Introduction

• Cause: malformation, toxicity, neoplasia, endocrinopathy, metabolic (lipidosis), auto-immune (lymphocytic cholangitis), infection.
• Signs: non-specific - lethargy, anorexia, vomiting. Signs of hepatic encephalopathy.
• Diagnosis: biochemistry, hepatic function tests, ultrasonography, hepatic biopsy.
• Treatment: elimination of cause, supportive.
• Prognosis: depends on severity and treatment of inciting factor.
• See also Liver: acute disease Liver: acute disease.
  Print off the owner factsheet Liver problems in your cat  Liver problems in your cat  to give to your client.

Pathogenesis

Etiology

• Idiopathic chronic hepatitis.
• Drugs - cats have a relative sensitivity to many drugs due to low levels of glucuronyl transferase delaying metabolism, eg acetaminophen, griseofulvin, megestrol acetate, ketoconazole.
• Infectious, eg FeLV Feline leukemia virus, FIP Feline sarcoma virus; bacterial, fungal and parasitic.
• Portosystemic shunt (congenital) Congenital portosystemic shunt (CPSS).
• Neoplasia, lymphoma Lymphoma or metastatic.
• Endocrinopathies.

Pathophysiology

• Cumulative hepatic insult   →   functional reserve capacity exceeded   →   failure to perform diverse metabolic functions   →   clinical signs.

• Hepatic functional reserve large   →   75% damage before exhausted   →   periacinar zonal necrosis, infiltration of inflammatory cells due to toxins, living agents and metabolic disease will cause massive damage.
• Decreased production of clotting factors   →  bleeding tendency.
• Hepatic cellular damage   →   cellular release of bilirubin   →  icterus.
• Inflammation of biliary system   →   partial obstruction to biliary flow   →  icterus.
• Inadequate bile delivery to intestine   →   impairment of fat digestion   →  diarrhea.
• Failure to maintain euglycemia   →  hypoglycemia Hypoglycemia.
• Decreased production of albumin   →  hypoalbuminemia.
• Failure to detoxify ammonia and other mercaptans from intestine   →  hepatic encephalopathy Hepatic encephalopathy.

Diagnosis

Treatment

Outcomes