Cirrhosis & Fibrosis of the Liver in Cats: A Vet’s 2025 Guide to Diagnosis, Treatment & Long‑Term Support 🐱🍃
In this article
Cirrhosis & Fibrosis of the Liver in Cats: A Vet’s 2025 Guide to Diagnosis, Treatment & Long‑Term Support 🐱🍃
By Dr Duncan Houston, BVSc
🔍 What Are Fibrosis & Cirrhosis?
Liver fibrosis is the excessive build-up of scar tissue replacing healthy cells; when widespread and nodular, it becomes cirrhosis, severely disrupting liver architecture and function :contentReference[oaicite:3]{index=3}.
⚠️ Common Causes
- Chronic hepatitis—viral, bacterial or lymphocytic inflammatory liver disease that progresses to scarring :contentReference[oaicite:4]{index=4}.
- Fatty liver disease (hepatic lipidosis), often secondary to anorexia or endocrine disease :contentReference[oaicite:5]{index=5}.
- Inherited conditions like amyloidosis or copper storage in certain breeds (e.g. Persians, Abyssinians) :contentReference[oaicite:6]{index=6}.
- Toxins, drug reactions, chronic biliary obstruction, parasites, neoplasia or trauma :contentReference[oaicite:7]{index=7}.
🚩 What to Watch For
- Lethargy, poor appetite or weight loss, jaundice (yellow gums/eyes), GI upset :contentReference[oaicite:8]{index=8}.
- PU/PD, fluid accumulation in the abdomen, dark urine, pale or tarry stools :contentReference[oaicite:9]{index=9}.
- Neurologic signs (hepatic encephalopathy): confusion, circling, drooling, seizures :contentReference[oaicite:10]{index=10}.
🔬 Veterinary Diagnostics
- **Bloodwork & urinalysis:** Elevated liver enzymes (ALT, ALP, bilirubin), bile acids, clotting times; evaluate for infections, endocrine disorders :contentReference[oaicite:11]{index=11}.
- **Ultrasound:** Shows small, nodular or irregular liver, changes in texture, fluid in abdomen :contentReference[oaicite:12]{index=12}.
- **Biopsy (fine-needle or surgical):** Gold standard to confirm fibrosis, cirrhosis, and identify underlying liver pathology :contentReference[oaicite:13]{index=13}.
- **Special tests:** Copper analysis, infectious panels, clotting assays for complications :contentReference[oaicite:14]{index=14}.
🛠️ Treatment & Management
1. Remove or Treat Underlying Cause
- Antibiotics (culture-based) for infections; corticosteroids or immunosuppressives for inflammatory disease :contentReference[oaicite:15]{index=15}.
- Treat metabolic contributors: control hepatic lipidosis with feeding tubes, address endocrine or biliary disease :contentReference[oaicite:16]{index=16}.
2. Liver-Supportive Medications & Supplements
- S‑adenosylmethionine (SAMe) & silybin: Antioxidant hepatoprotectives :contentReference[oaicite:17]{index=17}.
- Ursodiol: Cholagogue to promote bile flow in cholestatic disease :contentReference[oaicite:18]{index=18}.
- Vitamin support: B-complex, K, E, zinc to correct malnutrition and clotting issues :contentReference[oaicite:19]{index=19}.
- N‑acetylcysteine (NAC): Antioxidant used in acute injury, may support liver regeneration :contentReference[oaicite:20]{index=20}.
- Anti-fibrotic agents: L‑carnitine, corticosteroids, copper‐chelators in some cases :contentReference[oaicite:21]{index=21}.
3. Dietary Management
- High-energy, easily digestible protein with restricted copper and moderate fat; e.g., hepatic prescription diets :contentReference[oaicite:22]{index=22}.
- Feeding tubes if anorexic to ensure consistent intake :contentReference[oaicite:23]{index=23}.
- Small, frequent meals to reduce metabolic stress :contentReference[oaicite:24]{index=24}.
4. Supportive Care
- IV/SC fluids to correct dehydration & electrolytes :contentReference[oaicite:25]{index=25}.
- Treat hepatic encephalopathy with lactulose, antibiotics & enemas if needed :contentReference[oaicite:26]{index=26}.
- Anti-nausea & appetite stimulants to maintain food intake :contentReference[oaicite:27]{index=27}.
🏡 Home Care & Monitoring
- Track appetite, weight, vomiting, urine/stool color, behavior.
- Offer prescribed liver diet via free-feeding or tube; use water fountains for hydration.
- Provide calm, warm environment with cozy bedding from **Woopf** & **Purrz**.
- Use **Ask A Vet** app for dosing reminders, vet communication, and early concern alerts.
📅 Follow-Up & Prognosis
- Monitor labs, ultrasound, blood pressure every 4–12 weeks depending on severity.
- Cirrhosis is irreversible, but progression can be slowed; fibrosis may partially resolve :contentReference[oaicite:28]{index=28}.
- Early detection improves comfort and length of life; advanced cirrhosis often becomes palliative.
📝 Quick Reference Table
| Aspect | Essential Info |
|---|---|
| Condition | Scar tissue build-up (fibrosis) progressing to cirrhosis |
| Signs | Appetite loss, jaundice, GI issues, PU/PD, neurologic signs |
| Diagnosis | Bloodwork, ultrasound, biopsy |
| Treatment | Address cause, meds, diet, supportive care |
| Home Care | Nutrition logs, comfort, hydration, app support |
| Outlook | Variable—some stabilization possible; advanced disease is palliative |