Steroid Related Liver Disease in Cats
Vacuolar hepatopathy causes liver cells (hepatocytes) to undergo reversible vacuolar changes due to glycogen accumulation. The storage form of glucose, glycogen accumulates in liver cells because of steroid medication overuse, an overproduction of steroids in the body, or due to an endocrine disorder (e.g., hyperadrenocorticism, atypical adrenal hyperplasia).
Vacuolar hepatopathy is rare in cats.
Symptoms and Types
Symptoms are ultimately based on the underlying cause of the hepatopathy; some of the more common signs include:
- Loss of hair (alopecia)
- Increased thirst and urination (polydipsia and polyuria)
- Increased appetite (polyphagia)
- Abdominal distention
- Muscle weakness
- Bruises on skin
- Friable (easily crumbled) skin
Although it is rare, the cat may demonstrate symptoms of liver failure.
- Drug administration (e.g., glucocorticoids)
- Atypical adrenal hyperplasia
- Chronic infections
You will need to give a thorough history of your cat’s health, including the onset and nature of the symptoms. The veterinarian will then conduct a complete physical examination, as well as a biochemistry profile, urinalysis, and complete blood count (CBC) -- the results of which will depend on the underlying cause of the condition.
Blood testing, for example, may reveal anemia, abnormally high number of red blood cells (polycythemia), increased number of leukocytes or white blood cells, and abnormally high number platelets (thrombocytosis). Biochemistry profile, meanwhile, may reveal abnormal levels of liver enzymes, high levels of albumin (blood protein), and bilirubin, and abnormally high levels of cholesterol.
Your veterinarian will conduct the abdominal X-rays to identify the size of the liver, and thoracic X-rays to determine the size of lymph nodes, or metastasis, in the case of tumor(s) and cardiac or pulmonary disorders. Abdominal ultrasound, meanwhile, may reveal enlarged liver and changes in liver tissue due to extensive lesions and other concurrent problems within abdominal cavity.
There are also other, more specific and sensitive tests available to evaluate the liver, thyroid gland, and pituitary gland functions. Your veterinarian may take a live tissue sample to be sent to veterinary pathologist for further evaluation, often revealing the presence of vacuoles within liver cells and changes related to this abnormal accumulation. In addition, liver biopsies help in ruling out other liver diseases.
If infection is suspected, your veterinarian will take the sample to be sent to laboratory for culture and sensitivity. Culturing the sample helps in growing and identifying the causative organisms and sensitivity provide information related to antibiotics most effective against isolated organisms.
The course of treatment will depend on the underlying cause of the disease. However, due to reversible nature of this condition, early treatment will usually completely resolve the problem.
If pituitary masses are present, radiation therapy is used to destroy these masses within pituitary glands. Tumor(s) may also be excised surgically. In case of dental disease, proper antibiotics are used to control the infection. In case of infections, proper antibiotics are used to control and treat infections after culture and sensitivity testing. And in cases of underactive thyroid glands (hypothyroidism), thyroxine supplementation is required.
Living and Management
The cat will require regular follow-up exams following treatment to evaluate the animal its liver function. Your veterinarian will also often recommend modifying the cat's diet, especially if it has developed pacreatitis, which will require a low-fat diet.
Prognosis depends on the extent of disease; in some patients, prognosis is poor despite treatment.
Pertaining to the lungs
The prediction of a disease’s outcome in advance
Excessive eating or swallowing
A treatment of certain neoplasms that is administered using an x ray
The term for a type of medication that impacts immunity, metabolism, sexual characteristics, and other such elements of a living thing
An in-depth examination of the properties of urine; used to determine the presence or absence of illness
A gland found in the neck of humans and animals that secretes glands responsible for metabolic rate, calcitonin, and others.
Pertaining to the chest
A medical condition involving excessive thirst
The gland that is found at the bottom of the brain whose job is to maintain appropriate levels of hormones in the blood
A certain pigment that is produced when hemoglobin is destroyed.
Deviating from the normal; not typical.
A condition of the blood in which normal red blood cell counts or hemoglobin are lacking.
A type of protein that can be dissolved in water; found in milk, egg white, certain muscle, blood, and some urine.
The process of making something larger by dilating or stretching it
Cells in the liver
The space in the abdomen that holds the major digestive organs in an animal. Normally referred to as the area between the diaphragm and the pelvis. Also referred to as the peritoneal cavity.
Small structures that filter out the lymph and store lymphocytes
A condition of different cells; means extra erythrocytes