My senior cat has liver failure. Can they survive? What's next?

Poor guy. It is tough when you are in these situations where you are deciding on continued care (which isn’t 100% guarantees to work) or Humane euthanasia. Unfortunately we don’t have enough information about your cats particular case to help you decide things here. Perhaps a consultation would be best to comb through all of the details such as lab work findings (even seeing the normals is quite helpful), medications tried so far, and his physical exam findings would also be helpful. But generally speaking if your pet is ill from liver disease, which can be any condition such as hepatitis, hepatic lipidosis (carries a poorer prognosis unless aggressive treatment is implemented including a feeding tube in most situations), liver cancer or even gallbladder disease can cause elevated liver enzymes, then it’s best fo an abdominal ultrasound to determine what specific liver condition is present. The prognosis of your pet should be determined by your vet and then carefully considered when determining if continued care should be done or if Humane euthanasia is the better option. I hope this helps and best wishes moving forward with a good decision regarding Elmo’s care.

If you are worried she is dying she needs to be seen by a veterinarian right away. Not eating is a serious problem in cats and will only cause her further liver damage, plus she is likely severely dehydrated by the lack of drinking. She needs immediate supportive care and reevaluation to see if anything can be done to save her life and make her more comfortable.

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.

I am so sorry you have to go through this. It is so difficult to make these choices for our pets because we want them to be with us forever. Sometimes, we need to make a tough decision that will end their pain and suffering. Our thoughts are with you at this difficult time.

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!

Liver failure can be acute or chronic, some acute cases resolve completely while other are fatal within a very short period. chronic cases can also survive several months/years, every case is different.

Getting down to the cause of the liver failure is important for treatment. I would be concerned about the lumps and irregular breathing pattern. Chest x-rays would be helpful to determine if there is an abnormality with the heart or lungs or enlarged lymph nodes within the chest. The lumps could indicate cancer, either primary or secondary to another location. The liver is a common site of cancer or metastatic cancer. I would recommend talking to your vet about a liver biopsy or biopsying the masses to determine if they are cancerous. Antibiotics and steroids can help with infections of the liver or an inflamed liver, but if there was poor response then these are unlikely the causes of the elevated liver values. Denamarin is a supplement that contains antioxidants to protect the liver; it does not treat liver failure.