My senior cat has elevated liver enzymes. Is an ultrasound needed?

Hi, yes in cats even small changes in liver enzymes can be significant and are worthy further investigations. An ultrasound will have a look at the liver structure and biliary tree and will definitely provide more useful information.

Hello and thank you very much for your question. Because the liver enzymes are increasing, even with liver protectant medications on board, I now believe it is time to perhaps consider a liver biopsy. It is possible that when the original ultrasound was performed, there was a liver specific disease that was not detectable on the ultrasound. So at the very least, I would repeat the ultrasound, as well as try to get a liver biopsy. Make certain that your general practitioner feels confident with this procedure. If they are not, please have them refer you to an internal medicine specialist. Thanks a lot for your question. I hope you find the answer.

Although we can not prescribe treatment via an online method (illegal with our veterinary licenses), what i can tell you is that an ultrasound can not assess liver function. Ultrasound is just an image so it can tell you size and texture changes to organs and evaluate for masses, fluid, etc. Also the good appetite and energy level are not typical with liver failure. Your cat has elevated liver enzymes and total bilirubin but this does not always mean liver failure. I would try to get better clarification from your vet about what was seen on the ultrasound and were the other organs normal (pancreas, GI tract, etc.). More common causes of these bloodwork changes would include liver/biliary infection, pancreatitis, and underlying GI disease associated with the above. Cancer and certain infectious diseases such as FIP can as well. So options would include additional testing to search for a cause (such as pancreatitis testing, liver aspirates, etc.) and/or symptomatic treatment can be attempted for pancreatitis, liver infection, etc. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Liver enlargement means that the liver is bigger than it should be. It could be because of liver inflammation due to infection (bacterial or viral) or toxins ingestion. In young cats like Arya liver tumors are very uncommon, but enlargement of one liver lobe could be caused by a liver abscess or a cyst. The best way to assess liver size is ultrasound scan and/or x-ray. Blood test tells about liver function. In other words, it tells if the liver, ,despite being enlarged or diseased, is still able to maintain its function. Blood test also can assess the extent of liver damage. It is hard to say anything about the prognosis without knowing why the liver is enlarged and what are the blood results. In general, liver have huge capacity to recover from any insult, but again it really depends what has happened.

Thanks for using Petco Pet Education Center, formerly Petcoach. I’m so sorry to hear about Beyoncé! This may be a good one to open a consultation with us about because there are lots of variables. First, if the calcium was a little high, kidney disease seems most likely and further testing may not be needed. If the calcium was significantly elevated, I start to worry about cancer and it may be worth doing the ultrasound. I’m not sure how long you’re out of town, but it may be worth just rehydrating her to help her feel better and get her stable. Then holding further testing until you get home. Obviously if there is something serious later found on the ultrasound, you may have wished you had just done the ultrasound in the first place. A feeding tube is indicated for fatty liver disease or if she has been more than 3 days without eating. Otherwise I’d probably hold on that. Of course all of these are general rules and I cannot make the same kind of judgements as the vet who is there looking at and examining her. I’d recommend calling that vet with questions and a budget. The vet will be able to best use your money if you are up front with how much you can spend. Hope this helps and very best wishes to you and Beyoncé!

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. I am sorry to hear that Kitty is not feeling very well. With the description and blood results, I worry about a condition known as hepatic lipidosis (fatty liver disease) or triaditis (inflammation of the pancreas, liver and small intestines). For fatty liver disease, a feeding tube is generally recommended to help bring cats out of this condition as nutritional support is key and extremely important in these cases. I would recommend an abdominal ultrasound as the next diagnostic step to help better determine what the cause could be. If Kitty is still not wanting to eat, you need to consider hospitalization and feeding tube placement to help her get through this. I hope this helps guide you in the right direction. Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

It is unlikely that diet alone is the cause of significant decrease to liver function. I would agree that Royal Canin and Hill's are not very different in terms of dietary quality. I feel that starting on a liver diet at this point based on one blood test is very premature and that further diagnostics are likely warranted. Some possible causes of increased liver values including endocrine conditions, liver shunts, hepatitis, bile duct / gall bladder issues, liver / gall bladder tumors, or fatty liver disease. Depending on the nature and magnitude of the elevation, it may be insignificant as well if Maki's findings were not coupled with any clinical signs of illness. Some additional diagnostic testing to look into things more would be additional more specific blood work, radiographs, and ultrasound. Rather than dietary change, there are more target liver supplements. One that comes to mind is called Denamarin. There is a feline formulation available that would work fine. Hope this helps.