Liver Flukes in Cats (Platynosomiasis): 2025 Vet Insights 🐱💛

Hi, I’m Dr Duncan Houston BVSc, feline veterinarian and founder of Ask A Vet. In this comprehensive 2025 guide, we explore liver fluke infection—especially Platynosomum and other trematodes that invade the bile ducts and liver of cats. You’ll learn causes, signs, diagnostics, treatment with safe anthelmintics like praziquantel/fenbendazole, prognosis, and home-care support—complete with Ask A Vet, Woopf, and Purrz tools to guide recovery. Let’s protect your cat’s liver health together. 💙

📌 What Are Liver Flukes?

Liver flukes are flat parasitic trematodes that inhabit bile ducts and gallbladder. In cats, species include Platynosomum concinnum (“lizard poisoning fluke”), Opisthorchis felineus, and other trematodes found in fish-eating regions :contentReference[oaicite:3]{index=3}. Cats become infected by ingesting infected lizards, amphibians, or fish that carry encysted larvae.

⚠️ Why It Matters

These parasites may cause bile duct inflammation (cholangitis), liver dysfunction, fibrosis, and chronic disease. Heavy infestations can lead to bile duct obstruction, jaundice, and even cholangiocarcinoma in rare cases :contentReference[oaicite:4]{index=4}.

👥 Who’s at Risk?

• Cats that hunt: lizards, frogs, small fish, rodents
• Outdoor or free-roaming cats in endemic areas of North America, Latin America, and Asia :contentReference[oaicite:5]{index=5}
• Often adults but kittens with high exposure risk may show disease

🔍 Signs & Symptoms

Symptoms are variable and may be subtle or severe:

• Intermittent vomiting, diarrhea, poor appetite, weight loss :contentReference[oaicite:6]{index=6}
• Jaundice—yellow gums, skin, eyes
• Abdominal pain, bloating or ascites
• Lethargy, low-grade fever, occasional anemia or bleeding tendencies :contentReference[oaicite:7]{index=7}
• Chronic cholangitis signs—vomiting, fever, elevated liver enzymes :contentReference[oaicite:8]{index=8}

🔬 How Vets Diagnose Fluke Infection

1. Fecal Exam: detection of eggs via sedimentation but often false-negative early :contentReference[oaicite:9]{index=9}.
2. History/Signs: Outdoor hunting, intermittent cholangitis and liver enzyme elevations
3. Bloodwork: Elevated ALT, ALP, bilirubin, leukocytosis; eosinophilia possible
4. Ultrasound/Imaging: Hyperechoic biliary sludge, gallbladder thickening, and duct dilation :contentReference[oaicite:10]{index=10}
5. Advanced Imaging: CT may show ‘tunnels and caves’ of necrosis in severe infections—but rare in cats :contentReference[oaicite:11]{index=11}
6. Biopsy: Liver histology (if needed) to confirm chronic cholangitis and fluke damage

🛠️ Veterinary Treatment Protocols

🐛 Anthelmintic Drugs

• Praziquantel: 20 mg/kg once daily for 3–5 days; repeat after 12 weeks :contentReference[oaicite:12]{index=12}
• Fenbendazole: 50 mg/kg daily for 5–10 days, sometimes combined with praziquantel :contentReference[oaicite:13]{index=13}
• Lower-dose protocol (5.75 mg/kg twice, weeks apart) has shown long-term clearance in one report :contentReference[oaicite:14]{index=14}
• Repeat dosing recommended to address immature flukes and reinfection risk

💉 Supportive Liver Care

• IV/subcutaneous fluids for dehydration :contentReference[oaicite:15]{index=15}
• Antibiotics when cholangitis or secondary infection suspected :contentReference[oaicite:16]{index=16}
• Ursodeoxycholic acid for bile duct protection (15–20 mg/kg) :contentReference[oaicite:17]{index=17}
• Anti-nausea meds: maropitant or metoclopramide :contentReference[oaicite:18]{index=18}
• Hepatoprotectants like SAMe, vitamin E to help repair liver damage :contentReference[oaicite:19]{index=19}
• Steroids (prednisolone) in severe inflammatory cholangitis for 2–4 weeks :contentReference[oaicite:20]{index=20}
• Feeding tube in anorectic cats to ensure nutrition :contentReference[oaicite:21]{index=21}

🔬 Interventional & Surgical Support

Uncommon but possible if bile ducts obstructed—surgical intervention may remove bile duct flukes or relieve blockages :contentReference[oaicite:22]{index=22}.

🌱 Prognosis & Follow-Up

With thorough treatment, most cats recover fully; chronic fluke damage may persist and require long-term supportive care :contentReference[oaicite:23]{index=23}. Follow-up includes:

• Repeat fecal and 12-week anthelmintic cycles
• Re-evaluate every 2–4 weeks with bloodwork and ultrasound
• Monitor liver enzyme trends and clinical well-being
• Prevent reinfection: indoor-only policy, prevent hunting :contentReference[oaicite:24]{index=24}

🐾 Home & Telehealth Tools

• Ask A Vet: 24/7 help on dosing, monitoring fluke clearance, liver support
• Woopf: Guidance and supplies for fluids, meds, feeding tubes
• Purrz: Track appetite, vomiting, jaundice, behavior—and flag any relapses early

🔬 2025 Veterinary Advances

• Higher-sensitivity antigen/fecal PCR tests emerging for early detection
• AI ultrasound to detect subtle bile duct changes and sludge earlier
• New long-acting flukicides in trials aiming to simplify dosing
• Improvements in hepatoprotective drug formulations

✅ Vet-Approved Care Roadmap

1. Look for risk factors—outdoor hunting + liver signs
2. Run fecal, bloodwork, and ultrasound diagnostics
3. Treat with praziquantel ± fenbendazole repeat after 12 weeks
4. Support liver with fluids, antibiotics, SAMe, ursodeoxycholic acid
5. Monitor labs and imaging every few weeks until improvement
6. Use Ask A Vet, Woopf, Purrz for home care support
7. Prevent reinfection—keep cats indoors and recheck regularly

✨ Final Thoughts from Dr Houston

Liver fluke infection in cats can fly under the radar—but with risk awareness, thorough diagnostics, and safe treatment (praziquantel/fenbendazole), most cats can return to full health. Combining veterinary care with home support via Ask A Vet, Woopf, and Purrz ensures your cat gets the best liver recovery possible. Your love, vigilance, and care truly make all the difference. 💙🐾

Seeking guidance? Visit AskAVet.com or download the app for personalized liver-fluke support and 24/7 expert care.