Last week, we discussed hepatitis lipidosis, or "fatty liver" syndrome in cats. While dogs can "starve" for days to weeks without going into organ failure, cats — especially obese ones — can only go without food for 3-5 days before going into liver failure.

However, just because your cat stops eating and turns jaundiced (where the skin turns yellow) doesn’t meant it’s hepatitis lipidosis.

Three other important major categories of disease that cause cats to be jaundiced include:

• Pre-hepatic (i.e., changes to the body that occur prior to or "in front of" the liver)
• Hepatic (i.e., liver disease)
• Post-hepatic (i.e., changes to the body that occur after or "behind" the liver)

Pre-hepatic changes that can cause your cat to be jaundiced include the following: getting a red blood cell transfusion (and having a transfusion reaction), having severe electrolyte changes that cause rupture of the red blood cells (e.g., phosphorous), presence of parasites in the red blood cells (e.g., hemobartonella), or secondary to rare immune system (e.g., immune-mediated hemolytic anemia) or drug reactions.

Hepatic changes that can cause your cat to be jaundiced include the following: hepatic lipidosis, inflammation of the liver (e.g., cholangiohepatitis), cancer of the liver (e.g., lymphosarcoma, adenocarcinoma, etc.), drugs or toxins (e.g., oral Valium or benzodiazepines, essential oils, etc.), and cirrhosis, amongst other conditions.

Post-hepatic changes that can cause your cat to be jaundiced include the following: pancreatitis, gall bladder problems (e.g., gall bladder cancer, gall bladder stones, etc.), gastrointestinal problems, or even extra-hepatic biliary duct obstruction.

While this list isn’t all inclusive, it gives you a general idea of the numerous causes for jaundice in a cat. As you can see from all these causes, it’s imperative that your veterinarian identify the proper underlying cause of jaundice to ensure the best treatment. This is one of the reasons why your veterinarian may be pushing for an abdominal ultrasound and aspirate or biopsy of the liver. Obviously, the prognosis is very different for each disease, but the clinical signs are all pretty similar, including:

• Anorexia or inappetance
• Vomiting
• Weight loss
• Dehydration
• Muscle wasting (especially over the back area in a cat)
• Diarrhea
• Jaundiced skin or gums
• Nausea
• Decreased or excessive thirst or urination

Coming up with the correct diagnosis is important, as one wouldn’t want to unnecessarily anesthetize a cat in order to put in a long-term feeding tube if cancer is disseminated throughout the body. However, if the diagnosis comes back as hepatic lipidosis, a feeding tube is a must for the best outcome.

When in doubt, seek a veterinary specialist (in internal medicine, radiology, etc.) to have an ultrasound of the liver and more thorough internal medicine work-up performed as needed.The sooner you diagnosis the underlying cause for jaundice in your cat, the better the outcome as we can start the appropriate treatment sooner!

Has your cat succumbed to any of these diseases besides fatty liver?

Dr. Justine Lee

Image: Rembering Tom Tom by stratman2 / via Flickr