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Disclaimer: the information provided below is not intended
to replace or override the advice of your veterinarian. Both the author
and the site owner assume that this information will be used to work with
your vet in planning the best treatment plan for your cat
When my (Vick's) cat, Sam, was hospitalized for liver and pancreatitis issues in January 1998, the vets said that the only reason he had a chance (and survived) was because I always pay close attention to my cats. I know who is and isn't eating, and can usually figure out who has or hasn't peed or pooped. I worked as a vet assistant at the time, so getting Sam seen was only a matter of bringing him to work with me. For once, it seems, my obsessive care and paranoia paid off :)
What I noticed was the night before he wasn't interested in eating, and he threw up sometime during the evening while I was out. His energy level was down and he was sitting all hunched up all the time, which was very out of character for him. He threw up again overnight, and showed no interest in food the next day. I brought him to work, and said he needed to be seen before I left. We waited until the end of the day, and by then he was obviously jaundiced and quite ill. From experience at the clinic, I know most cat owners don't pick up on the cat being ill until now, and many will wait until the morning to see if the cat is still sick. I honestly didn't even notice the jaundice. So right now, take a look at the whites of your cats' eyes, the roof of their mouth and the flesh inside the ear. All should be pretty white, with the mouth and ear possibly having a pink cast. Glance at them from time to time so you know what looks normal. If your cat is throwing up and/or lethargic and these areas look grayish-yellow to golden yellow, call your vet and get your cat in that day.
Other signs of liver problems may include one or more of the following:
What should I do if I suspect my cat is in trouble?
Call your vet. Do not pass go, do not collect $200. Describe the symptoms and let them know you are concerned it may be liver problems and you would like the cat to be seen ASAP. Chances are, they will want to see the cat ASAP!
Rack your brain and try to think of anything the cat could have ingested
that would cause a problem. Does your cat go outside? Could it have ingested
a toxic reptile, plant or insect? Is it on any type of medication? Have
you used any flea and tick preventative on your cat? Have they been in
contact with insecticides or herbicides? Any potential trauma to the liver
(did the cat fall or could it have been hit by a car)? Your vet will want
to know if there is a likely cause of the problem.
What can I expect at the vet's office?
When our vet examined Sam, she took his temperature, palpated his abdomen and asked me questions to try to determine what the cause was. After the physical exam, blood and urine were taken to determine where we were. I'm not a vet, but will try to break down what specifically your vet will look at:
Urine: The most important factor is the presence of bilirubin in the urine. The presence of even trace amounts of bilirubin in feline urine is considered abnormal and indicates disease involving the liver, bile ducts or excessive destruction of red blood cells. The color of the cat's urine is also noted. When Sam had his problems his urine was a brownish, golden yellow. Red urine is caused by blood, dark yellow to brown urine with yellow foam is caused by bilirubin. Urine should also be clear.
Feces: a fecal exam will likely be done to look for parasites that may be causing the problem. Flukes in the liver can cause serious illness, but they are quite rare.
Blood: Your vet will look for several indicators in the blood work.
Do not be surprised if your vet wants to keep your cat overnight. Sam spent a week in the hospital on IV fluids. His case was complicated by pancreatic involvement, so the treatment was a bit more involved. Your vet will want to get fluids and food into the cat, something that will probably require at least a night's stay, possibly more. Please, follow their lead. Aggressive care is the only thing that saved Sam. I am a firm believer in herbs, homeopathy and nutrition, but allopathic medicine can't be beat in acute care cases.
If you are fortunate enough to have a holistic vet taking care of your cat throughout, they can help you decide if herbs, homeopathy or home prepared foods have their place in the treatment plan. I worked with an allopathic vet who was willing to listen to anything I suggested provided there was something more than anecdotal evidence to back it up.
What are the different types of liver problems?
There are two main types of liver disease common in cats: Hepatic Lipidosis and Cholangiohepatitis.
Hepatic Lipidosis: a.k.a. Fatty Liver Disease. This is the most common form of liver dysfunction in cats.Fatty liver disease occurs when the cat's fat stores are mobilized from lack of food. The liver is overwhelmed by the rapid accumulation of fat and basically begins to shut down. The most common reason for this is when a cat stops eating due to some traumatic (to him) event. This can be anything from real trauma or ingestion of a toxic substance to a change in his routine if he's highly sensitive.
Whatever the underlying cause, the cat stops eating. Since most people free-feed and have more than one cat, they don't realize their cat is not eating. Within a week or two, the cat develops fatty liver disease (yet another good argument against free-feeding :)
This is a case where aggressive veterinary care is pretty much required. Your vet will run tests and likely do a biopsy, then begin to re-introduce food. Most cats will need force-feeding. If the owner can manage to syringe feed the cat by mouth, they will be sent home with instructions and special food as soon as the cat is stabilized. Some cats require the insertion of a feeding tube to get them back up to speed. Again, the cat can go home once he's stabilized, and the owner will use a syringe to "feed" the cat via a PEG (Percutaneous Endoscopically placed Gastric) tube. Once the tube is removed and the cat is pronounced "cured", supplements and dietary modifications can rebuild and protect the liver from future episodes.
Cholangiohepatitis: this is kind of a catch-all phrase to describe a complex of feline liver and biliary tract diseases. This type of liver disease is generally considered to be the least serious of the liver problems. Left untreated, however, it will lead to liver destruction and failure. Cholangiohepatitis is an inflammation that involves the biliary tract. It can be associated with both FeLV (feline leukemia) and FIP (feline infectious peritonitis).
This diagnosis should be confirmed by biopsy, as some of the treatment for cholangiohepatitis will harm cats with hepatic lipidosis. Generally, cats with this form of liver disease are given supportive care, including IV therapy, antibiotics, medications to "de-sludge" the biliary tract and, sometimes, appetite stimulants. They may also be given a medication to prevent them from vomiting.
This is a tough row to hoe.... My Cornell Book of Cats says that the "aim of therapy is to control the disease; a complete cure is rarely obtained". To this I say, in the immortal words of Col. Sherman T. Potter, "bull cookies!" Sam tested normal on all liver values a mere 4 months after he was released, and has continued to test within normal ranges ever since. He was on antibiotics for a month and medicine to de-sludge his biliary tract for 2 months after he was released, and as soon as I felt comfortable, I put him on a low fat raw diet. He has eaten a raw diet ever since, and recently went back to full-fat.
While hepatic lipidosis and cholangiohepatitis are the most common liver maladies, other causes of liver dysfunction are possible:
When you first bring your cat home, you will likely come home bearing medications, special food and a whole lot of instructions. If you're like me, you'll sit down and start thumbing through all your natural cat care resources trying to figure out ways to help. The best advice I can give now is to either work with someone who is qualified to adjust your cat's medicines and diet (like a holistic vet or an experienced herbalist or nutritionist). You'll likely do your cat more harm than good by haphazardly whipping up a diet and supplement regimen and discarding the one your vet prescribed.
I kept Sam on most of his medications for the entire time they were prescribed. The only one I didn't use past the first day or two was the one that kept him from throwing up because it really went against what I believe in (that is, that his body knew best). For the first day, I force fed him 6-7 small meals of Hill's Prescription Diet r/d a day. The next day, he ate a little on his own and I didn't have to force feed him as much. By the third day, he was eating on his own. For the rest of the week, I stuck with canned foods that were on an approved list my vet gave me, then gradually added raw foods. By the end of the next week, he was eating an entirely raw diet, and has been ever since.
Should my cat eat a special diet?
Your vet will let you know what, if anything, should be added to, removed from or restricted in your cat's diet. If your vet is not familiar with home-prepared diets, they will probably try to persuade you from attempting to make your own food. If you're also unfamiliar with creating a home-prepared meal, this isn't the best time to learn. Consult with a holistic vet for the best ways to meet your cat's specific dietary needs. Hill's Science Diet has made recipes for their prescription foods available to vets. If your cat was sent home with a Hill's Prescription Diet, you may be able to find a recipe for a homemade version of that food here.
Pitcairn recommends "small, frequent, easily digested meals" during your cat's recovery (287). Puotinen notes that animals with liver problems should be fed organically grown foods as any "chemical residue will stress the liver" (392). At the least, consider switching to a premium commercial food which has no artificial colors, preservatives, or flavors, as these must be processed by an already compromised liver (Frazier 376). Many holistic veterinary practitioners recommend adding digestive enzymes to all meals.
Some also feel that feeding raw (preferably organic) liver is an excellent way to support your cat's liver. Low-fat, preservative - and chemical - free diets are also recommended. If you use milk products, yogurt and kefir are fine, but it's best to stay away from other dairy foods. Avoid tap water, replacing it with bottled or filtered water. If you use Dr. Pitcairn's Cat Powder and Oil, discontinue the oil (except Vit E) until the cat has recovered, then reintroduce it gradually. Anitra Frazier also modifies her Vita-Mineral Mix for cats with liver disease.
Stressed repeatedly in all the sources we consulted was the fact that the food you feed is paramount to recovery. Low fat (some suggest slightly lowering protein levels, too), organic, fresh, high-quality foods will put the least stress on the liver and allow your cat to recover.
What supplements will help my cat?
There are a number of supplements which can help a cat with liver problems. The following list was compiled from recommendations from Puotinen, Schwartz, and Frazier.
Herbs specific for Liver:
Sources Consulted:
Looking for a supplement or remedy mentioned above? Check out MotherNature.com's
Home Page - a portion of your sale will be donated to the Holisticat
List Fund for kitties in need