Feline Liver Disease Review
23 November 2016
Southern BSAVA delegates were treated to two fascinating talks on feline liver disease from Dr Sheila Wills, RCVS Recognised Specialist in Feline Medicine and European Specialist in Veterinary Internal Medicine. Sheila started with an in depth discussion on liver parameters and how we can gather more information from routine laboratory tests by understanding the unique features of the cat liver and the way different diseases can subtly affect the relative rises in common liver parameters. For example, gamma glutamyltransferase (GGT) is more markedly increased compared to alkaline phosphatase (ALP) in necroinflammatory liver disease, bile duct obstruction and/or inflammatory intrahepatic cholestasis.
The second talk focused on feline inflammatory disease, reviewing the classification and approach to treatment. Sheila emphasized that the key factor in the assessment of liver pathology (from a clinical perspective) is determining if the liver lesions have a predominantly neutrophilic or lymphocytic inflammatory infiltrate. The World Small Animal Veterinary Association (WSAVA) recently established a liver standardisation group to more clearly define the histological criteria for liver diseases and this is based around the above, more clinically helpful, inflammatory pattern. The WSAVA classification scheme broadly classifies cholangitis into three distinct forms:
- Neutrophilic cholangitis
- Lymphocytic cholangitis
- Cholangitis associated with liver fluke (not relevant to the UK)
Sheila discussed the diagnostic approach to identify the type of cholangitis and the importance of adjunctive and supportive therapies such as S-adenosyl methionine and ursodeoxycholic acid in their management.