Integrative Pet Vet column: Fatty liver syndrome in cats
Integrative Pet Vet
Cats can be affected by a variety of liver and gall bladder problems including inflammation, infections, cancer and metabolic and degenerative disorders. Fatty degeneration of the liver (hepatic lipidosis) is one of the most common liver disorders in cats. The cause of fatty liver syndrome is not completely understood, but it is more common in obese cats that stop eating. Rapid identification and aggressive therapy are critical.
The liver is an incredible organ that is essential for life. It is located in the abdomen and processes blood from the intestine including nutrients, potentially toxic compounds and immune reactive substances before they are carried to other parts of the body. In addition, the liver is responsible for a wide range of other activities such as assisting digestion, synthesis of protein, regulating energy, storing certain vitamins, processing and eliminating toxins and waste products, and it has a role in immunity.
Cats are unique in many ways. The liver has some unusual aspects such as a low ability, compared to other species like dogs or humans, to perform certain metabolic processes. This results in a reduced metabolism and elimination of drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, certain antibiotics, and opiates like morphine. In addition, cats have less ability to metabolize some phenolic compounds like those found in certain plants and essential oils. Any compounds that are slowly metabolized have higher risk for overexposure and potential toxicity. Interestingly, cats also have faster ability to metabolize other compounds using a different enzyme process in the liver.
One aspect of the cat liver that can result in problems is the tendency of the liver to undergo fatty infiltration. While the cause for fatty infiltration is not clearly understood, it is thought to occur when the cat is rapidly breaking down body fat to supply energy while not eating (anorexia). This rapid fat breakdown overwhelms the liver resulting in fat being excessively stored in the liver cells, reducing liver cell function and ultimately overall liver function. Over 90% of affected cats experience fatty liver syndrome secondary to another condition like obesity, diabetes, pancreatitis, hyperthyroidism, kidney disease, cancer and other liver disorders. Regardless of the primary problem, fatty infiltration is always preceded by three to four consecutive days of not eating or two weeks of a 50-75% reduction in eating. Obese cats are at higher risk, but any body composition can be affected.
Cats that are affected with fatty liver syndrome can have vague signs like lethargy, drooling, constipation, weight loss and weakness. As the problem progresses they can become jaundiced with the white part of the eyes, skin and membranes in the mouth becoming yellow. Once this happens, it is vital to make a clear diagnosis and begin support care without delay. Left untreated, fatty liver syndrome can be fatal. Unfortunately, even with supportive care, some cats are unable to recover. Diagnosis involves a review of the history, a physical examination, blood tests for the liver, and sometimes ultrasound and a needle biopsy. It is also important to determine why the cat stopped eating so that problem can be effectively addressed while working to resolve the fatty liver.
Treatment for fatty liver syndrome should be started early and involves aggressive feeding with high protein, high energy food. Sometimes this requires surgical placement of a feeding tube so that adequate food volumes can be provided. Intravenous fluids can also be valuable early. Supportive care with herbs like milk thistle and vitamins like the B complex vitamins can be helpful. Therapy can take six weeks or longer.
If you have questions about your cat’s liver, contact your veterinarian.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.
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