by Suzanne Morris, DVM
It’s time for the excesses of Mardi Gras, and the appreciation due to that often abused, detoxifying organ, the liver. While cats do not tend to knowingly push their livers to the limit on forays to New Orleans, they can suffer from a variety of liver diseases.
The classic indication of possible liver disease is yellow skin, or icterus. The yellow hue can be seen over the skin of the ears, the whites of the eyes, and mucous membranes (such as the gingiva). This is the result of an accumulation of red blood cell break down product called bilirubin. Underlying causes can include diseases affecting red blood cells (such as infectious disease), but other rule-outs are generally liver diseases, since the liver processes bilirubin.
To investigate suspected liver disease, a CBC and blood chemistry will likely be recommended as a starting diagnostic. A blood chemistry profile will typically include liver enzyme levels (as well as bilirubin), which may be increased. Abdominal ultrasound, liver cell samples (aspirates), and/or liver biopsy samples are additional diagnostics that may help to determine the underlying disease process.
The top liver diseases in cats include cholangiohepatits, hepatic lidosis, and triaditis. Liver signs can also be caused by parasites that affect the liver.
Cholangiohepatitis (or cholangitis) is inflammation of the bile tract as well as the surrounding liver cells. This disease process is more common in cats than it is in dogs and has several classifications including infectious disease, inflammatory disease, and autoimmune disease. In order to investigate the underlying disease process, often abdominal ultrasound with liver cell samples or biopsies may be recommended (along with a blood panel and urinalysis). If the infectious process is suspected or diagnosed, antibiotics will likely be prescribed. Steroids may be prescribed following a course of antibiotic as well.
Hepatic lipidosis, also known as fatty liver disease, is due to triglyceride, or lipid, accumulation in the liver. Fatty liver is reportedly the most common liver disease affecting cats in the U.S. and is classically initiated by periods of anorexia, particularly in overweight cats. The process by which hepatic lipidosis occurs is not fully understood, but it is thought to involve the metabolism of bodily fat in an attempt to meet the anorexic cat’s energy needs. The treatment of hepatic lipidosis focuses on the cat’s nutritional intake (which may involve the placement of a feeding tube), as well as other supportive care measures (such as fluid therapy and anti-nausea medications) and likely administration of vitamin K, which supports the production of the blood’s coagulation factors, which are generated by the liver.
Triaditis is the combination of cholangitis, pancreatitis, and inflammatory bowel disease (IBD). Because triaditis involves three conditions, it often entails multiple treatments, including medications and diets to support/encourage the appetite, pain medications (as pancreatitis can be uncomfortable), and steroids to decrease inflammation.
If you notice a yellow hue to your kitty’s skin, consult with your veterinarian for further evaluation, and remember to keep Kitty safe this Fat Tuesday.
Webb CB. Top 5 Liver Conditions in Cats. Clinicians Brief 2013; Apr 31-33.
Rothrock K. Hepatic lipidosis. Feline Associate VIN. https://www.vin.com/Members/Associate/Associate.plx?from=GetDzInfo&DiseaseId=2782 (2011, accessed 03 March 2019.