Introduction
Liver failure in cats occurs when the liver is no longer able to perform its essential functions, such as removing toxins from the blood and aiding digestion. This can be a life-threatening condition that requires urgent veterinary care. Liver failure has a variety of causes in cats, including obesity, infections, poisoning, cancer, and problems with blood flow. Common symptoms of liver failure in cats include loss of appetite, vomiting, jaundice (yellowing of the skin and eyes), diarrhea, weight loss, increased thirst and urination, lethargy, and fluid buildup in the abdomen. If left untreated, liver failure can lead to neurological symptoms, seizures, coma, and ultimately death. While liver failure is a serious condition, the earlier it is caught and treated, the better the prognosis for recovery. Treatment focuses on identifying and addressing the underlying cause, providing nutritional support, and managing complications. With aggressive treatment, cats can recover from liver failure, especially when it’s caught early. But in severe or end-stage cases, euthanasia may be the most humane option.
Signs of Liver Failure
Some common signs of liver failure in cats include:
Jaundice – This appears as a yellow discoloration of the skin, eyes, and mucous membranes, and is caused by a buildup of bilirubin. Jaundice is one of the most indicative signs of liver issues (Source).
Loss of appetite – Cats with liver disease often lose interest in food and have decreased appetite. This happens because the liver is less able to metabolize nutrients from food (Source).
Vomiting and diarrhea – Gastrointestinal signs like vomiting and diarrhea frequently occur with liver disorders. This is due to impaired digestion and toxin buildup (Source).
Weight loss – Despite decreased appetite, weight loss can also stem from inefficient nutrient utilization and dysfunctional metabolism (Source).
Increased thirst – Toxic buildup can also lead to increased thirst and urination as the kidneys try to flush out toxins (Source).
Causes of Liver Failure
There are several potential causes of liver failure in cats, including:
Inflammation
Inflammation of the liver, known as hepatitis, is a common cause of acute liver failure in cats. Causes of hepatitis include bacterial, viral, and fungal infections. Inflammation interrupts normal liver function and can lead to rapid cell death 1.
Cancer
Cancer in the liver, such as lymphoma or metastasis of other cancers, can damage liver tissue over time. As cancer cells multiply, they disrupt the liver’s structure and ability to function 2.
Toxins
Exposure to toxins like certain medications, poisonous plants, pesticides, and other chemicals can injure liver cells. The liver tries to filter out toxins but can become overwhelmed and start to fail 3.
Infections
Viral infections like feline infectious peritonitis (FIP), feline leukemia virus (FeLV), and feline immunodeficiency virus (FIV) can all damage the liver over time. Bacterial infections may also spread to the liver from other parts of the body 2.
Blockages
Obstructions of the bile ducts, either from masses, strictures, or gallstones, can back up bile and cause liver cell death. This is known as extrahepatic biliary obstruction 3.
Is Liver Failure Painful?
Yes, liver failure often causes significant abdominal pain and discomfort in cats. As the liver stops functioning properly, toxins build up in the bloodstream and the abdomen may become distended with fluid (ascites). This fluid buildup stretches the abdominal cavity, putting pressure on the internal organs and nerves which can be very painful for cats.
According to veterinarians, signs of a cat in liver failure experiencing abdominal pain include (cite: Merck Veterinary Manual):
- Crying or meowing in pain
- Hunching of the back
- Reluctance to move or jump
- Excessive licking or biting at the abdomen
- Hiding or isolating from family
As liver disease progresses to end-stage failure, a cat’s discomfort and pain will continue to worsen. Providing medications, fluids, and other palliative treatments can help ease some of the pain and make a cat feel more comfortable.
Abdominal Pain
Cats with liver failure often experience abdominal pain due to the inflammation and dysfunction of the liver. Some common signs of abdominal discomfort and pain include a tender belly, crying or meowing when touched, and a hunched posture with the back arched up.1 The belly may feel tense or hard to the touch. Cats tend to hide signs of pain, so any outward indicators of discomfort are noteworthy.
According to the Merck Veterinary Manual, liver inflammation causes nausea, inappetence, and abdominal pain.2 The abdominal cavity contains a large network of nerves, so diseases affecting organs in this area often cause significant pain. With liver disorders, the surrounding organs like the stomach, intestines, and spleen may also become inflamed, adding to the discomfort.
In advanced liver failure, fluids can accumulate in the abdomen causing a distended or bloated appearance. The belly may feel tight and painful. Seeking veterinary care is imperative if your cat shows these signs of possible ascites or abdominal swelling.
Discomfort
Liver failure in cats can cause significant discomfort. As the liver loses function, toxins build up in the bloodstream which can make cats feel unwell. Signs of discomfort include:
Restlessness – Cats with liver failure may pace, seem unable to get comfortable, and have difficulty settling down to rest. The buildup of toxins can cause an overall feeling of unease.
Decreased activity – Where cats once played, explored, and followed regular routines, they may become withdrawn and inactive as liver failure progresses. Simple movements may become an effort.
Irritability – The discomfort of liver failure can make cats short-tempered. They may hiss, growl, or bite when approached or petted, even if they were previously docile.
According to veterinarians, these discomfort signs are not necessarily indications of pain, but rather a general feeling of unwellness as toxins accumulate. However, liver failure can be painful in some cases, especially as fluid buildup and swelling develops in the abdomen, which will be covered next.
Treatment
Treatment for liver failure in cats focuses on supporting the cat and easing symptoms while the liver tries to heal. According to the Merck Veterinary Manual, treatment often includes:
Intravenous fluids to help correct dehydration and electrolyte imbalances. Fluids can help flush toxins from the body and provide nutrients when cats are not eating.
Anti-nausea medications such as maropitant to control vomiting. Vomiting can lead to electrolyte imbalances.
Liver support supplements containing milk thistle, SAMe, and antioxidants. Milk thistle helps protect liver cells from toxins while SAMe supports liver function. Antioxidants neutralize cell-damaging free radicals.
According to PetMD, cats may need to be fed via a feeding tube if they are unwilling or unable to eat on their own. Providing nutritional support is critical.
With aggressive supportive care, some cats can recover from acute liver failure. However, the prognosis depends on the underlying cause and how much irreversible damage has occurred.
Outlook
The prognosis for cats with liver failure depends greatly on the underlying cause and how early treatment is started. In cases of acute liver failure where the cause can be identified and treated promptly, cats have a good chance of recovery if there is no substantial permanent damage. However, chronic liver disease and cirrhosis have a more guarded prognosis.
For cats in acute liver failure, the outlook is best when treatment begins within 48 hours of the start of symptoms. With aggressive therapy, over 50% of cats with acute liver failure can recover normal or near normal liver function. However, delays in treatment beyond 2-3 days dramatically reduce the chances of recovery.
For chronic liver disease and cirrhosis, prognosis depends on the extent of scar tissue and cell death. If a large amount of the liver is permanently damaged, the prognosis is poorer. However, even in these cases, with careful management medications and diet, cats can often live comfortably for years.
Regular follow up blood work and imaging are necessary to monitor liver health and catch any deterioration early. Close monitoring and adaptation of treatment is key to maintaining quality of life.
Easing Pain
There are some ways to help ease pain and discomfort in cats with liver failure. These can help improve quality of life as the disease progresses.
Pain medication prescribed by a veterinarian is often used to help manage pain. Drugs like buprenorphine or meloxicam can help relieve abdominal discomfort and control pain. It’s important to follow dosage instructions from your vet.
Applying warm compresses to the abdomen can also help soothe pain. Use a warm, damp towel and apply gentle pressure to the belly for 5-10 minutes at a time. This can provide relief without medication.
Gentle massages can also help. Carefully rub the cat’s belly using small circular motions. Avoid pressing too hard. The light massage can relax muscles and stimulate blood flow to ease discomfort.
While these methods may not eliminate pain entirely, they can provide some comfort and relief for cats dealing with declining liver function and related pain issues.
When to Euthanize
Unfortunately, liver failure in cats is often fatal. At a certain point, treatment is no longer effective and the cat’s quality of life declines dramatically. Euthanasia may be the most humane option when the cat is experiencing little to no quality of life and is not responding to treatment.
Signs that a cat with liver failure may be ready for euthanasia include:
- No longer eating or drinking
- Severe lethargy and lack of interest in surroundings
- Difficulty standing or walking
- Labored breathing
- Significant weight loss and muscle wasting
- Little to no response to medications or fluid therapy
- Persistent vomiting or diarrhea
- Jaundice not improving with treatment
Euthanasia spares the cat prolonged suffering when liver failure has progressed to an untreatable stage. It is one of the hardest decisions a pet owner faces, but often the last act of love we can offer our beloved companions. Consulting with your veterinarian can help determine the most humane course based on your cat’s condition and prognosis.
