Liver failure in cats appears as a consequence of certain liver diseases that affect liver functions, such as hepatic lipidosis, cholangitis, amyloidosis or tumors, but it can also be due to extrahepatic or toxic diseases.
In this article we will talk about what is liver failure in cats, its causes and symptoms.
What is liver failure in cats?
Liver failure refers to certain diseases and circumstances that alter the proper functioning of the liver in cats. There are many diseases that decrease the functionality of the liver, some are primary while others are secondary due to toxins or extrahepatic diseases.
The feline liver fulfills numerous functions, since it intervenes in digestion, in the synthesis of bilirubin, glycogen, lipoproteins, albumin and filters toxic compounds. In addition, it is adapted to the carnivorous nature of cats because through meat they obtain, among other nutrients, taurine and arginine, which are two essential amino acids for cats.
The feline liver forms bile salts from the conjugation of bile acids with taurine and arginine, it is involved in the synthesis of ammonia from urea and its elimination. Therefore, an arginine deficiency will cause ammonia poisoning in our cat, causing hepatic encephalopathy that, unfortunately, usually has a fatal outcome.
Causes of feline liver failure
These are the different causes of liver failure in cats:
- Liver disease
- Infectious diseases.
- Portosystemic shunt.
Symptoms of liver failure in cats
The symptoms of feline liver failure are nonspecific. However, depending on the process that causes it and its severity, we can find:
- Lack of appetite.
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 can occur.
As always, it is very important to take your cat to the vet as soon as you see that he experiences any of the symptoms mentioned above or any other abnormality.
How is feline liver failure diagnosed?
The diagnosis of diseases that can cause liver failure in cats is completed with a study of the patient’s medical history, clinical examination, blood and biochemistry tests, ultrasound and biopsies. Let’s see each of these processes below.
During the anamnesis and examination of the feline we must observe the clinical signs that the cat presents, observe its state of hydration, coat, state of the mucous membranes to assess jaundice and body condition, as well as palpation of the animal and look for the presence of fluid in the cavity indicative of ascites. Jaundice and ascites are late signs of liver disease in cats, with liver failure being the most specific.
A blood count and biochemistry of the cat should be performed. Functional markers and any type of liver disease will be looked for:
- Markers of liver disease: an increase in ALT and AST enzymes indicate cellular damage in the liver, although since they have a half-life of a few hours in the cat, if we do not see them increase, it does not have to be related to the liver. An increase in ALP and GGT enzymes leads more to damage to the bile ducts and canaliculi, if only GGT increases, it leads more to liver damage.
- Markers of liver function: these are altered when liver failure is advanced, being hyperbilirubinemia (increased bilirubin), hypoglycemia (low glucose level), hypoalbuminemia (low albumin level), hypo or hypercholesterolemia (decreased or increased cholesterol) and increased of clotting times (due to vitamin K deficiency). Bilirubin increases in the absence of hemolytic anemia or pancreatic disease are a good indication of liver failure. In addition, before appearing increased in the laboratory test, cats usually present bilirubinuria (bilirubin in 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 an increase in bile acids on an empty stomach and after two hours of ingestion.
Specifically, the useful technique in these cases is abdominal ultrasound, although it is usual not to find alterations even when the cat really has liver disease. In some cases, focal lesions are observed, an enlarged liver with hyperechoic parenchyma (white in the image) suspected of lipidosis, dilation of the bile ducts suggestive of cholangitis, or we can look for vascularization for the diagnosis of portosystemic shunt.
The definitive diagnosis of many diseases that cause liver failure in cats is achieved through a pathological study from the taking of biopsies. However, in cases of lipidosis it can be diagnosed by following the previous steps and a liver fine needle cytology (FAP), where numerous cells with fat will be seen, although it must be taken into account that it can coexist with other diseases, so it will not always be definitive, requiring a biopsy. In suspected cases of cholangitis, bile can be obtained from these ducts for cytology and culture, without the need for biopsy in cases of neutrophilic cholangitis.
Early detection of feline liver failure is essential for effective treatment. Faced with any symptoms, do not hesitate to take your pet to the vet so that he can choose the best way to treat the animal’s disease.