Editor’s note: This story originally appeared in the September/October 2015 issue of Catster print magazine. Click here to subscribe to Catster magazine.
“What am I? Chopped liver?” You’ve probably heard this figure of speech, but as a cat veterinarian, I can assure you that the liver (unchopped, at least) is anything but worthless. In fact, it’s one of the most important and versatile organs in the body.
When examining a cat at my cats-only veterinary practice, certain things tell me that the liver might not be working perfectly. The biggest clue is the presence of jaundice. This is a yellow discoloration of the tissues, which is mainly visible in the whites of the eyes, on the gums, and in the skin inside the ears. If the whites of the eyes are the color of a New York City taxicab, a liver problem rises to the top of my list.
An important part of any feline physical examination is abdominal palpation. This is the gentle pressing and feeling of the abdominal organs. Normally, a person can barely feel a cat’s liver protruding beyond the last rib. If I detect an enlarged, firm, or irregular-feeling liver, I worry about liver disease.
The most consistent clinical symptom of liver disease is poor appetite. Vomiting is another common finding. Because these signs are pretty non-specific, blood tests are usually necessary to confirm suspicions that liver function has gone awry. If I see elevated liver enzymes on a chemistry panel, it supports my notion that the liver is affected.
Once I’m pretty certain that the liver is the culprit for a cat feeling sick, my next step is to figure out exactly which liver disorder is present. This usually requires obtaining a biopsy specimen. Ultrasound can provide lots of information about the liver, and vets can usually biopsy the liver during the ultrasound procedure. (We make sure cats are asleep for this, of course.)
The most common liver disorder in cats is hepatic lipidosis, or fatty liver disease. The classic scenario for this disorder to arise is when a chubby cat stops eating. The body reacts to this by breaking down fat to supply the cat with energy, but something goes wacky with the cat’s metabolism, and the fat clogs up the liver instead. The treatment for fatty liver disease is food, food, and more food. Because these cats have no appetite, some might require syringe feeding or even a special feeding tube to supply enough nutrients to overcome the disorder.
Hepatitis (inflammation of the liver) is another common liver malady. If a biopsy specimen shows lots of infection-fighting cells in the liver, a bacterial hepatitis is the probable cause, and antibiotics are warranted as a treatment. If the biopsy shows many inflammatory cells in the liver, an inflammatory hepatitis is the probable diagnosis, and anti-inflammatory drugs are prescribed.
Sadly, liver cancer does occur in cats now and then. Sometimes it’s a primary cancer (the liver itself becomes cancerous), and in some cases a cancer in another part of the body spreads to the liver. Treatment depends on the type of cancer. If a discreet portion of the liver is affected, surgery to remove that part might be curative. If the liver is diffusely affected, chemotherapy could be an option.
Because the liver enzymes are often elevated when vets run a chemistry panel on a cat with liver disease, we often monitor how the cat is responding to treatment by checking the chemistry panel during therapy and seeing whether the numbers are returning to the normal range. I’ve treated many cats with liver disease. As the medicine I prescribe starts to take effect and the cat starts eating and gaining weight, I’ll run a chemistry panel to confirm the progress I see. Telling a client that his or her cat’s liver parameters have returned to normal is news I love to de-liver. (Couldn’t resist, sorry.)
About the author: Dr. Arnold Plotnick is the founder of Manhattan Cat Specialists, a feline-exclusive veterinary practice on Manhattan’s Upper West Side. He is also an author of The Original Cat Fancy Cat Bible. Dr. Plotnick is the former Ask the Veterinarian columnist for CAT FANCY magazine, and is a frequent contributor to feline publications and websites, including his own blog, Cat Man Do. He lives in New York City with his cats, Mittens and Crispy. Follow him on Facebook and Twitter.