Opal is a gentle, pretty, petite white cat with distinctive orange tabby markings on her head and tail. She was adopted as a kitten from the local shelter. Other than having a bit of a cold when first brought home, she was a normal, healthy young cat for the first year of her life. She tested negative for feline leukemia and feline immunodeficiency virus and parasites. She was fully vaccinated then spayed and declawed at six months of age. She lived with one other cat and seemed to be thoroughly enjoying her new role as a pampered indoor kitty. However, at little over a year of age the owner started to notice some worrisome changes in Opal. Over a two week period, she started vomiting, losing weight and becoming depressed. At first the changes were subtle, but they rapidly became more frequent and severe. The owners were very concerned.
When Opal was presented to us, she was very thin, dehydrated and depressed. She had a yellow tinge to her gums and the whites of her eyes. We also noted she had significant dental disease and inflammation of the gums (gingivitis) for such a young cat. We didn’t know yet what was causing the problem but we knew Opal was a very sick little kitty! She was immediately started on intravenous fluids and blood and urine samples were drawn for testing.
The initial tests showed that Opal had significant changes in her liver and high levels of bilirubin in her blood and urine (making her jaundiced or icteric). We needed to find out what was causing these changes so that we could treat her appropriately. There were many questions to answer. Did Opal have primary liver disease or were the changes secondary to something else? Did she have a portosystemic shunt (abnormal blood flow through the liver)? Inflammation or infection in the liver? Pancreatitis? A tumour? Opal was immediately scheduled for x-rays and ultrasound of the abdomen to get more information. These tests confirmed that her liver was slightly enlarged – further evidence that there was a problem.
Before we could really help Opal, we needed to find out exactly what was going on with her liver so that we could treat the problem appropriately. The best way to do this was to do a liver biopsy. Biopsies involve taking small samples of tissue and sending it away to a pathologist for analysis. In the past, getting a sample of the liver involved fairly major surgery – we would have to make an incision into the abdomen that was big enough to see the liver then reach in to get our samples. As you can imagine, Opal was already feeling lousy….the last thing we wanted to do was make her undergo major surgery if we didn’t have to!
Fortunately for Opal, we were able to get our biopsy samples laparoscopically. This meant that instead of making one big incision we were able to make two tiny incisions and use a specialized camera and biopsy instruments to get our samples. Because laparoscopy uses high tech video cameras, it offers the advantage of being able to actually see inside the patient and take a good look at the internal organs like never before. While getting Opal’s liver biopsy samples, we were able to see that her liver was enlarged, pale and mottled – definitely not normal!
We sent our samples to a veterinary pathologist in Toronto and within a couple of days we had our diagnosis – Opal was suffering from severe Hepatic Lipidosis. Please see part two of Opal’s story to find out what happened next!