Understanding Feline Liver Disease
The liver is a vital organ that has many essential functions in cats. It processes nutrients from food, filters toxins from the blood, regulates blood clotting, and produces bile to help digest fats (1).
Some common liver diseases in cats include (2):
- Hepatitis – inflammation of the liver, often caused by infections or toxins
- Cholangiohepatitis – inflammation of the bile ducts and liver tissue
- Lipidosis – fat accumulation in liver cells
- Cirrhosis – scarring of the liver tissue
- Tumors – benign or cancerous liver masses
Risk factors that can lead to liver disease in cats include obesity, high fat diets, infections, toxins, cancer, and genetics. Older cats are more prone to developing liver problems. Liver disease is serious and can be life-threatening if left untreated (3).
Catching liver disease early and determining the underlying cause is important for successful treatment and management. Treatment aims to resolve the cause and support liver function.
Symptoms of Liver Failure in Cats
Liver failure can cause a variety of concerning symptoms in cats. Some of the most common signs of liver disease include:1
- Loss of appetite
- Vomiting
- Diarrhea
- Weakness and lethargy
- Jaundice (yellowing of the skin and gums)
- Weight loss
A cat with liver failure will often stop eating or have a reduced appetite. They may begin vomiting more frequently. The vomit may be yellow or even tinged with blood. Diarrhea is also common, and feces may appear grey or clay-colored.2
Lethargy and overall weakness is another sign of liver problems in cats. Jaundice results when bilirubin builds up in the blood and causes a yellow discoloration to the gums, ear flaps, and even the skin. Weight loss usually accompanies liver failure as well.
Diagnosing Liver Failure
There are several diagnostic tests veterinarians use to diagnose liver failure in cats:
Physical exam – The veterinarian will check for signs of liver disease like jaundice, weight loss, vomiting, and abdominal pain. They will also feel the abdomen to check liver size.
Blood tests – Bloodwork like a chemistry panel and liver enzyme tests can help detect liver inflammation, dysfunction, and liver cells being destroyed. Increased bilirubin levels indicate jaundice.
Imaging – X-rays and ultrasound allow the vet to examine the liver’s size and look for masses, cysts, or abnormal architecture that would indicate disease. Ultrasound also helps guide needle biopsies.
Biopsy – Taking a sample of liver tissue for analysis under a microscope can help determine the type of liver disease and stage of damage to design treatment.
These diagnostic steps allow the vet to determine the cause, type, and severity of liver failure to guide treatment recommendations.
Treatment Options
Treatment for liver failure in cats often requires hospitalization so that intensive care can be provided. This includes administering IV fluids to prevent dehydration and give nutritional support. Medications that may be used include SAMe, acetylcysteine, vitamin supplements like vitamin B and E, and ursodiol to help protect liver cells.
Dietary changes are a critical part of managing liver disease in cats. Your vet will likely recommend a high-calorie, high-protein diet, with moderate fat and restricted copper content. This provides the nutrients the cat needs while reducing strain on its damaged liver. They may prescribe a veterinary therapeutic food for liver health. Supplements like milk thistle and antioxidants can also help support liver function.
According to PetMD, “Medications such as SAMe, acetylcysteine, vitamin supplements, and ursodiol are often used to treat liver disease.” https://www.petmd.com/cat/conditions/endocrine/liver-disease-cats
The Merck Veterinary Manual states, “Treatment may include antifungal drugs and antibiotics for skin infections, zinc and vitamin supplementation, administration of amino acids, high-protein diets, and lactulose.” https://www.merckvetmanual.com/cat-owners/digestive-disorders-of-cats/disorders-of-the-liver-and-gallbladder-in-cats
Providing At-Home Care
Caring for a cat with liver disease at home is crucial for your cat’s health and quality of life. Here are some tips for providing excellent at-home care:
Follow your veterinarian’s instructions carefully. This includes giving all medications as directed, monitoring symptoms, and calling the vet if you have any concerns. Your vet may recommend supplements like milk thistle or SAMe to support liver health.
Encourage eating by feeding smaller, frequent meals. Offer smelly foods like tuna, sardines, or boiled chicken to stimulate appetite. Hand feeding may also help. Ask your vet about prescription appetite stimulants if needed.
Avoid fasting for too long, as cats with liver issues can develop hepatic lipidosis. Feed a vet-recommended liver support diet that is highly digestible with extra vitamins and amino acids.
Provide easy access to fresh, clean water to prevent dehydration. Canned foods also contain moisture.
Monitor litter box habits, as constipation or diarrhea can occur. Ask your vet about adding fiber or probiotics to your cat’s diet if needed.
Weigh your cat weekly and track symptoms like vomiting, diarrhea, lethargy, or jaundice. Update your vet regularly on your cat’s condition.
Make sure your cat is comfortable by providing soft bedding in a quiet area without stress. Cats with liver disease need lots of rest.
Give any oral medications gently, preferably mixed in food or a liquid treat. Pilling cats can worsen stress.
Show your cat love and care through gentle grooming, massages, and play time if interested. Quality time together supports emotional health.
Caring for a cat with liver disease takes patience and dedication. Work closely with your vet and monitor your cat closely to provide the best at-home care possible.
Dietary and Lifestyle Changes
Making changes to your cat’s diet and lifestyle is crucial when managing liver disease. Since the liver plays an important role in protein metabolism, cats with liver failure often need to switch to a low protein diet. This helps reduce the workload on the damaged liver. Look for cat foods with protein primarily from dairy, soy and egg sources rather than meat. It’s also important to ensure the carbohydrates are highly digestible. Supplementing with omega-3 fatty acids can help reduce inflammation and support liver health. Sources like fish oil are a good option.
Avoid exposing your cat to toxins and chemicals that could further damage the liver. This includes things like cigarette smoke, insecticides, mold and heavy metals. Try to use natural cleaning products in your home. It’s also important to be diligent about not giving human medications to your cat without first consulting your vet, as many can be hard on the liver.
Additional lifestyle changes like ensuring your cat maintains a healthy body weight, drinks adequate water and gets regular moderate exercise can also be beneficial. Work closely with your veterinarian to determine the ideal diet and lifestyle plan for your individual cat.
Prognosis
The prognosis for cats with liver failure depends greatly on the underlying cause and how early treatment is started. If treatment begins quickly after the onset of symptoms, and the underlying cause can be addressed, cats have a good chance of making a full recovery1. In cases of acute liver failure, most cats will recover completely within 3-6 weeks if they can survive the first few critical days of intensive treatment and hospitalization2.
For chronic liver disease, the prognosis is more guarded. However, if caught early and treated aggressively, some cats can still have a favorable outcome and go on to live a relatively normal life. Dietary changes, supplements, and medications can help slow the progression of chronic liver failure and minimize symptoms. But cats with advanced chronic liver disease often deteriorate over time. Close monitoring and dedicated care is required to maintain quality of life3.
Unfortunately, cats presenting with end-stage liver failure have a grave prognosis, and humane euthanasia is often elected within days. But with swift veterinary intervention after initial symptoms arise, cat owners have a good chance of nursing their feline back to health.
Preventing Liver Disease in Cats
There are several ways cat owners can help prevent liver disease in their feline companions:
Get annual veterinary exams. Annual exams allow vets to check for early signs of liver issues like elevated liver enzymes. Catching problems early makes treatment more effective.
Feed a high-quality diet. A nutritionally balanced cat food supports liver health. Look for foods with high-quality protein, limited carbohydrates, and omega fatty acids. Avoid cheap brands with fillers. Obesity stresses the liver, so don’t overfeed.
Avoid toxins. Keep cats away from toxic plants, chemicals, moldy food, alcohol, and medications not prescribed for them. Don’t use flea/tick products not approved for cats. Monitor litterboxes to ensure cats aren’t eating clumping litter.
Maintain a healthy weight. Obesity causes fat deposits in the liver leading to inflammation and damage. Follow your vet’s feeding guidelines to keep your cat trim.
With preventative care and a healthy lifestyle, cat owners can reduce the likelihood of liver disease in their pets. But even with the best care, genetic and unknown factors can still cause liver issues. So be vigilant for any signs of illness and respond quickly if problems develop.
Coping with a Cat that has Liver Failure
Learning your cat has liver failure can take an emotional toll. It’s normal to feel sadness, anger, or guilt. Give yourself time to process these emotions. Consider joining a pet loss support group to connect with others going through the same experience.
You’ll likely need to make adjustments to care for your sick cat. For example, you may need to give medicines, prepare special meals, and provide more hands-on care. This can be demanding, so don’t be afraid to ask family, friends, or a pet sitter for help.
At some point, you’ll need to make difficult decisions about palliative care or euthanasia. Your vet can help you determine when your cat’s quality of life is declining. Focus on your cat’s comfort and reducing any pain or suffering. Saying goodbye is painful, but find reassurance in knowing you gave your cat the best life.
Taking care of yourself is also crucial when coping. Make sure to take breaks, get exercise, eat well, and lean on your support system. Commemorate happy memories with your cat through a journal, photo album, or memorial. Though this is a hard time, cherish the joy and companionship your cat brought you.
When to Consider Euthanasia
One of the most heartbreaking decisions pet owners face is determining when to euthanize a cat with liver failure. While every situation is different, there are some general guidelines to help assess your cat’s quality of life and determine if euthanasia may be the most humane option.
As liver failure advances, your cat is likely to experience a deteriorating quality of life. Key things to look for include:
- Loss of appetite and rapid weight loss
- Persistent vomiting or diarrhea
- Lethargy, inability or unwillingness to move around
- Hiding or isolating from family members
- Labored breathing or panting
- Signs of pain or difficulty getting comfortable
- Lack of interest in surroundings or interactions
It’s important to focus on your individual cat’s wellbeing. Consider their personality and what a good life means for them. Have they lost interest in activities they once enjoyed? Do they seem like they are suffering or in distress? Marked shifts in quality of life or personality can help signal when euthanasia may be the most merciful option.
There are also some medical indicators late in the disease process that may point to euthanasia. These include persistent uncontrolled vomiting, significant jaundice, and ascites or fluid buildup in the abdomen. Your veterinarian can help assess clinical signs that show liver function is severely impaired.
While saying goodbye is incredibly painful, euthanasia can be an act of love to prevent needless suffering. Focus on your cat’s quality of life and work closely with your vet to make this decision.
