Hepatology in dogs and cats: The importance of diagnostics and dietary management in clinical practice – a summary of the webinar with vet Aleksandra Szuba
- Ecommercy
- 2026-09-22
- 15:14
- 0 comments
Liver diseases in dogs and cats remain one of the more complex groups of internal medicine disorders, both diagnostically and therapeutically. Their non-specific clinical presentation, the liver’s considerable functional reserve and the frequent coexistence of gastrointestinal and pancreatic diseases or endocrine disorders mean that diagnostic results must always be interpreted within the broader clinical context.
During the webinar presented by vet Aleksandra Szuba, we discussed the most common hepatopathies in dogs and cats, the importance of the gut–liver axis, the role of laboratory and diagnostic imaging, and practical aspects of dietary management in patients with liver disease.
The liver as a central metabolic organ
The liver plays a key role in maintaining homeostasis. It is responsible for the metabolism of proteins, fats and carbohydrates, the synthesis of albumin and some coagulation factors, participation in the urea cycle, storage of vitamins and trace elements, and detoxification.
Particular attention was given to the close relationship between the liver and gastrointestinal tract via the portal venous system. Microbiome disturbances, chronic enteropathies and increased intestinal barrier permeability may have secondary effects on inflammation and hepatocyte metabolism. As a result, assessment of the gut–liver axis and an integrated gastroenterological and hepatological approach are becoming increasingly important in clinical practice.
The most common hepatopathies in dogs and cats
The webinar covered the most common conditions, including:
• chronic hepatitis
• copper-associated hepatopathies
• steroid hepatopathy
• gallbladder mucocele
• cholestasis and biliary tract diseases
• portosystemic shunts
• toxic liver injury
• feline hepatic lipidosis
• cholangitis and cholangiohepatitis
• triaditis in cats
Species differences were also highlighted. Chronic hepatopathies, copper storage disorders and gallbladder mucoceles are more commonly seen in dogs, whereas biliary tract disorders, triaditis and secondary hepatic lipidosis associated with anorexia are particularly important in cats.
Clinical presentation – why can hepatopathies be diagnostically challenging?
One of the main topics of the webinar was the non-specific nature of clinical signs. The liver has considerable functional reserve, which means that some patients may show no obvious clinical signs for a long time despite progressive histopathological changes.
Clinical signs may include:
• chronic or intermittent loss of appetite
• nausea, reflux and salivation
• vomiting and changes in stool
• loss of muscle mass
• weakness and lethargy
• deterioration in coat quality
• increased thirst and polyuria
• jaundice
• signs of hepatic encephalopathy
In cats, it is particularly important to respond quickly to even a short period of reduced food intake, as this may lead to the development of hepatic lipidosis.
Diagnostics – interpreting results within the broader clinical context
The webinar strongly emphasised that no single laboratory parameter can be used to diagnose liver disease. Results should always be interpreted alongside the patient’s clinical presentation, medical history, current medications, diet and diagnostic imaging findings.
The significance of key laboratory parameters was discussed, including:
• ALT, AST and GLDH as markers of hepatocellular injury
• ALP and GGT as cholestatic enzymes
• bilirubin in the context of cholestasis and impaired bile flow
• albumin as an indicator of hepatic metabolic function
It was also highlighted that increased liver enzyme activity may occur secondary to other conditions, including gastrointestinal disorders, obesity, endocrinopathies and long-term pharmacotherapy.
Dietary management – a key component of treatment
A significant part of the webinar focused on practical nutritional management of patients with liver disease. Dietary therapy should always be individualised and take into account:
• the degree of hepatocellular injury
• the presence of cholestasis
• fat tolerance
• the risk of hepatic encephalopathy
• nutritional status and loss of muscle mass
• concurrent gastrointestinal disease
It was emphasised that excessive protein restriction should not be standard practice for every patient with liver disease. Protein quality and digestibility, as well as adjusting the amount of protein to the patient’s current clinical condition, are considerably more important. In clinical practice, malnutrition and progressive loss of muscle mass can significantly worsen prognosis.
The webinar also discussed the importance of controlling copper intake, providing adequate energy, ensuring diet palatability and using appropriate nutritional supplementation to support patients with liver disease.
FAQ – questions raised during the webinar
Does a mild increase in ALT always require further diagnostic investigation?
Not every increase in ALT indicates severe liver disease. However, persistently abnormal values or concurrent clinical signs require further investigation, particularly when accompanied by abnormalities on ultrasonography or in other laboratory parameters.
Why is even a short period of anorexia so dangerous in cats?
Cats are highly predisposed to developing hepatic lipidosis secondary to reduced food intake. Even a few days without adequate food intake may lead to severe metabolic disturbances.
Do all hepatopathies require a low-protein diet?
No. Protein restriction should be considered individually, primarily in patients with hepatic encephalopathy or severe disturbances of nitrogen metabolism. Excessive restriction may exacerbate sarcopenia.
How important is the gut–liver axis?
Its importance is increasingly recognised. Microbiome disturbances and chronic enteropathies may influence inflammation and hepatocyte metabolism and may contribute to secondary abnormalities in liver parameters.
Summary
The webinar with vet Aleksandra Szuba highlighted the importance of an interdisciplinary approach to patients with liver disease. Hepatopathies rarely occur entirely in isolation from the gastrointestinal tract, microbiome or metabolic disorders. Effective management therefore requires an integrated assessment of the patient’s clinical condition, diagnostic findings and nutritional needs.