Liver Failure in Cats - Symptoms and Treatment

Author: Peter Berry
Date Of Creation: 14 February 2021
Update Date: 26 September 2024
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Feline Liver Disease | Symptoms, Causes, & Treatments | Dr. Bill’s Pet Nutrition | The Vet Is In
Video: Feline Liver Disease | Symptoms, Causes, & Treatments | Dr. Bill’s Pet Nutrition | The Vet Is In

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Liver failure in cats appears as a result of liver diseases that affect the liver functionality, such as hepatic lipidosis, cholangitis, amyloidosis or tumors, but it can also be due to extra-hepatic diseases or toxins.

The symptoms of all these diseases are nonspecific and include, among others: lethargy, weight loss, loss of appetite, increased water intake and vomiting. In advanced stages of liver damage appears jaundice (yellow mucous membranes), hepatic encephalopathy and even ascites (accumulation of fluid in the abdomen).

Want to know more details about the liver failure in cats - symptoms and treatment? Keep reading this PeritoAnimal article and you will get to know better the diseases that can cause liver failure in your little feline.


What is liver failure in cats?

With the term feline liver failure, we refer to all diseases and circumstances that alter the correct functionality of the cat's liver. There are many diseases that decrease liver functionality, some are primary and others secondary due to toxins or extrahepatic diseases.

The liver of cats fulfills numerous functions, as they are essential for digestion, for the synthesis of bilirubin, glycogen, lipoproteins, albumin and filter out toxic compounds. Furthermore, it is adapted to the carnivorous nature of cats, as through the meat they obtain, among other nutrients, taurine and arginine, which are two essential amino acids for cats.

The liver forms bile salts from the conjugation of bile acids with taurine and arginine, intervenes in the synthesis of ammonia from urea and its elimination, therefore, an arginine deficiency will cause ammonia poisoning in our cat, causing a hepatic encephalopathy that usually has a fatal outcome.


Causes of Feline Liver Failure

Liver failure in cats can be caused by a variety of reasons, including purely liver disease, infectious disease, disease in organs other than the cat's liver, or by toxins:

liver diseases

There are different liver diseases that can affect the cat's liver and thus develop a more or less severe insufficiency:

  • liver lipidosis: also called fatty liver, there is a fat infiltration in the feline liver cells causing its dysfunction, being potentially deadly for our felines. It usually occurs in overweight cats who fail to eat for two or three days for some reason, releasing fat from their body stores into the blood and reaching the liver. It can be caused because, when they stop eating, they do not synthesize the low-density lipoproteins that mobilize triglycerides out of the liver or prevent the oxidation of fatty acids by carnitine deficit, which is obtained through two essential amino acids that the cat must get on with your diet. Secondary causes that can produce it are cholangitis, pancreatitis, gastrointestinal or endocrine disease (hyperthyroidism, diabetes mellitus).
  • Neutrophilic cholangitis: inflammation of the bile ducts of the liver from gastrointestinal bacteria infection (Escherichia coli, streptococci or clostridia). It is usually associated with an inflammatory bowel disease and/or pancreatitis, this is common in cats and is called the feline triad, because the liver and pancreatic ducts lead together to the intestine, so diseases of the intestine or pancreas can affect the liver.
  • lymphocytic cholangitis: it is a chronic progressive immune-mediated disease with lymphocyte infiltration.
  • Hepatical cirrhosis: appears at the end of a chronic liver disease and consists of the appearance of fibrosis, abnormal regeneration nodules and vascular anastomoses of the portal vein.
  • amyloidosis: consists of the deposit of amyloid protein in the liver, which can break it, causing blood to flow into the abdomen (hemoabdomen). It also tends to occur in other organs, such as the kidney, and is usually a response to chronic inflammation. It is most often described in the Abyssinian, Siamese and Oriental cat.
  • liver tumors: are rare in cats, the most prevalent being bile duct carcinoma. We can also see lymphomas in the liver, but we usually find them elsewhere as well.

Infectious diseases

Among the infectious diseases that can cause liver failure in cats, we highlight:


  • PIF: by formation of pyogranulomas in the liver in the dry form of the disease.
  • toxoplasmosis: by hepatocyte necrosis (death of liver cells) and inflammation.

Toxins

Cats have a enzyme deficit metabolizing glucuronyl transferase, which is responsible for the conjugation of certain drugs or their metabolites with glucuronic acid to proceed with their metabolism and elimination. Some medications that use this route and should not be administered to our cats because they are very toxic and can cause liver necrosis, are: acetaminophen, ibuprofen and aspirin. Other drugs that have liver toxicity in cats are methimazole, tetracyclines, diazepam, L-asparaginase and doxorubicin.

Portosystemic Shunt

It consists of an alteration in the circulation of the cat's liver of congenital origin by the existence of an additional blood vessel which connects the portal vein and the caudal vena cava (systemic circulation), so that certain toxic substances from the intestine reach the liver but are not filtered through vascular communication, then pass directly into the general circulation, resulting in toxic damage to the brain . Furthermore, as a result of this, the liver atrophies, reducing its size and producing liver failure.

Among all of them, the diseases that most commonly cause liver failure in feline species are hepatic lipidosis and cholangitis.

Symptoms of Liver Failure in Cats

Signs of Feline Liver Failure are unspecific, depending on the process that originates it and its severity, we can find several reasons, such as jaundice in cats:

  • Lack of appetite
  • Weight loss
  • Lethargy
  • vomiting
  • Diarrhea
  • Anorexia
  • polydipsia
  • dysuria
  • Depression
  • Apathy
  • Jaundice
  • Ascites

In cases of hepatic encephalopathy due to an increase in toxins not filtered by the liver, seizures, blindness, hypersalivation, behavioral changes, aggressiveness, stupor and even coma will be seen.

Diagnosis of feline liver failure

The diagnosis of diseases that can cause liver failure in our cats is completed through a good history, clinical examination, blood and biochemical analysis, ultrasound and biopsies.

Physical exam

During the anamnesis and examination of the feline, we must observe and ask the tutor about the clinical signs it presents, observe its hydration status, coat, mucosal status to assess a possible picture of jaundice and body condition, as well as the animal's palpation and seek if there is presence of fluid in the abdominal cavity indicative of ascites. Jaundice and ascites are some of the late signs of liver disease in the cat, being the most specific of liver failure.

blood test

A complete blood count and blood biochemistry of the cat is performed. In it they should look for markers of functionality and liver disease:

  • liver disease markers: an increase in the enzymes ALT and AST indicate cell damage in the liver, although as it has an average life of a few hours in the cat, if we do not see them increased, there is no reason not to have liver disease. An increase in the enzymes ALP and GGT leads more to damage in bile ducts and canaliculi, while increasing only GGT leads to more liver damage.
  • Liver functionality markers: these are changed when liver failure is advanced, being hyperbilirubinemia (increased bilirubin), hypoglycemia (low glucose), hypoalbuminemia (low albumin), hyper or hypocholesterolemia (decrease or increase in cholesterol) and increased clotting time (due to vitamin K deficiency). Increased bilirubin in the absence of hemolytic anemia or pancreatic disease is a good indication of liver failure, and before it appears increased in the analysis, cats usually have bilirubinuria (bilirubin in the urine) which is always pathological in this species. If bilirubin is normal, the most sensitive and specific marker for detecting liver failure in cats is the increase in bile acids during fasting and within two hours of food intake.

Diagnostic imaging

Specifically, the useful technique in these cases is the ultrasoundabdominal, although it is common not to find changes even when the cat does have liver disease. In some cases, focal lesions, enlarged liver with hyperechoic parenchyma (white in image) that is suspected of lipidosis, dilatation of the bile ducts that suggest cholangitis, or vascularization can be examined for the diagnosis of portosystemic shunts.

liver biopsy

The definitive diagnosis of many diseases causing liver disease in cats is obtained by means of a anatomopathological study by performing biopsies. However, in cases of lipidosis it can be diagnosed by the previous steps and a fine-needle liver cytology (FAP), where numerous fat cells will be seen, although it must be taken into account that it may coexist with other diseases, so not always will be definitive, requiring biopsy. In suspected cases of cholangitis, bile can be obtained from these channels for cytology and culture, without the need for a biopsy in cases of neutrophilic cholangitis.

Treatment of liver failure in cats

The treatment of liver failure in cats is complex and it will depend on the disease or diseases that coexist in the animal. Each of these must be specifically treated once diagnosed separately and according to symptoms. Below we'll list several possible treatments, including some cat liver remedies that will help you a lot.

Treatment of hepatic lipidosis

Is hepatic lipidosis in cats curable? Lipidosis is a very serious disease that must be diagnosed and treated early in order to save our cat, only then can it be cured. Your therapy is mainly based on:

  • enteral nutrition with esophagostomy or nasogastric tube (it is increased by 25% each day until reaching the daily kcal that the cat needs on the fourth day).
  • fluid therapy with isotonic crystalloids supplemented with potassium, if necessary.
  • Nutritional supplements and vitamins: taurine (to prevent or treat disability), L-carnitine (to increase the oxidation of fatty acids) and vitamins E (antioxidant), B and K (to treat coagulopathy due to its deficiency).
  • If you have hepatic encephalopathy, it should be administered lactulose orally combined with antibiotics such as amoxicillin or metronidazole. They are the best remedy options to treat these liver problems in cats.
  • To replenish lost glutathione reserves that protect against oxidizing agents, it must be administered N-acetyl-cysteine slowly intravenously. Antiemetics, gastric protectors, appetite stimulants, and buprenorphine should also be given to control pain if there is associated pancreatitis.

Treatment of neutrophilic cholangitis

The correct remedies to be administered are the antibiotics, for 4-6 weeks, with previous culture and antibiogram (cephalosporins, amoxicillin-clavulanic, fluoroquinolones, metronidazole). If the answer is not good, should be added steroids. Depending on the severity, a supportive treatment with:

  • Fluid therapy.
  • Enteral nutrition.
  • Antiemetics.
  • Ursodeoxycholic acid to stimulate biliary secretion, but provided there is no obstruction, in addition to anti-inflammatory, immunomodulatory and antifibrotic.
  • Antioxidants such as S-Adenosyl Methionine (SAMe) and Vitamin E to reduce disease-causing oxidative stress.
  • Nutritional supplements and vitamins.

Lymphocytic cholangitis treatment

Antibiotics and prednisolone are given in high doses (2-3 mg/kg/24 hours) with progressive dose reduction according to response and supportive treatment similar to that of neutrophils. If the response to prednisolone is not sufficient, other remedies for cats may be added, including immunosuppressants such as clrambucil.

Treatment of infectious diseases

In cases of infectious origin diseases, the disease must be treated and the cat's liver protected with antioxidants (SAMe, vitamin E), administered ursodeoxycholic acid and symptoms treated with antiemetics, fluid therapy, appetite stimulants or enteral feeding, control of pain relief and nutritional and vitamin supplements.

Treatment of liver tumors

In cases of neoplasms, protocols for chemotherapy adapted to the tumor and, in removable tumors, surgery.

Portosystemic shunt treatment

The indicated treatment will be the surgery, but it doesn't always go well and first it is necessary to stabilize it with antibiotics, lactulose and a low-protein diet.

Now that you know the symptoms of liver failure in cats and also know the treatments with the best remedies for cat liver, you may be interested in the following video about the 10 most common diseases in felines:

This article is for information purposes only, at PeritoAnimal.com.br we are not able to prescribe veterinary treatments or perform any type of diagnosis. We suggest that you take your pet to the veterinarian in case it has any type of condition or discomfort.

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