammation or infection, medications will likely be used to help support liver function and fight infection. Antibiotics, steroids, and liver protectants or detoxifiers may be prescribed. Specific treatment depends on the cause – bacterial infection, viral infection, autoimmune disease, etc. (petmd.com).
Supportive care is also very important. This includes providing excellent nutrition, maintaining hydration, and monitoring blood work. The liver helps metabolize nutrients and detoxify the body, so nutritional support is vital. Intravenous fluids may be given to prevent dehydration. Blood work helps assess liver function and response to treatment.
With appropriate treatment of the underlying disease and good supportive care, many cats can recover fully from jaundice. However, the prognosis depends greatly on the cause and how quickly treatment is started.
Diet and Nutrition
Cats with liver disease require a customized diet to reduce strain on the liver and provide adequate nutrition. The primary dietary focus is providing a low-fat, highly-digestible, and calorie-dense diet.
Since fat is harder for a compromised liver to process, veterinarians typically recommend reduced fat cat food for liver disease. Hill’s Prescription Diet l/d Feline Liver Care (https://www.hillspet.com/cat-food/pd-feline-liver-care) and Royal Canin Hepatic Formula (https://www.medicanimal.com/Understanding-hepatic-diets-and-feeding-cats-with-liver-disease/a/ART111487) are commonly prescribed low-fat, high-calorie foods. These diets have modified protein and supplement antioxidants like vitamin E to support liver health.
Cats with liver disease are prone to weight loss and cachexia due to poor nutrient absorption. Maximizing calorie intake is essential to maintain muscle mass and body condition. Adding supplemental oils like fish or olive oil to food can increase palatability and calories.
Homecooked diets for cats with liver disease should also be low in fat and copper while providing high-quality protein. Lean proteins like egg whites, cottage cheese, or white fish are recommended. Carbohydrates from cooked potatoes, pasta or oatmeal are easily digested. With any homemade diet, expert veterinary guidance is imperative to formulate a nutritionally balanced recipe.
Prognosis
The prognosis for a cat with jaundice depends on the underlying cause. Some diseases causing jaundice can be fatal if not treated promptly, but others have a good prognosis for full recovery if caught early and properly managed.
If the jaundice is caused by an obstruction of the bile ducts, the prognosis is generally good if the blockage can be removed. However, if the jaundice is caused by severe liver disease or failure, the prognosis may be poor even with treatment (VCA Hospitals).
With prompt veterinary care and treatment of the underlying condition, many cats can recover fully from jaundice. However, jaundice caused by diseases like feline infectious peritonitis (FIP) may have a grave prognosis. In these cases, treatment is focused on managing symptoms and making the cat comfortable.
Overall, the earlier jaundice is diagnosed and treated, the better the prognosis. Regular veterinary checkups and bloodwork can help detect liver disease and jaundice before it becomes severe. With supportive care and treatment of the underlying cause, cats with jaundice can often go on to live many healthy years.
Prevention
There are several steps cat owners can take to help prevent jaundice in their cats:
Vaccines: Getting your cat vaccinated against common feline viruses like feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) can help prevent infections that may lead to liver damage and jaundice. Annual vet visits for vaccine boosters are recommended.
Avoid toxins: Keeping your cat away from toxins like antifreeze, certain plants, lead, and rodenticides can prevent liver damage that contributes to jaundice. Make sure your home and surroundings are cat-safe.
Regular vet visits: Annual check-ups allow your vet to monitor your cat’s overall health and catch any early signs of liver issues. Bloodwork helps identify problems before they progress. Early treatment improves outcomes.
Overall, prevention focuses on proper vaccination, avoiding toxin exposure, and routine veterinary care. Taking these proactive steps can help protect cats from developing jaundice and associated liver diseases.
