dvm360: The Icteric Cat: Diagnosis and Treatment of Common Feline Hepatopathies

Feline cholangiohepatitis syndrome (CCHS) and hepatic lipidosis are 2 of the most common feline hepatopathies. Signs of both conditions are mostly varied and nonspecific. In these conditions, icterus results from decreased clearance of bilirubin, diarrhea results from portal hypertension or cholestasis, and vomiting results from decreased toxin clearance or direct vagal stimulation.

Hepatic encephalopathy (HE) occurs either from portosystemic shunting or is caused by hepatic lipidosis from amino acid imbalance. HE manifests as ptyalism, dullness, ataxia, and/or seizures.4 Polyuria/polydipsia may result from medullary washout (low urea), dehydration, or HE. Dysuria may be noted from ammonium biurate urolithiasis. Anesthesia intolerance may result from decreased hepatic metabolism of GABAergic drugs (benzodiazepines). Gastrointestinal bleeding can be seen with portal hypertension or coagulopathy.

Dr. Kelly Cairns is Vice President of Medical Excellence and Education at Thrive Pet Healthcare, with over 20 years of veterinary experience. A graduate of Colorado State University’s veterinary program, she completed a small animal rotating internship at Cornell University and an internal medicine residency at The Ohio State University, earning board certification as a Small Animal Internal Medicine Specialist. Dr. Cairns is an adjunct faculty member at Lincoln Memorial University College of Veterinary Medicine and serves on several boards, including the Chicago Veterinary Medical Association. A dedicated member of the American Association of Feline Practitioners (AAFP) for 20 years, she has specialized in feline internal medicine, building a subpractice that drew patients from across the U.S. Dr. Cairns is passionate about advancing veterinary education and supporting the profession's well-being.