Hepatocellular liver cancer

Main signs of liver disease in cats

The liver is a vital organ that performs many functions:

• detoxification - processes metabolites, in particular ammonia, which is formed during protein metabolism;
• participates in digestion, produces bile;
• protein synthesis.

Impaired functioning of the organ leads to various disorders both in the gastrointestinal tract and other organs.

The clinical picture of liver diseases depends on the etiology and pathogenesis.

1. In the presence of an inflammatory process or replacement of an organ with connective tissue, an increase in the size of the liver is observed - hepatomegaly, and sometimes an enlargement of the spleen is also observed.
2. Dyspeptic disorders are manifested by nausea, vomiting, stool disturbances - both diarrhea and constipation can develop.
3. A change in the color of the mucous membranes is observed with jaundice. Pathology is classified into the following types: hemolytic - not associated with diseases of the parenchymal organ, occurs as a result of massive destruction of red blood cells for various reasons;
4. parenchymal develops against the background of severe damage to the liver structure, while the appearance of yellowness of the visible mucous membranes is caused by the loss of the ability of liver cells to capture free bilirubin from the blood;
5. mechanical develops as a result of difficulty in the outflow of bile through the biliary tract, for example, in the presence of stones or a tumor in the liver or gall bladder.

1. Ascites occurs with the development of portal hypertension - increased pressure in the portal vein. In this case, fluid exits into the abdominal cavity and accumulates. In addition, the formation of pathology is facilitated by the low content of albumin proteins in the blood, as a result of which the oncotic pressure of the blood decreases. The syndrome is manifested by an increase in the circumference of the cat's abdomen, and when the animal is positioned on its hind legs, ascitic fluid flows into the lower sections, as a result of which the abdomen takes on the shape of a pear.
2. Some diseases are accompanied by the development of cholestatic syndrome, which is characterized by intense itching of the skin. This symptom is caused by irritation of skin receptors by bile acids released into the blood.
3. With jaundice, there is a change in the color of urine towards dark shades, and becomes light in color.
4. As a result of severe liver dysfunction, multiple hemorrhages develop on the skin. In severe cases, internal bleeding may occur.

Symptoms of ascites in a cat

Types of cancer in cats

Cancers are classified in veterinary medicine in the same way as in human medicine.

The common nomenclature is TNM, which is used to describe the anatomical features of the spread of degenerative processes. So the letter of the Latin alphabet T means the size and location of the primary focus of the pathological process. This is a necessary indicator for identifying solid types of tumors - carcinomas or sarcomas. The letter N (translated from Latin as nodus or lymph node. This designation is used to determine and record the presence of mestastases in the area of ​​regional lymph nodes (located in close proximity to the tumor), the absence or presence of metastases in the regional lymph nodes and the degree of their damage. Letter M - metastasis is used to characterize the presence or presence of metastases in the body.

There are a huge number of types of malignant tumors in cats. But they are all divided into several main stages, namely:

• initial stage - characterized by the formation of a small nodule, does not have pronounced symptoms;
• second stage – there is active growth and development of the pathological process in the tissue structures of the organ, nearby cells and tissues are affected;
• third stage - characterized by the end of tumor growth, but progressive destruction of the entire organism;
• the fourth stage is the process of decomposition of a cancerous tumor, poisoning the body with toxic substances from the tumor. During this period, almost the entire body of the animal is affected and most often the fourth stage ends with the death of the pet.

There are many types of cancer, but the most commonly diagnosed types are:

1. Skin cancer in a cat . One of the most dangerous and diverse diseases in the field of symptoms. It represents about 20% of the total number of diagnosed malignant neoplasms in pets. Factors that provoke skin cancer are excess ultraviolet rays, chemical burns and others. Because there are several layers of the dermis, skin cancer is divided into cutaneous lymphoma, mast cell tumors, melanocytic and sarcomas, and squamous cell carcinomas.
2. Lungs' cancer . A disease such as lung cancer in cats is also one of the most frequently diagnosed in veterinary medicine. It is worth noting that this disease is rarely registered independently, but more often with metastases. In the first stages of the disease, any symptoms are completely absent. The appearance of a cough and characteristic shortness of breath are symptoms of the final stages, and in such cases it is rarely possible to save the animal.
3. Liver cancer in cats. Oncology, more often diagnosed in older animals aged 7-12 years. Just like lung cancer, it is rarely an independent disease. More often it develops as a result of metastasis from other organs affected by the tumor. As a result of the special compensatory properties of the liver structures, diagnosing cancer in them is very problematic. The most common malignant tumors in the liver are neuroendocrine tumors, bile duct carcinomas, mesenchymal sarcoma, and hepatocellular carcinoma.
4. Blood cancer in cats. Lymphoma or lymphosarcoma is another name for blood cancer. It is a malignant process of proliferation of lymphocytes and immune cells throughout the body. Lymphoma is diagnosed as often as skin cancer, and accounts for about 30% of the disease diagnosis statistics. The reasons for the development of lymphosarcoma, like other neoplasms, remain questionable, but there is a predisposition that lymphoma develops against the background of damage to the cat’s body by the leukemia virus, increasing the chances of developing pathology tenfold. Blood cancer has the following types - multifocal lymphoma, alimentary lymphoma, mediastinal lymphoma, renal, bone, spinal and nasal lymphomas.
5. Colon cancer in cats. The pathology is rarely diagnosed in domestic cats, but always has an unfavorable prognosis and outcome. As a rule, intestinal cancer manifests itself as blockage and obstruction, as well as various digestive disorders. There are many reasons for the development of a malignant intestinal tumor, but they are all based on assumptions and not on exact facts. Intestinal cancer develops in overwhelming cases in old animals after 12 years.
6. Stomach cancer in cats . A dangerous disease that is difficult to diagnose. Symptoms of the first stages of the disease are not immediately noticeable and are similar to infectious or chronic diseases. Quite often, stomach cancer is confused with gastritis in the acute stage or ulcerative manifestations. When an accurate diagnosis is established, as a rule, it is already too late to take measures to eliminate the disease.
7. Kidney cancer in cats . It is rarely presented as an independent formation, and more often occurs as a result of the transfer of malignant mutated cells from another focus of pathology. Since the kidneys are a filtration organ, disturbances in their functioning are noted almost immediately. Over time, the progression of cancer in one or both organs of the urinary system leads to problems with urination, vomiting and eruption of gastric contents mixed with blood. All this indicates the beginning of poisoning of the body with its own waste products. The kidneys cannot cope with the job and begin to fail. Often secondary metastasis and renal carcinomas are fatal.
8. Uterine cancer in a cat . A rarely diagnosed malignant neoplasm that occurs in cats over 8 years of age. It has been proven that in cats that are sterilized at an early age, the risks of developing pathology are reduced. Uterine adenocarcinoma is particularly aggressive, capable of growing and developing most rapidly. Gives metastases to the ovaries, bladder, kidneys and adrenal glands. In the last stages of uterine cancer, the pulmonary structures, the diaphragm, and even the brain are affected.
9. Brain cancer in a cat. A practically untreatable manifestation of malignant neoplasms. A brain tumor is one of the most secretive in the area of ​​symptoms. When characteristic signs of pathology appear, the process goes too far and the chances of recovery with treatment are very small. The most dangerous symptom of brain damage as a result of a tumor is convulsions and seizures, as well as paralysis. Swallowing may be impaired and normal breathing becomes difficult. When the respiratory center is compressed, the animal dies from asphyxia.

Most common liver diseases

The most common liver pathologies in cats include hepatitis, cirrhosis, lymphocytic, neutrophilic cholangitis, which are included in the general group of cholangitis syndrome in cats, cancer and other ailments.

Neutrophilic cholangitis

The pathology is characterized by damage to the bile ducts as a result of infection with pathogenic bacterial flora. Experts suggest that the source of infection is the intestines, but the etiology of the disease is not completely clear.

The disease usually manifests itself acutely - the animal vomits repeatedly, the mucous membranes and skin turn yellow, there is general malaise and signs of intoxication - decreased activity and appetite, a lethargic state.

Young individuals are susceptible to the disease. Treatment leads to complete recovery within one to one and a half weeks. Relapses are observed in rare cases; chronicity of the disease is not typical.

Lymphocytic cholangitis

Unlike neutrophilic, it is not associated with an infectious process. Experts suggest that a disorder of the immune response plays a major role in the pathogenesis of the disease. Most often, middle-aged and elderly animals are susceptible to pathology.

The resulting autoimmune complexes affect the bile ducts, resulting in a gradual increase in liver size, disruption of its function, and accumulation of ascitic fluid in the abdominal cavity. In the terminal stage, the pathological process also involves the liver parenchyma. There are high risks of transition of neutrophilic cholangitis to cirrhosis.

As a rule, animals respond well to treatment, but the course of therapy lasts several weeks. Recovery is often replaced by relapses of the disease and the acute course of neutrophilic cholangitis becomes chronic.

Hepatic lipidosis

Hepatic lipidosis is a disease caused by the deposition of lipids in hepatocytes. Fatty liver is manifested by dyspeptic disorders - nausea, vomiting, stool disorders develop, and the animal refuses to eat for a long time. Jaundice may appear.

Severe liver failure develops in the absence of adequate therapy. In this case, the cat exhibits signs of depression of the central nervous system - behavior changes, lethargy and increased salivation are noted, and an unusual tilt of the head may appear.

The causes of the disease are unknown. In many cases, the development of the disease is preceded by the pet's hunger or stress, intestinal diseases, or inflammation of the pancreas.

Poisoning

Food poisoning, as well as toxic substances, can occur, for example, while walking, when an animal eats food from the ground or from a trash can. Intoxication with salts of heavy metals, industrial compounds and other toxic substances often leads to the formation of hepatitis, cirrhosis and death of the pet.

Hepatitis

Hepatitis is an inflammation of the liver tissue, in which there is no violation of its architectonics. The etiological factor is infectious agents, as well as poisoning by toxic compounds.

Pathogenesis consists of infiltration of the liver with viral metabolites, bacterial waste products or toxins, resulting in local inflammation of the tissue. Massive poisoning can lead to the development of cirrhosis.

Symptoms are usually represented by yellowing of the mucous membranes and skin, nausea, vomiting, abnormal stool, and general poor health of the animal.

Yellow mucous membrane in a cat

Hepatosis

Develops due to the accumulation of lipids in the liver. Hepatosis can occur against the background of existing pancreatitis, cholecystitis and other ailments. Most often, the fatty form occurs, less often - the pigmented form, in which the metabolism of bilirubin is disrupted.

The pet experiences dyspeptic disorders, loss of appetite and weight, and a depressed state.

Cirrhosis

Cirrhosis is a chronic liver disease in which a structural disorder of the organ’s architecture occurs and the formation of regenerated nodes against the background of fibrosis, that is, replacement of the parenchyma with connective tissue. The disease is characterized by a severe course that cannot be treated. As a rule, it develops against the background of hepatitis, which can occur due to a lack of vitamins, poor nutrition, toxin poisoning, the presence of stones in the bile ducts, and helminth infestation.

Symptoms of cirrhosis in cats include signs of intoxication, loss of appetite, ascites, and jaundice. In the terminal stage, liver failure occurs as a result of toxic damage to the brain - the animal can become aggressive, restless, and gait is impaired.

Liver cancer

Cats are susceptible to cancer. Liver cancer often develops. The origin of atypical tumor cells can originate from both the hepatocytes themselves and the bile ducts and other structures of the liver. Most often, malignant liver tumors are metastases, and their introduction is possible both hematogenously and lymphogenously. The disease is characterized by a severe course, ending in death.

Helminthiasis

Helminthiasis is a group of infectious diseases caused by parasitic worms. There are a large number of helminths that can infect the internal organs of cats. The most favorite habitat is the liver. Invasion of an organ by parasites leads to the gradual destruction of its structure. Without taking medications, liver cirrhosis develops. Read the article about deworming cats and kittens.

Infectious diseases

Cats are susceptible to infection by Leptospira bacteria. As a result of infection, leptospirosis develops. The disease affects the liver and other internal organs. Infection occurs through contact with other animals and their biological secretions.

The clinical picture is represented by hepatomegaly, ascites, but, as a rule, there is no jaundice.

Liver cancer treatment

In the treatment of liver cancer, none of the methods is highly effective:

• Chemotherapy. Its low effectiveness is due to the fact that the liver is a wastewater treatment plant for the body. Delivery of the drug to cancer cells is possible only if this ability of the liver is reduced (it needs to be “killed”). Chemotherapy is advisable only as an auxiliary treatment method after surgery to prevent the formation of metastases in other organs.
• Surgical treatment is more effective, but the problem is due to the fact that the liver has a complex histological structure. Violation of its structure at the cellular level (which occurs during a cut) leads to serious consequences, poisoning of the body and death. As a result, the tumor is removed along with the removal of a certain lobe of the liver (an incision is made along the border of the lobes).

As you can see, of all treatment methods, only surgical intervention makes sense. In addition, cats are saved by the strong segmentation of the liver (7 lobes, this is more than in humans). The method is segment resection, bisegmental resection or economical liver resection.

For a benign tumor of only one segment of the liver, surgical treatment can provide a favorable prognosis. In this case, the average life expectancy is 3-4 years, which is a very high figure for cats (their average life expectancy in general is 8-10 years).

With a malignant tumor of several lobes of the liver, the average life expectancy is six months, no more than 10-15% of animals survive up to a year, less than 5% survive up to 3-5 years. Unfortunately, metastases are often recorded in other organs (usually in the lungs and kidneys), which usually greatly reduces the survival rate of animals.

Diagnosis, treatment

When the first symptoms of liver disease appear in your pet, you should contact a veterinary clinic. The specialist first conducts an external and physical examination. At this stage, the presence of ascitic fluid, hepatomegaly, yellowness of the oral mucosa, eyes, and skin can be detected. Next, the veterinarian prescribes additional research methods.

1. A clinical blood test in the presence of an inflammatory reaction in the body is characterized by leukocytosis and an increase in ESR.
2. A biochemical blood test is aimed at determining the concentration of pigments, alkaline phosphatase and other criteria that may indicate the presence of liver disease.
3. X-ray of the abdominal organs can reveal an increase in the size of the liver, changes in its contours, the presence of abscesses and other pathologies.
4. Ultrasound accurately determines structural changes in the liver; in case of cirrhosis and other pathologies, it is possible to detect areas with increased echogenicity. In addition, the study allows you to estimate the size of the organ.

Treatment of the disease depends on the diagnosis. Determination of timing, dosage and choice of medication is carried out by a veterinarian.

For a bacterial infection, the veterinarian will prescribe a course of antibiotic therapy. The choice of drug, its dosage and duration of use is based on the type of pathogen.

If liver changes are detected due to autoimmune processes, it is advisable to prescribe glucocorticosteroids.

Also read the article on how to feed a pill to a cat.

Cirrhosis does not respond to drug therapy; only relief of unpleasant symptoms is possible.

Therapy for helminth infestation involves taking special medications. In severe cases, surgery is possible.

An important component of treatment is diet, which helps reduce the load on the digestive organs and speed up the healing process.

Mr. Cat recommends: prevention of liver diseases in cats

To avoid the occurrence of liver diseases in your pet, you need to monitor your pet’s diet - the menu should include all the necessary nutrients, and the portions and amount of food consumed should correspond to the age, breed, and weight of the pet. In addition, you should undergo routine vaccination and preventive administration of anthelmintic drugs in a timely manner.

The spleen is the main source of circulating lymphocytes; it acts as a filter for foreign particles and bacteria entering the body, and also produces antibodies. Finally, it is an organ that takes an active part in blood circulation; the spleen serves as a reservoir of red blood cells, which may be needed at a critical moment.

Important functions of the spleen are:

• immune function;
• hematopoietic function;
• filtration function;
• it is involved in the metabolism of iron and proteins.

According to research, dogs with short-haired breeds, such as boxers, bull terriers, Staffordshire terriers, Labradors and others, are most often susceptible to spleen diseases. In cats, the percentage of tumor diseases of the spleen is much lower. Moreover, there is no significant breed predisposition. If you look at age relationships, tumors most often occur in animals that are more than 7 years old. “New growths” that appear in the spleen can be either primary in nature or metastasize from other organs and tissues. They are divided into three types - these are lymphoid, hemangiosal and fibrous neoplasms, originating from the corresponding tissues, which are provided in the greatest quantities in this organ.

Treatment

The surgical method is the most effective in treating liver tumors.

The use of chemotherapy for primary liver tumors in medicine has not led to the expected results and has also proven poorly in veterinary medicine. Chemotherapy is used to treat systemic diseases such as lymphosarcoma. According to various authors (Weis et al., 2005), lymphosarcoma accounts for 7% of all liver cancers. It uses the SOP (vincristine and cyclophosphamide) and ASOP (vincristine, cyclophosphamide, doxorubicin) regimens. Chemotherapy in combination with surgery is also used for metastatic liver disease with tumors sensitive to chemotherapy. In a metastatic process, for example, from breast cancer, one of the possible regimens includes several drugs: 5-fluorouracil, cyclophosphamide and doxorubicin. The choice of regimens and doses of chemotherapy drugs depends on the morphogenesis of the tumor, the general condition of the sick animal, the results of blood tests, and the degree of dehydration.

The evaluation of the use of radiotherapy in animals with hepato-biliary tumors has not been well studied.

If the general condition of the animals is unsatisfactory, it is necessary to begin surgical treatment only after stabilization of the condition with the help of infusion therapy using antibacterial drugs, hepatoprotectors, etc.

In case of a single liver lesion, regardless of its morphological origin, a lobectomy or marginal resection of the affected lobe was performed. For a primary tumor, treatment is only surgical; for a metastatic process, the issue of using chemotherapy was decided in the postoperative period.

To perform a lobectomy, it is recommended to perform a combined approach to the abdominal cavity, which includes a median laparotomy, a lateral incision parallel to the caudal edge of the last rib, and resection of the falciform ligament. According to our data, 80% of tumors were localized in the left half of the liver.

After the above access, the affected lobe was isolated and two twisting ligatures were applied to its base. When applying the knot, the thread cut through the liver parenchyma and ligated the main vascular lines.

In case of multiple liver lesions, the extent of liver resection should be minimized and combined with local treatment methods, such as sclerotherapy and cryodestruction. In this case, it is more convenient to combine access with a Segal retractor.

Cryodestruction

Cryodestruction is based on rapid freezing of the tumor with liquid nitrogen followed by thawing, which leads to cell damage and death. This method can be used as monotherapy, and it is also used as an addition to lobectomy when ablastic tumor removal is not possible.

Alcoholization (sclerotherapy)

96* alcohol causes thrombosis of the arteries feeding the tumor, its ischemia and necrosis. The size of the tumor should not exceed 5 cm. The number of foci should not be more than 3-5, and the maximum dose should not be higher than 0.5 ml per kilogram of body weight. The introduction of alcohol must be done along the edge of the tumor until the color of the lesion changes.

As a rule, with multiple liver tumors, re-intervention by laparoscopy, performed 30 days after surgery, allows you to evaluate the effect of the treatment and, if necessary, repeat the local effect.

Macro- and microscopic structure of liver tumors

Liver tumors, according to the WHO tumor classification, are divided into:

1. A. Epithelial benign: hepatocellular adenoma, adenoma of the intrahepatic bile ducts, cystadenoma of the intrahepatic bile ducts.

B. Epithelial malignant: hepatocellular cancer, cholangiocarcinoma, bile duct cystadenocarcinoma, mixed hepatocholangiocellular cancer, hepatoblastoma, undifferentiated cancer.

1. Non-epithelial tumors: hemangioma, infantile hemangioendothelioma, hemangiosarcoma, embryonal sarcoma, etc.
2. Various other types of tumors: teratoma, carcinosarcoma, etc.
3. Unclassified tumors.
4. Tumors of hematopoietic and lymphoid tissues.
5. Metastatic tumors

In table 2 and 3 present our results of a morphological study of primary and metastatic liver lesions in dogs and cats undergoing surgical treatment

Table 2 Morphological types of primary liver tumors in dogs and cats (n=23)

Table 3 Morphological types of metastatic liver lesions in dogs and cats (n=21)

Analysis of the table shows that among primary liver tumors, hepatocellular cancer is the most common, which coincides with the data of the international veterinary literature. Metastases of breast cancer prevail over metastases from other organs. This is likely due to the large number of animals suffering from mammary tumors.

Treatment results and prognosis

For benign liver lesions, as well as for primary malignant lesions, with a single lesion, the prognosis ranges from favorable to cautious. In case of multiple liver damage or a metastatic process, the prognosis depends on the general condition of the animal, the functional reserves of the liver, as well as the condition of other vital organs.

Table 4. Life expectancy of animals depending on the type of tumor

With adequate treatment, the number of animals with metastatic liver damage that survived the one-year mark exceeded the number of animals with primary liver damage. This is due to the fact that in animals with liver metastases at the time of examination, 1-2 affected lobes were more often detected, and in animals with a primary malignant liver tumor at the time of diagnosis, as a rule, more than 3 affected lobes were detected (Table 4).

If the animal owners refused treatment, not a single animal lived for more than 6 months, regardless of the final diagnosis and the degree of damage.