Emergency Care for Feline Hepatic Failure: Quick Tips

1. The complete blood count (CBC) results can either fall within the normal range or indicate mild anemia or an elevated white blood cell count.

2. Biochemical tests often reveal elevated liver enzymes, electrolyte imbalances, increased bilirubin, and elevated levels of albumin and globulin, along with low blood glucose, low blood urea nitrogen, and low cholesterol. These tests can also aid in ruling out other conditions.

3. Urinalysis helps assess kidney function and hydration levels in your pet, and may uncover abnormalities in bilirubin levels.

4. Coagulation disorders are not uncommon in liver diseases, so it's important to evaluate coagulation function.

5. Serum bile acid tests are paired blood tests conducted before and after meals to assess liver function. This test is safe and can be performed at your local veterinary hospital. It can be conducted even when bilirubin levels are normal in your pet.

6. Ammonia level testing is a blood test that, when abnormal, often suggests liver disease. However, the inaccuracy of this test is a concern, as many factors can influence the results, and special handling is necessary.

7. Abdominal Xrays may show normal results or indicate fluid in the abdomen, liver enlargement, or liver shrinkage.

8. Abdominal ultrasound is often recommended to evaluate all abdominal organs, including the liver, and to rule out other disorders that may be initially indistinguishable from liver failure. Under ultrasound guidance, liver samples can typically be obtained through aspiration or biopsy for assessment and culturing/sensitivity testing. A clotting analysis should be performed first, and liver tissue samples can only be obtained if clotting parameters are normal. Ultrasound is generally considered a good diagnostic tool. While sampling tumor tissue may require sedation or general anesthesia with some risks, ultrasound itself is a noninvasive procedure, making it a recommended choice by veterinarians. However, these procedures often require expertise or referral to a specialty hospital.

Beyond these diagnostic methods, your veterinarian may suggest additional tests to rule out or diagnose other conditions, or to provide a clearer diagnosis of liver failure. These tests are not necessary in every case but can be beneficial for certain pets and are chosen based on the specific situation. These include:

1. Laparoscopy. This procedure allows for the observation and sampling of abdominal structures through a small incision. It is more invasive than ultrasoundguided biopsy but allows for a direct view of the liver and related structures, which is often beneficial for larger biopsies. However, it requires general anesthesia and should be performed by someone with surgical and appropriate equipment experience.

2. Laparotomy. This is a surgical procedure that allows for a close inspection of the entire liver and other abdominal structures. It can obtain larger biopsy samples and may be used when biliary obstruction needs to be relieved and分流. This process should be left to experienced veterinarians and conducted in facilities with close postoperative monitoring.

Advanced Treatment

Treatment for liver failure has several goals, including eliminating any underlying causes, providing an environment for liver recovery, and controlling complications. Pets with liver failure often require hospitalization and aggressive treatment. While the initial prognosis is usually guarded, animals that survive a few days may have the potential for full recovery. The diagnosis of liver failure is crucial, as the treatment plan depends on the final diagnosis.

1. Eliminating any underlying diseases or factors, such as removing toxic drugs or treating leptospirosis, is an important aspect of treatment.

2. Providing an environment for liver rest and regeneration is one of the most critical parts of treatment.

3. Hospitalization and supportive care, including fluid and electrolyte therapy and intravenous glucose to supplement nutrition, are necessary based on the need for dehydration, electrolyte imbalances, and hypoglycemia.

4. In some cases, nutritional support may be provided through intravenous routes.

5. Dietary recommendations for pets with liver disease include protein modification. When creating a diet for pets with liver disease, a primary challenge is that these animals often suffer from malnutrition. It is crucial to maintain weight and muscle mass while minimizing symptoms of liver failure. Several prescription diets are available on the market, such as Hill's Prescription Diet L/D® specifically formulated for pets with liver disease, as well as certain appropriate homemade diets.

Here are methods to control complications of feline liver failure:

1. Diuretics, such as spironolactone, can be used to treat fluid retention.

2. Treatment for hepatic encephalopathy, a disease affecting the central nervous system that can occur in late liver disease, is essential. Lactulose (Chronulac®), a medication that slows the absorption of ammonia from the intestines into the body, should be taken orally or as an enema diluted with warm water. Neomycin enemas may also be effective. Oral neomycin or metronidazole, among other antibiotics, may be recommended.

3. Treating brain edema is crucial, and a combination of mannitol, furosemide (Lasix®), and oxygen should be considered early in the disease.

4. Gastrointestinal ulcers can be treated with medications to reduce stomach acid production. Drugs like cimetidine (Tagamet®), famotidine (Pepcid®), ranitidine (Zantac®), misoprostol (Cytotec®), and omeprazole can accelerate healing of gastrointestinal ulcers related to liver disease.

5. Antiemetics may be considered to reduce vomiting. Metoclopramide (Reglan®) or chlorpromazine (Thorazine®) are good options.

6. Coagulation disorders related to liver disease may be treated with injections of vitamin K or the use of fresh frozen plasma.

Posttreatment Care for Feline Liver Failure

The best approach to treating your pet's liver failure is a combination of athome care and professional veterinary care. Followup is crucial, especially if your pet's symptoms are not improving promptly.

Always follow your veterinarian's instructions regarding prescribed medications and diets. If you encounter any issues with treating your pet, be sure to notify your veterinarian promptly.

In addition, blood should be monitored every one to two days at the beginning of treatment, and then weekly or monthly based on the underlying cause.