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Jaundice in Cats

By: Dr. Bari Spielman

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Jaundice, also referred to as icterus, describes the yellow color taken on by the tissues throughout the body due to elevated levels of bilirubin, a substance that comes from the break down of red blood cells.

Regardless of the cause, jaundice is considered abnormal in cats. Jaundice is recognized by a yellow color to the animal's skin. It is often more apparent in the whites of the eyes and in the skin at the base of the ears. There are three primary classifications of causes of jaundice.

Prehepatic Causes

Prehepatic causes are those occurring before the blood passes through the liver and are also referred to as hemolytic causes. These result from a breakdown of red blood cells.

  • Blood parasites – hemobartonellosis, cytauxzoonosis
  • Drugs
  • Immune-mediated hemolytic anemia
  • Blood transfusion reactions
  • Low phosphate levels in the blood
  • Heartworm disease (rare in cats)

    Hepatic Causes

    Hepatic causes are those disorders associated with the liver and include:

  • Fatty infiltration of the liver (hepatic lipidosis)
  • Inflammatory diseases of the liver (hepatitis), bile duct system (cholangitis), or both (cholangiohepatitis)
  • Toxins, such as heavy metals, certain chemical flea and tick dips and sprays
  • Certain drugs, such as diazepam, acetaminophen, griseofulvin
  • Cancer
  • Infections - viral, bacterial, protozoal
  • Cirrhosis (severe, end-stage liver disease)

    Posthepatic Causes

    Posthepatic causes are disorders that occur after blood passes through the liver and include disorders that result in blockage of the bile flow from the liver.

  • Pancreatic diseases, such as pancreatitis and pancreatic cancer
  • Gall bladder diseases, such as gall stones, cancer, or inflammation of the gall bladder and bile duct
  • Intestinal diseases that block the bile ducts

    What to Watch For

  • Yellow color to gums, whites of the eyes, skin
  • Lethargy
  • Loss of appetite, weight loss and loss of body condition
  • Difficulty breathing
  • Vomiting, diarrhea
  • Abdominal distension
  • Excessive drinking and urinating

    Diagnosis

    Baseline tests such as a complete blood count (CBC), biochemical profile, and urinalysis are recommended in jaundiced patients. The tests also evaluate electrolytes, blood sugar, protein level, and urine concentration. Additional tests may include:

  • Abdominal and chest X-rays to assess organ size and shape and to assess for the presence of any masses or foreign objects

  • Abdominal ultrasound to assess the size, shape, and structure of abdominal organs, especially the liver

  • Serologic tests for infectious diseases that may affect the liver or cause destruction of red blood cells, including feline leukemia virus, feline immunodeficiency virus, feline infectious peritonitis virus, toxoplasmosis

  • Coagulation profiles to assess blood clotting, as abnormal clotting may occur with severe liver disease and pancreatitis

  • Liver biopsy where liver disease is a consideration

  • A Coombs test to evaluate for immune-mediated destruction of red blood cells

  • Exploratory laparotomy in those patients where all other tests have not provided a diagnosis

    Treatment

    There are several steps your veterinarian might recommend to treat the jaundiced patient symptomatically, especially during diagnostic testing and prior to obtaining an underlying cause and instituting specific therapy. These include:

  • Discontinue any therapy initiated before the onset of jaundice.
  • Allow the patient to rest and avoid stress.
  • Administer intravenous fluid and electrolyte therapy to those patients that are severely ill or dehydrated.
  • Administer blood products to those patients that are profoundly anemic.

    Home Care

    Administer all prescribed medication as directed by your veterinarian. Observe your pet very closely. If clinical signs are not improving and/or are getting worse, contact your veterinarian at once.

    Remove any drugs or other substances in the environment that may have triggered the jaundice.

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