My 13 year old cat has had at least 3 serious, life threatening liver infections over the past 2 years. Two within the last 6 months. The treatments prednisone and antibiotics initially work well but never entirely, as she remains a little jaundice even at her peak wellness. The treatments seem only to partially work as the infections reoccurs (not really gone??) In the past couple of years she has gone from a 15 pound cat to weighing only over 8 (she is a maincoon)
She has been blood tested for Feline autoimmune deficiency and thyroid problems which were negative.(but when she was 3 years old she tested positive for feline auto immune deficiency) Also a sonogram of liver and gall bladder indicate no damage.
Her symptoms always start out as anorexia and lethargy. She seems to be hungry all the time but only eats a little at a time. The vet has not got at the cause of the liver infections or really even the cure.
My questions are: What can be causing these reoccurring infections? What are some general precautions I can take to prevent infections stemming from bacteria, etc (which I am beginning to suspect)? Could it be viral instead of bacterial? Any general thoughts would be greatly appreciated as well.
Love, love my cat!
Dr. Marie replied:
Oh, I am sorry to see that Issie is going through this.
Liver disease is one of the most frustrating things to deal with. I have several cases in my practice like this where we just don't know what is wrong.
Has Issie had a biopsy done of her liver? This could possibly give us some more insight as to what is going on. But, she would need an anesthetic and it can be expensive to do this.
Has your vet determined for sure that the jaundice is due to liver disease? Or is it possible that it is due to anemia? If there is something destroying her red blood cells then this can cause jaundice. When we have ongoing jaundice due to anemia then often steroids need to be given long term. Some animals can be changed to a medication called cyclosporin if they are having side effects from the steroids.
If your vet thinks that it is due to liver disease, then it is really really hard to say why. It is not likely to be viral. It may be something called cholangiohepatitis which is inflammation in the liver and bile duct. Some cats just get this and we don't know why.
If your vet does think it is due to liver disease you can ask him about a medication called sam-E. This product is really good at helping to support the liver.
I wish I could give you more information but it is really hard to know what to do in animals with liver disease even when we have all sorts of tests. It is very frustrating!
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Thank you for your response and support.
No biopsy yet. He wants to try that next. He has not mentioned anemia but I do know her liver functioning for some levels are very high (I want to say the bilo something??).
Since the only thing I have control over is her environment, is there anything I can do to reduce bacteria or other contaminates that may play a role in lets say, the inflammation of her bile duct? I have noticed that sometimes there is clumping liter in her water bowl transferred from her tags that get wet, dipped in liter then back in the bowl. Could this possible be a cause of inflammation?
Dr. Marie replied:
The word you are looking for is "bilirubin". :) This is the pigment that causes a cat to be jaundiced. There are two main reasons for an increase in bilirubin. One is liver disease (because the bile duct gets compressed) and the other is if red blood cells get destroyed - then they release bilirubin.) It sounds like the first one is the cause of the increase in bilirubin for Issie.
It is really unlikely that there is anything you can do in her environment to help her. If this is due to bacteria, it's not due to her ingesting or taking in bacteria in any way.
I know how helpless you must feel...it is not fun battling with liver disease.
If your vet feels it is a good idea then I really think the biopsy is the best way to go. If we can find out why the liver is struggling it will really help us know what to do next!
Ok. One more thing. Based on your response, is it possible that FIV is causing the second reason for the increace in bilirubin due to anemia - as you mentioned earlier? And isnt it true that you can have a fasle negative for FIV ( she was diagnosed with this 10 years ago then tested negative about a year or two ago.)
Is it possible that her lack of appetite is effecting the liver not the other way around? I say this because she is hungry and eats, she wants to eat all the time, not like a sickly animal that avoids food. She just cant eat much each time.
I will do the biopsy but want no (less intrusive) stone unturned first. Thanks again.
Dr. Marie replied:
FIV can cause anemia...but this would be really obvious on bloodwork though. It is definitely possible to have a false positive FIV test or a false negative FIV test.
I understand what you're saying about the connection between appetite and liver...it can be a vicious cycle where a cat doesn't feel well and then doesn't eat and as a result the liver gets affected. This leads to a condition called fatty liver.
A biopsy of the liver should really tell us if we are dealing with fatty liver.
There are a number of other medicines that she could go on that may help. But personally,I would want to do the biopsy first to determine what is going on before I start throwing medicines at her. It's no fun giving medicines to cats!
Ok Thanks. Have a great weekend.
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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