Introduction
Liver disease is common in cats, with some studies estimating that up to 30% of cats having some form of liver disease during their lifetime (1). The liver plays an essential role in digestion, metabolism, and detoxification. When the liver becomes damaged or diseased, it can have serious health consequences for cats. Liver disease can be acute or chronic in nature and has a variety of causes, including infections, toxins, cancers, and genetic conditions. Catching liver disease early is critical, as many types of liver disease are reversible if treated promptly before permanent scarring and cirrhosis develop. However, liver disease is often asymptomatic in its early stages, making regular veterinary checkups and bloodwork important for early detection. With appropriate treatment and management, cats can go on to live normal lives even with chronic liver conditions. This article provides an overview of the common causes of liver damage in cats, diagnosis, treatment options, and tips for prevention.
Signs of Liver Disease in Cats
Cats with liver disease often show a variety of symptoms. Some of the most common signs of liver problems in cats include:
- Loss of appetite – Cats with liver disease frequently have decreased appetite or may stop eating entirely. The liver helps regulate appetite, so liver dysfunction leads to poor appetite.
- Weight loss – Appetite loss combined with an inability to properly digest food and abnormal metabolism leads to weight loss in cats with liver disease. Weight loss despite a normal appetite can also indicate liver problems.
- Vomiting – Vomiting is a very common symptom of liver disease in cats. This results from a buildup of toxins in the blood due to the liver’s inability to filter and remove toxins properly.
- Diarrhea – Diarrhea and digestive upset are also frequently seen with liver dysfunction. This stems from a reduction in bile acids and improper food digestion.
- Increased thirst and urination – Impaired liver function can lead to increased thirst and urination as the kidneys try to flush out the buildup of toxins in the bloodstream.
- Jaundice – Yellowing of the skin, gums, and other mucous membranes (jaundice) results from a buildup of bilirubin due to decreased liver function. The whites of the eyes may also appear yellow.
- Lethargy – Lethargy and overall malaise are common with liver disease as vital bodily processes are disrupted.
Cats exhibiting any of these signs should be evaluated by a veterinarian to check for underlying liver disease.
Diagnosing Liver Disease
There are several tests veterinarians use to diagnose liver disease in cats:
Physical Exam
During a physical exam, the veterinarian will check for signs of liver problems like jaundice, abdominal swelling, or behavioral changes. They may also feel the liver to check for enlargement or pain (Source).
Blood Tests
Blood tests can check liver enzyme levels like ALT, AST, and GGT. Elevated levels indicate liver cell damage. Blood tests can also check bilirubin levels, low albumin, and glucose. Changes in these levels can point to liver malfunction (Source).
Ultrasound
Abdominal ultrasounds allow vets to visualize the liver’s size, shape, and texture. It helps identify masses, cysts, tumors, or obstruction of bile flow (Source).
Biopsy
A liver biopsy involves taking a tissue sample and examining it under a microscope. This helps definitively diagnose the type of liver disease (Source).
Causes of Liver Damage
There are several potential causes of liver damage in cats, including:
Infections
Viral infections such as feline infectious peritonitis (FIP) can cause significant liver damage in cats. Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) may also infect the liver and lead to inflammation and scarring over time (Source).
Toxins
Exposure to certain toxins like acetaminophen, antifreeze, or toxic plants can damage the liver. Cats may ingest these toxins accidentally or through improper dosing of certain medications (Source).
Cancer
Cancer affecting the liver, bile ducts, or blood vessels in the liver can impair liver function and lead to cell death. Lymphoma, mast cell tumors, and hepatic carcinomas are examples of cancers that may impact the liver.
Hepatic Lipidosis
Also called fatty liver disease, hepatic lipidosis occurs when fat accumulates in liver cells. It often develops when a cat stops eating for several days, forcing the liver to mobilize fat for energy.
Cholesterol/Fatty Liver Disease
An overabundance of fat and cholesterol in the diet can lead to a buildup of fat in the liver over time. Obesity is a major risk factor for developing a fatty liver.
Treating the Underlying Cause
The key to reversing liver damage in cats is to identify and treat the underlying cause. Some common causes and their treatments include:
Infections: Antibiotics can be used to treat bacterial, viral, or fungal infections affecting the liver. Examples include doxycycline for hepatozoonosis or fluconazole for fungal infections (Merckvetmanual).
Toxins: Removing the source of toxins and providing supportive care can allow the liver to recover. Toxins may include certain medications, plants, or chemicals (PetMD).
Cancer: Cancer may be treated with surgery, chemotherapy medications, or other therapies as recommended by a veterinary oncologist.
Hepatic Lipidosis: This condition can often be reversed through nutritional support, typically via feeding tube and a high protein, moderate fat therapeutic food (iCatCare).
Supportive Care
There are several supportive care measures that can help manage liver disease symptoms and support liver function in cats. According to VCA Hospitals, “certain basic and simple supportive measures are useful and strongly recommended” for cats with liver disease.
One key component of supportive care is administering intravenous (IV) fluids. IV fluid therapy helps maintain blood pressure, prevents dehydration, and flushes out toxic substances from the body that can build up with liver dysfunction. Providing nutrients and vitamins through IV fluids may also be beneficial.
Specific vitamins and supplements can aid liver function and reduce oxidative stress. These include vitamin B, vitamin C, vitamin E, vitamin K, S-Adenosylmethionine (SAMe), milk thistle, and L-carnitine. However, you should consult your veterinarian before giving any supplements.
It is also important to provide excellent nutritional support. Your vet may recommend a special veterinary liver diet. These diets are designed to provide key nutrients while being highly digestible and low in copper. According to the Merck Veterinary Manual, dietary changes can help delay progression of liver disease.
Additionally, reducing stress is vital for cats with liver disorders. Providing a calm, comfortable environment away from other pets can help lower stress levels.
While these measures cannot reverse liver damage, they can support liver function and minimize symptoms. Your veterinarian will create a tailored supportive care plan for your cat’s individual needs. Consistent follow-up care is crucial to monitor your cat’s condition.
Dietary Changes
Making dietary changes is an important part of caring for a cat with liver disease. The goal is to reduce the workload on the liver by feeding an easily digestible diet high in quality protein and low in fat and copper.
Veterinarians typically recommend feeding a therapeutic hepatic formula cat food for cats with liver disease. These diets are formulated to be highly digestible and contain high quality proteins like chicken, turkey, or egg whites. The fat content is reduced to be easy on the liver. Copper levels are also minimized as excess copper can be toxic to cats with liver issues.
Some other tips for feeding cats with liver disease include:
- Feed small, frequent meals instead of one or two large meals to reduce stress on the liver
- Avoid fatty cuts of meat, organ meats, and fish oils that could overtax the liver
- Add supplements like SAM-e and milk thistle which can help protect liver cells
- Provide plenty of fresh water to support hydration and kidney function
It’s important to follow your veterinarian’s recommendations for dietary changes. They can suggest an appropriate commercial or homemade diet tailored to your individual cat’s needs. With dietary management, you can support your cat’s liver health and minimize symptoms of hepatic disease.
Monitoring and Follow-Up
Ongoing monitoring and follow-up care are important parts of managing liver disease in cats. Here are some tips for monitoring your cat’s condition after initial treatment:
- Have your vet perform repeat blood work about every 3-6 months to check indicators like ALT, AST, bilirubin, and albumin levels. Changes can help gauge whether the liver disease is stable, improving, or worsening. Your vet may adjust medications or treatment plans based on blood work trends over time. NovaVet Diagnostics offers comprehensive liver function panels for cats.
- Your vet may recommend repeat ultrasounds every 6-12 months to visually assess any changes in the liver’s size, shape, and internal architecture. Ultrasounds allow your vet to monitor for progression of inflammation, scarring, or cancer nodules if applicable.
- Keep track of your cat’s appetite, energy levels, and weight at home. A decreasing appetite, lethargy, or weight loss can indicate a worsening condition. Inform your vet promptly about any concerning changes. Maintaining good nutrition is important for supporting liver function.
Staying on top of monitoring, even when your cat seems stable, allows you to catch any changes early and modify treatment as needed. Work closely with your veterinarian for ongoing care of your cat’s liver disease.
Prevention
There are several ways to help prevent liver disease in cats:
Limit toxin exposure. Make sure all household cleaners, chemicals, plants, and medications are kept safely out of your cat’s reach. Exposure to toxins is one of the major causes of liver damage in cats. Keep a close eye on your cat when they are outdoors to ensure they don’t ingest any toxins or poisonous plants.
Annual vet visits. Take your cat for annual wellness checkups with your veterinarian. Your vet will perform a physical exam and run bloodwork that can often detect early signs of liver issues. Treating liver problems early leads to much better outcomes. Your vet may recommend additional liver function screening tests as your cat ages.
Diet and weight control. Obesity is very hard on the liver, so maintaining a healthy weight through portion-controlled feeding and exercise is crucial. Feed a high quality diet formulated for your cat’s life stage and activity level. Limit treats and avoid giving people food, which is often higher in unhealthy fats and sugars.
Prognosis
The prognosis for cats with liver disease depends significantly on the underlying cause and how early treatment is initiated (1). If the primary disease is successfully treated, many cats can live for years with proper supportive care and management of liver disease. However, chronic liver failure has a guarded prognosis and is progressive. With appropriate treatment, cats with early stage liver disease have a better prognosis. According to Lap of Love, cats treated in later stages of liver disease typically survive weeks to months with therapy (1). Overall, the prognosis can vary widely based on the specific cause and extent of the liver damage.
Early diagnosis and treatment is critical for the best prognosis. As the liver can regenerate, proper function can often be restored if the initial cause is addressed promptly (2). With timely intervention, we can greatly improve the outlook for cats with liver disease (3). While the prognosis depends on the individual case, many cats go on to live happily for years with appropriate management of their liver condition.
Sources:
(1) https://www.lapoflove.com/resource-center/common-diseases-in-cats/liver-disease
(2) https://blog.petwellbeing.com/blog/cats/understanding-liver-disease-in-cats
(3) https://thecatsite.com/c/liver-disease-in-cats/
