Felis ISSN 2398-2950

Liver: chronic disease

Contributor(s): Kyle Braund, Philip K Nicholls, Penny Watson

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

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Godfrey D R & Rest J R (2000) Suspected necrolytic migratory erythema associated with chronic hepatopathy in a cat. JSAP 41 (7), 324-328 PubMed.
  • Center S A (1999) Chronic liver disease - current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.

Other sources of information

  • Johnson S E (2000) Chronic hepatic disorders. In:Textbook of Veterinary Internal Medicine.5th edn. Ettinger S J & Feldman E C (eds). W B Saunders, Philadelphia. pp 1298-1325.
  • Laflamme D P (2000) Nutritional management of liver disease. In:Kirk's Current Veterinary therapy XIII.Bonagura J D (ed). W B Saunders, Philadelphia. pp 693-697.
  • Center S A (1996) Feline hepatic disease - Current therapeutic concepts. Proceedings of BSAVA Waltham Symposium on liver disease. pp 56-63.
  • Watson T (1996) Nutritional management of canine liver disease. Proceedings of BSAVA Waltham Symposium on liver disease.pp 42-46.
  • Michel R (1995) Nutritional management of liver disease. Vet Clin North Am Small Anim Pract 25, 485.


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