Liver Inflammation & Hepatitis in Cats – Vet Guide 2025 🩺🐱

By Dr. Duncan Houston BVSc

Inflammation of the liver—commonly grouped under terms like hepatitis, cholangitis, cholangiohepatitis, or CCHS—is a serious health concern in cats. In 2025, vets recognize the interconnected liver, bile duct, and gallbladder issues that characterize this syndrome. It can lead to vomiting, loss of appetite, jaundice, and irreversible liver damage if untreated. Let’s explore the causes, symptoms, diagnostics, treatments, and proactive care strategies, with support from Ask A Vet, Woopf, and Purrz to ensure your cat’s recovery and comfort. 🍵

1. What Is Cholangiohepatitis (CCHS)?

Cats rarely have isolated liver inflammation—most suffer from inflammation involving the bile ducts (cholangitis), liver (hepatitis), and gallbladder (cholecystitis). That's why vets often diagnose cholangiohepatitis-cholangitis complex (CCHS) :contentReference[oaicite:3]{index=3}. This impairs bile flow, disrupts digestion, and can trigger liver failure if not treated promptly.

2. Why It Happens – Underlying Causes

• Bacterial/fungal infections: Microbes ascending from the gut via bile ducts :contentReference[oaicite:4]{index=4}.
• Immune dysregulation: Lymphocytic portal hepatitis—often in older cats or those with hyperthyroidism :contentReference[oaicite:5]{index=5}.
• Biliary stones/obstructions: Gallstones or obstruction of ducts causing bile backup and damage :contentReference[oaicite:6]{index=6}.
• Concurrent inflammation: Conditions like pancreatitis and IBD often occur alongside cholangiohepatitis :contentReference[oaicite:7]{index=7}.
• Parasites or toxins: Liver flukes, hepatotoxins (e.g. certain medications or plants) contribute to inflammation :contentReference[oaicite:8]{index=8}.

3. Recognizing the Symptoms

• Poor appetite or anorexia, often longstanding
• Vomiting, with or without bile or blood :contentReference[oaicite:9]{index=9}.
• Weight loss, lethargy, and abdominal pain :contentReference[oaicite:10]{index=10}.
• Jaundice—yellowing of skin, gums, and eyes :contentReference[oaicite:11]{index=11}.
• Diarrhea or pale stool; increased water intake and urination
• Chronic cases may lead to ascites, bleeding disorders due to impaired clotting factor production :contentReference[oaicite:12]{index=12}.

4. Possible Complications

• Hepatic lipidosis: Starvation from anorexia causes excess fat infiltration, risking liver failure :contentReference[oaicite:13]{index=13}.
• Cirrhosis: Long-term scarring, loss of liver function :contentReference[oaicite:14]{index=14}.
• Hepatomegaly: Enlarged liver may compress organs or swell abdomen :contentReference[oaicite:15]{index=15}.
• Liver failure: Can present acutely with vomiting, weakness, bleeding, neurological signs—emergency :contentReference[oaicite:16]{index=16}.
• Parasite infections: Liver flukes worsen inflammation and may complicate treatment :contentReference[oaicite:17]{index=17}.

5. Diagnostic Process

1. Physical exam with abdominal palpation—look for liver enlargement or gallbladder pain :contentReference[oaicite:18]{index=18}.
2. Bloodwork: CBC, liver enzymes (ALT, ALP, GGT), bilirubin, clotting profile :contentReference[oaicite:19]{index=19}.
3. Urinalysis: May show bilirubin or protein presence.
4. Imaging: Ultrasound for liver/bile duct/gallbladder structure; aspirates via ultrasound-guided FNA :contentReference[oaicite:20]{index=20}.
5. Biopsy: Needle or surgical samples confirm type and detect cancer or fibrosis :contentReference[oaicite:21]{index=21}.
6. Parasitology: Tests if flukes or other parasites suspected :contentReference[oaicite:22]{index=22}.

6. Treatment Plan

Successful treatment targets the underlying driver and supports liver healing:

• Antibiotics or antifungals: For confirmed infections :contentReference[oaicite:23]{index=23}.
• Anti-inflammatories/immunosuppressants: For immune-mediated disease :contentReference[oaicite:24]{index=24}.
• Surgical intervention: Bile duct obstructions require removals or cholecystectomy :contentReference[oaicite:25]{index=25}.
• Parasite deworming: Treat fluke infestations :contentReference[oaicite:26]{index=26}.
• Symptomatic care: Fluid therapy, anti-nausea meds, pain management, vitamin K.procoagulants if needed :contentReference[oaicite:27]{index=27}.
• Hepatic supplements: SAMe, silymarin, milk thistle, ursodiol to protect liver cells and flow :contentReference[oaicite:28]{index=28}.

7. Nutritional Management

Diet is crucial for liver repair:

• Use **hepatic or low-sodium prescription diets** (Hill’s l/d, Royal Canin hepatic, Purina HP) :contentReference[oaicite:29]{index=29}.
• Provide gentle protein, low in copper, energy-dense to avoid anorexia :contentReference[oaicite:30]{index=30}.
• Use feeding tubes if cat isn’t eating to prevent hepatic lipidosis :contentReference[oaicite:31]{index=31}.
• Supplement vitamins: A, D, E, K, B-complex, especially B12 :contentReference[oaicite:32]{index=32}.

8. Supportive Care at Home

• Offer small, aromatic meals frequently to encourage intake.
• Ensure plenty of fresh water or wet food to support extraction.
• Administer all meds, supplements, and track appetite/stool.
• Schedule follow-ups: check bloodwork and ultrasound to monitor improvement.

9. Partnering with Ask A Vet, Woopf & Purrz 🛠️

Ask A Vet: Upload lab results, ultrasound images, diet photos, and behavior logs for veterinary review, dose adjustments, and dietary guidance.

Woopf: Use comfortable elevated feeding stations, calming mats, and supportive bedding to ease mealtime and rest.

Purrz: Offer enrichment like slow-feed toys and gentle play to maintain appetite, reduce stress, and encourage mobility during recovery.

10. When to Call the Vet

• Inappetence lasting >48 h, repeated vomiting or diarrhea.
• Jaundice appears or spreads.
• Abdominal swelling, pain, or difficulty breathing.
• Neurological signs: head pressing, disorientation, seizures.
• Bleeding, collapse, or extreme lethargy.

11. Prognosis & Follow-Up

The outcome depends on early diagnosis, underlying cause, and consistent treatment. Acute cases with infection or obstruction often respond well, while chronic immune-mediated or parasitic causes may need long-term management. Regular monitoring is key for favorable outcomes. Even cats with hepatic lipidosis can recover if treated early. :contentReference[oaicite:33]{index=33}

12. Final Thoughts

Liver inflammation in cats is multifaceted and can escalate quickly—prompt diagnosis, targeted therapy, nutritional support, and veterinary oversight define the best approach. With a supportive environment and proper management, cats can recover fully or live comfortably with chronic conditions. 🧡🐾

13. Call to Action 📲

If your cat shows signs of liver issues—loss of appetite, vomiting, jaundice—contact Ask A Vet right away. Share diagnostic data and treatment updates via the app. Use Woopf gear to aid eating and resting comfortably, and Purrz enrichment to support hydration and appetite. Early action leads to better outcomes! 🐱📱