Liver problems in cats are fairly common. We see both primary liver problems like hepatitis and liver cancer and also secondary liver problems like fatty degeneration resulting from prolonged inappetance. Diagnosing liver disease can be difficult from a physical exam alone. The symptoms of liver disease are often non-specific inappetance and lethargy. Occasionally, a cat with liver and gall bladder problems will appear yellow [jaundiced] on physical exam, but usually blood tests are required to diagnose feline liver disease. This is why blood tests can be invaluable when the physical exam doesnt reveal a cause for malaise, vomiting or inappetance. Sometimes a urine sample will lead us toward liver disease because of the presence of bilirubin in the urine. X-Rays may indicate an enlarged or abnormal liver. There are five enzymes in our Serum Chemistry Profile, which are associated with liver and gall bladder function. The pattern of their elevation or depression can tell us something about the liver disease- especially its severity, but they rarely reveal the succinct cause of the problem, which could be …
-Viral or bacterial hepatitis
-Fatty degeneration or other metabolic problems
-Lymphocytic infiltration
-Tumors, benign or malignant
-Toxic hepatopathy like Excedrin
-Fungal Diseases
-Obstructive disease like gallstones
-Parasitic problems like Toxoplasmosis
It is often necessary to go further with diagnostics. These procedures might include, bile acid testing, specific viral tests, x-rays, fecal tests and others. Commonly, ultrasound is a useful, albeit costly, ancillary test. Ultrasound is really medical sonar and is painless for your cat. By imaging the liver, gall bladder and bile ducts, a definitive diagnosis may be made. If the ultrasound is ambiguous, sometimes a small core biopsy will be taken guided by the ultrasound image. This may require short, mild anesthesia. Sometimes a very fine needle can be used to aspirate liver tissue. Both of these samples are then sent to consulting pathologists for diagnosis with 2-4 day turnaround time.
Once a diagnosis is achieved, more specific treatment can be started. We begin to treat all liver patients with a general liver protocol involving antibiotics, antiiflammatories, vitamins, amino acids and drugs to promote the normal movement of bile through the liver.
In some cases, exploratory surgery and biopsy might be a better route to consider than ultrasound, especially if we expect involvement of other organs or if bile duct obstruction is suspected.
Once a diagnosis is achieved, we will treat specifically and often recheck the serum chemistry frequently, as the change in liver values can be rapid [hours to days], this helps us determine if the treatment is successful or needs modification.
Liver diseases in the cat run the gamut from readily reversible to untreatable. Without thorough diagnostics it is hard to tell which cats will respond well, so complete testing is mandatory with feline liver disease.