Overview

There are basically four causes of feline liver failure. A fatty liver (aka hepatic lipidosis), lymphoma, infectious peritonitis, and cholangiohepatitis are generally recognized as the primary causes of feline liver failure. Other than hepatic lipidosis, cholangiohepatitis is the most common cause of liver failure. Cholangiohepatitis is essentially a bacterial infection that can be treated rather easily and with a high level of success.
Cholangiohepatitis is the inflammation of the liver and bile ducts. Because bile functions with the liver to rid the body of toxins but problems become apparent when infections reach this system. The liver is usually a sterile environment and as a result cannot handle the bacteria associated with cholangiohepatitis. During an infection it is therefore possible for a cat to suffer from liver failure which can ultimately result in death.

Symptoms and Diagnosis

The most serious symptom of cholangiohepatitis is liver failure. Liver failure is associated with illnesses like jaundice. Also, because the liver is responsible for ridding the body of toxins during liver failure the body can essentially be poisoned. This ultimately leads to death.
Diagnosis of cholangiohepatitis requires a liver biopsy. Because the other causes of liver failure (hepatic lipidosis, lymphoma, and feline infectious peritonitis) have much more serious implications but very similar symptomology veterinarians will usually insist that a biopsy is conducted in order to eliminate these other more serious illnesses as the cause of liver failure.

Treatment

Once cholangiohepatitis has been diagnosed there are several treatment options. Antibiotics are essential in order to kill the bacteria associated with cholangiohepatitis. Also, antibiotics help to reduce the amount of bacteria in the intestines and thereby limiting the number of toxins released into the body. Since the liver is not healthy enough to filter these toxins antibiotics are beneficial because they limit the amount of toxin.
Choleretics are used to liquefy bile thereby improving its movement throughout this waste removal system. The proper flow of bile is necessary to remove toxins and also prevents bacteria from moving toward the liver. Often choleretics are prescribed for life after a cholangiohepatitis infection.

S-adenosylmethionine is a common antioxidant that helps protect the liver from the toxins it normally filters. This is a nutritional supplement that has steadily been gaining in popularity.
Finally, immune suppression is a treatment that is often needed for cats to recover from cholangiohepatitis. While it seems contradictory to suppress the immune system while it is fighting a bacterial infection, there are several benefits to immune suppression. Form most cats suffering from a cholangiohepatitis infection, the route cause of the infection is inflammatory bowel disease which involves inflammation of the intestinal walls. Immune suppression is the primary treatment method for inflammatory bowel disease because the immune system can actually begin to attack the body’s own intestinal cells. When the immune system is suppressed this allows the intestinal wall to rebuild itself and prevents bacteria from replicating. This means that the bacterial infiltration of the liver and bile is reduced as is the inflammation associated with cholangiohepatitis.

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