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Name
Jaundice, Feline
Short Description
Hyperbilirubinemia
Affected Animals: Any age, sex, or breed can be affected. Obese
cats that suddenly stop eating are more at risk of developing
jaundice resulting from a syndrome called feline fatty liver
disease, or hepatic lipidosis.
Overview:
The whites of the eyes of a cat with jaundice
often are more yellow than they are white; the animal's skin and
gums may develop a yellowish tinge as well. These changes in color
result from deposits of bile pigment entering the cat's tissues, a
common occurrence among animals with jaundice. Unfortunately, this
yellowish hue is not as serious as the possible diseases that can be
associated with it, including kidney damage, liver disease, and
disorders of the nervous system.
Clinically known as icterus, jaundice occurs when the cat's body has
too much of a substance called bilirubin, which comes from red blood
cells that have been processed by the spleen, the liver, and by bone
marrow. In a normal cat, the liver will absorb, metabolize, and
excrete this bilirubin. Jaundice results when too much bilirubin is
being produced, when the liver is not able to adequately process the
bilirubin, or when the bilirubin cannot be excreted.
Jaundice is not a disease but a symptom caused by a wide range of
feline diseases that result in too much bilirubin being present in
the body. Some of these diseases can be fatal. When the underlying
illness is severe and irreversible, neither it nor the jaundice can
be treated.
Clinical Signs: Some signs noted are lethargy, anorexia, icterus,
altered mentation, weakness, dyspnea, polyuria, and polydypsia. A
history of receiving a recent blood transfusion is not uncommon for
some cats with jaundice. Common exam findings may include pale or
jaundiced mucous membranes, ascites, weight loss, hepatomegaly,
abdominal pain, melena, and peripheral lymphadenopathy.
Symptoms: In addition to jaundice, other symptoms include
tiredness; weakness; loss of appetite; a yellow-orange color to the
urine; a yellow color to the skin, gums, or whites of the eyes; a
decrease in mental alertness; trouble breathing; increased water
intake; increased urination; swollen stomach; weight loss; and a
"black tar" appearance to the feces.
Description:
Cats that have jaundice develop a yellowish color
to their skin, gums, and the whites of their eyes because of
deposits of bile pigment in their body tissues. Jaundice occurs when
the body has too much of a substance called bilirubin, which comes
from red blood cells that have been processed by the spleen, the
liver, and by bone marrow. In a normal cat, the liver will absorb,
metabolize, and excrete this bilirubin through the bile duct system.
Problems occur and jaundice results when too much bilirubin is being
produced, when the liver is not able to adequately process the
bilirubin, or when excretion of the bilirubin is prohibited.
Jaundice, which is not a disease but a symptom of many different
diseases, can make already existing liver disease worse. It can
result in an obstruction to the flow of bile, in kidney damage, and
even in comas and disorders of the nervous system. Many cats will
require hospitalization during diagnosis and treatment. Following
hospitalization, the owner may need to provide intensive at-home
nursing care.
Depending on the cause of the jaundice and the severity of the
illness, the liver may be able to repair itself. Some cats, however,
will never recover from the disease that causes the jaundice.
Diagnosis: Diagnosis is focused on finding the
reason why the cat has an excessive amount of bilirubin, or "hyperbilirubinemia,"
that is causing the jaundice. The veterinarian will take a careful
medical history about the animal, perform a complete medical
examination, and conduct appropriate diagnostic tests. Routine
laboratory testing will include a complete blood cell count, or CBC,
a serum chemistry panel, and urinalysis.
Additional testing needed may include abdominal and chest x-rays, a
blood coagulation profile, a test for blood parasites, a serum bile
acids test, an infectious disease serology, an abdominal ultrasound,
and an abdominal exploratory exam. Liver biopsies, taken by
ultrasound or surgery, are commonly needed in cases of liver
disease. The veterinarian will recommend the appropriate diagnostic
procedures based on a cat's individual case and its response to
therapy. Some complicated cases are referred to veterinary internal
medicine specialists.
Prognosis: The prognosis for most cats depends on which
diseases are causing the jaundice. Some diseases can be reversed
completely while others will be fatal. Cats' skin tissues may remain
yellow for some time after the hyperbilirubinemia has been
corrected.
Transmission or Cause:
Jaundice results when there is too much bilirubin
in the body. There are several reasons why a cat may have excessive
bilirubin, a condition that the veterinarian may refer to as
hyperbilirubinemia. One cause is pre-hepatic icterus, in which there
is so much bilirubin being produced that the liver is unable to
process all of it. Pre-hepatic icterus often results from a
breakdown of red blood cells due to the feline leukemia virus
infection, defects in the blood clotting mechanism, and certain
medications.
When a cat has an abnormal metabolism and excretion of bilirubin by
its liver cells, it has the primary hepatic form of jaundice.
Primary hepatic jaundice is the most common cause of icterus in the
cat. Liver diseases that can affect cats include acute toxic
hepatitis, cholangiohepatitis, cirrhosis of the liver, and feline
fatty liver syndrome. Other diseases that result in damage to the
liver -- such as diabetes mellitus, the feline infectious
peritonitis virus, cancer, and the feline leukemia virus -- can also
cause primary hepatic jaundice.
Finally, when the cat's bile duct system interferes with the
excretion of bilirubin, a type of jaundice called post-hepatic
icterus results. Causes of this include bile duct obstruction, a
rupturing of the bile duct, pancreatitic disease, cancer,
inflammation of the gallbladder, and inflammation of a bile duct.
Treatment:
There are various treatments for jaundice, all of
which depend on the symptoms and the cause. Some diseases that cause
jaundice, such as inoperable cancer, are irreversible and result in
death. However, other diseases, such as feline fatty liver syndrome,
in which fat gets deposited into the liver tissue, can be managed
quite effectively. Cats with life-threatening anemia will need a
blood transfusion.
Most animals with jaundice will require hospitalization initially.
Intravenous fluid administration, cage rest to encourage the liver
to heal, and appropriate nutritional support may be needed. The
veterinarian will prescribe medications to manage symptoms such as
vomiting, nausea, excessive abdominal fluid, and neurological
problems; these medications must be carefully monitored, however,
since the liver metabolizes many drugs. Follow-up visits with blood
and urine re-evaluations will be needed to determine the success of
the treatment.
Prevention: There are no preventives other than prohibiting
cats from consuming medications, chemicals, and toxic plants that
cause jaundice. Also, getting medical attention for cats showing the
initial symptoms of jaundice may improve the prognosis. An owner
should seek veterinary care if the cat is overweight and refuses to
eat for longer than two to three days in a row.
