Liver Failure in Cats
The most common cause of liver failure in cats is idiopathic hepatic lipidosis. The next most
common cause is cholangiohepatitis. Infectious diseases that involve the liver
include feline infectious peritonitis and toxoplasmosis.
and cancers that begin in the liver or spread there from other locations are
other causes of liver insufficiency.
This disease, unique to cats, is the most common metabolic
cause of liver failure. Although the precise cause(s) may be unknown, this
syndrome appears to be a type of anorexia that occurs when a cat has a
sustained loss of appetite and stops eating. The liver plays a major role in
fat (lipid) metabolism. With starvation, fat accumulates in liver cells. Lipid
mobilization (lipid molecules are moved out of storage in the tissues)
throughout the body, along with related secondary nutritional deficiencies,
seems to be the critical path to disease.
The liver becomes yellow, greasy, and enlarged. Signs of liver
failure (especially jaundice) appear as liver function deteriorates. Drooling
is common, and the cat may have an enlarged liver on palpation, X-rays, or
ultrasound examination. Usually, the loss of appetite has been going on for two
to three weeks, but cases do occur in which anorexia is present for just a few
Often, hepatic lipidosis is secondary to a systemic problem,
such as hyperthyroidism,
diabetes mellitus, urinary tract conditions, or upper respiratory
infections. Illnesses in which the cat cannot keep down food may also cause the
disease. However, anywhere from 15 to 50 percent of cases have no obvious
Hepatic lipidosis occurs in cats of both sexes and all ages.
Being overweight is a predisposing cause. Often, stress is the initiating
factor, but frequently the cause of the anorexia is unknown (idiopathic hepatic
lipidosis). Diagnosis is confirmed by liver biopsy and blood work.
Treatment: Early intensive fluid replacement and forced feeding
offer the best chance for reversing the process. Cats who receive early and
aggressive nutritional support, such as the placement of feeding tubes, have a
90 percent chance of survival. If the cat does not get this quick, aggressive
treatment, the survival rate goes down to 10 to 15 percent.
Appetite stimulants may be prescribed by your veterinarian, but
they are only effective if the cat is still eating at least a little on his
own. In most cases, nutritional support involves special diets and formulas
administered by your veterinarian by stomach tube or gastrostomy, an operation
in which a feeding tube is placed into the stomach through a small incision in
the abdominal wall. Nutritional support is continued until the cat recovers and
begins to eat on his own. Any nutritional supplements given through a feeding
tube should be warmed to room temperature.
Recovery may take two to three months and requires home nursing
care and complete dedication by the owner. Survival of the first four days of
intensive treatment is a very good sign, with 85 percent of those cats going on
to recovery. If pancreatitis is also present, the prognosis is poor.
When cats stop eating for even a day or two, they are prone to
liver disease. Seek veterinary attention whenever your cat refuses to eat for
more than two days.