【Liver Disease in Cats】10 Symptoms, Life Expectancy, and Treatment Options When Liver Enzymes Are ElevatedThe Power of Immunity to Overcome Liver Disease in Cats

• Cholangiohepatitis is the most common chronic inflammatory disease affecting the liver and bile ducts in cats.
• Extrahepatic bile duct obstruction does not occur on its own but is caused by other underlying conditions.
• For the recovery of energy and appetite, administering domestically produced SPF pig-derived placental powder for 1-2 months may show improvement.

Cholangitis can be categorized into suppurative (caused by bacterial infections such as E. coli, β-hemolytic streptococci, Klebsiella, Actinomyces, and Clostridium) and non-suppurative (no bacterial infection).

Suppurative cholangitis results from the infection of intestinal bacteria from the extrahepatic bile ducts to the intrahepatic bile ducts.

Non-suppurative cholangitis, also known as lymphocytic cholangitis, is believed to be associated with autoimmune diseases.

Similar to hepatitis, there are often no significant symptoms in the early stages, and even if blood tests show elevated liver values, imaging tests usually do not reveal any changes.

As the disease progresses, symptoms such as decreased energy and appetite, digestive symptoms like vomiting and diarrhea, and jaundice may appear. Blood tests may show elevated total bile acid levels as well as decreased levels of albumin (Alb) and blood urea nitrogen (BUN).

For a definitive diagnosis, liver tissue samples are collected via laparoscopy and submitted for pathological examination.

Treatment

In cases of suppurative cholangitis, the primary treatment involves the use of antibiotics to address the bacterial infection.

However, indiscriminate use of antibiotics can lead to the development of antibiotic-resistant bacteria, so it is recommended to select appropriate antibiotics based on bacterial culture of liver tissue.

For non-suppurative cholangitis, treating underlying conditions in other organs is prioritized, with the use of steroids to suppress inflammation.

Since steroids are also immunosuppressants, long-term use can lead to complications such as diabetes or bacterial infections. It is crucial to administer steroids while closely monitoring the patient’s condition through regular blood tests.

Additional treatments may include administration of antioxidants and liver protectants.

For cats with poor appetite, there is a risk of concurrent hepatic lipidosis, so placement of a feeding tube in the stomach or esophagus may be considered.

Furthermore, the anti-inflammatory effects of placenta may help alleviate symptoms.

Prevention

Avoid excessive use of medications and intake of harmful substances (such as additives) to prevent putting strain on the liver.

Here are some foods that support liver function.

Extrahepatic Bile Duct Obstruction

It can be classified into extraluminal compression and intraluminal obstruction. Extraluminal compression refers to the condition where the bile ducts are compressed from the outside due to inflammation, tumors, or trauma, while intraluminal obstruction refers to the condition where gallstones or concentrated bile block the ducts.

Symptoms vary depending on the underlying disease, but generally, loss of appetite and jaundice are common.

Due to the inability to effectively excrete bile, it is also characteristic for stools to become pale (grayish-white).

Since bile is involved in the synthesis of proteins related to blood coagulation, bleeding tendencies may also be observed due to bile secretion deficiency.

Treatment Methods

Additionally, since bile insufficiency can cause malabsorption of fat-soluble vitamins, subcutaneous administration of vitamin K may also be carried out.

Please see here for dietary ingredients that can actively support liver function as part of dietary therapy.

Prevention Methods

To prevent underlying diseases, it is important to provide a proper diet, exercise, and a stress-free lifestyle on a daily basis.

Portosystemic Shunt (PSS)

The toxins, such as ammonia, which are meant to be detoxified in the liver, enter the systemic circulation without being detoxified due to the shunt vessel, causing toxin-related damage to the body.

Additionally, the inability to supply adequate blood to the liver results in underdevelopment of the liver and impaired function, leading to growth disorders in the body itself.

Shunt vessels can be located inside the liver (intrahepatic) or outside the liver (extrahepatic). In cats, extrahepatic shunts are more common, and there are surgical techniques to close the shunt vessel using special instruments.

Compared to dogs, the incidence of portosystemic shunts in cats is said to be lower.

Most cases are congenital (present from birth), causing poor development and neurological symptoms.

Cats with portosystemic shunts exhibit growth retardation when compared to their littermates, fail to gain weight, and show symptoms such as loss of appetite, lethargy, diarrhea, postprandial vomiting, and neurological symptoms (drooling, aimless wandering, seizures, convulsions). In severe cases, it can be fatal.

Since genetic factors are suggested, one of the preventive measures is to avoid breeding dogs that might carry the genes for portosystemic shunts.
### Acquired Portosystemic Shunt

An acquired portosystemic shunt appears when blood pressure in the portal vein increases due to liver dysfunctions such as cirrhosis, hepatic fibrosis, chronic hepatitis, or bile duct obstruction, causing blood congestion in the liver.

Ultrasound examination is highly effective, and CT scans can also evaluate the portal vein.

Treatment Methods

As mentioned earlier, surgery can be effective in cases of extrahepatic shunt.

In terms of medical therapy, to prevent hepatic encephalopathy, ammonia production is controlled through protein-restricted diets, antibiotics, and lactulose.

For acquired cases, surgery is generally considered inappropriate, making the removal of the cause of elevated portal pressure crucial.

Prevention Methods

For congenital cases, it is suggested to prevent breeding to avoid the proliferation of offspring with portosystemic shunt, due to its hereditary nature.

For acquired cases, to prevent causes of elevated portal pressure, it is necessary to avoid excessive medication, harmful substances, and unbalanced nutrition intake.

Additionally, in breeds prone to the condition, regular checkups for early detection are also important.

### Hepatic Lipidosis

Also known as fatty liver syndrome, it is a condition where excessive fat (triglycerides, neutral fats) accumulates in the liver cells.

The accumulation of fat in the liver leads to hepatomegaly.

Liver function declines, bile stasis occurs, leading to jaundice, and in severe cases, there can be mental disorientation, hepatic encephalopathy, and potential fatality.

Obesity is one predisposing factor, but it can also result from other diseases causing bile duct inflammation or appetite loss, and sometimes stress can trigger rapid liver damage.

Blood tests show elevated liver values, triglycerides, and cholesterol, and if jaundice is present, total bile acid values will also be elevated.

If neurological symptoms such as mental disorientation or hepatic encephalopathy are observed, ammonia levels will also be high.

Radiographs may reveal hepatomegaly but cannot provide a definitive diagnosis. If echography shows a whitish liver, hepatic lipidosis is suspected.

For a definitive diagnosis, liver cells are extracted under echography to confirm fat accumulation and hepatomegaly via microscopic examination.

Treatment Methods

Forced feeding is often performed, but for severely ill cats or those who are sensitive to stress, forced feeding might further deplete their strength. In such cases, nutritional catheters are placed in the nose, neck, or stomach to administer liquid food.
### Translation

In cases of feline hepatic encephalopathy, excessive protein intake can exacerbate symptoms, so initially, a diet with controlled protein levels is provided.

Depending on the symptoms, intravenous fluids and antibiotics may also be used, and if there are other underlying conditions, treatments for those will be conducted simultaneously.

Additionally, for dietary therapy to support liver function, please refer to [these ingredients](https://cordy-en.com/maintain-liver-function/#syokuji).

### Preventive Measures

If unexplained loss of appetite persists, it’s important to have your pet checked as soon as possible.

## Feline Infectious Peritonitis (FIP)

Feline Infectious Peritonitis Virus (FIP virus) results from a mutation of the feline coronavirus in the intestines.

Presently, there is no cure, and it remains an incurable disease with only palliative treatments available.

It commonly develops in young or elderly cats, but any cat carrying the coronavirus is at risk of developing FIP.

It is estimated that half of the cats in Japan are asymptomatically infected with feline coronavirus (infected but showing no symptoms).

To prevent mutations, it is crucial to minimize stress and maintain the immune system.

Symptoms include fever, gastrointestinal issues such as loss of appetite and vomiting, dehydration, and anemia. As the condition progresses, liver dysfunction can occur, and accumulation of abdominal fluid or chest fluid can cause abdominal distension, which can compress the chest and lead to respiratory distress (wet form: effusive type).

In the dry form (non-effusive type), neurological symptoms such as paralysis, hyperesthesia, epileptic seizures, and personality changes, as well as eye issues like iritis and uveitis, can manifest. Vomiting, constipation, and jaundice related to organ impairment may also be observed.

### Treatment
As it is incurable, the focus is on symptomatic and palliative care to maintain quality of life (QOL).

Interferons and steroids may be used, and treatments to alleviate various symptoms (such as anti-nausea, anti-diarrhea, and pain relief medications) may also be administered.

For immune support, Cordy is recommended.

To support liver function, [placenta](https://cordy-en.com/dog-cat-placenta2/) is also considered effective.

For dietary therapy, please refer to [these ingredients](https://cordy-en.com/maintain-liver-function/#syokuji) which help support liver function.

### Preventive Measures
The primary prevention is to avoid stress.

For indoor cats, it is also important to maintain the hygiene of their living space, such as disinfecting their environment and keeping their litter boxes and dishes clean.
Please also visit the Feline Infectious Peritonitis (FIP) page.

The liver is one of the most important organs in the body. By reducing the burden on the liver, you can also expect to maintain the health of your dog or cat.

Improving their diet is useful both as a treatment and as a prevention measure. As additional support, we recommend using placenta.

Incorporate foods that support liver function and use Placenta Kiss Powder derived from domestically-produced SPF pigs to aim for a healthy body for your dog or cat.

For more information on Placenta Kiss Powder derived from domestically-produced SPF pigs, click here.

Harness the power of immunity for cat liver cancer and liver disease

For those concerned about your cat’s liver or whose cat is already suffering from a liver disease.

There is a possibility of improvement by administering Placenta Kiss Powder derived from domestically-produced SPF pigs for 1 to 2 months to help recover vigor and appetite.

If liver function improves, you can continue using Placenta Kiss Powder derived from domestically-produced SPF pigs while gradually reducing the amount, which not only helps rejuvenate the liver but also improves skin condition and coat quality.

If you have any questions about Placenta Kiss Powder derived from domestically-produced SPF pigs, BCAA, or krill oil (EPA/DHA oil extracted from Antarctic krill), please feel free to contact us.

監修獣医師：林美彩　　所属クリニック：chicoどうぶつ診療所

代替療法と西洋医学、両方の動物病院での勤務経験と多数のコルディの臨床経験をもつ。　モノリス在籍時には、一般的な動物医療（西洋医学）だけでは対応が困難な症例に対して多くの相談を受け、免疫の大切さを痛烈に実感する。
ペットたちの健康維持・改善のためには薬に頼った対処療法だけではなく、「普段の生活環境や食事を見直し、自宅でさまざまなケアを取り入れることで免疫力を維持し、病気にならない体づくりを目指していくことが大切である」という考えを提唱し普及活動に従事している。

所属：

• 獣医保健ソーシャルワーク協会

著書：

• 獣医師が考案した長生き犬ごはん 安心・簡単・作り置きOK!
• 獣医師が考案した長生き猫ごはん　安心・簡単・作り置きＯＫ！
• 獣医師が考案した一汁一菜長生き犬ごはん こだわりの安心レシピ&作り置きOK!