Liver Tumor in Cat
Meet Pintas, our 12-year-old neutered domestic shorthair male cat who was presented to Al Barsha Veterinary Clinic in February 2022 for a follow-up on chronic gingivostomatitis. Upon routine physical examination, a big mass was palpated in the cranial part of the abdomen.
Complementary examinations were performed on Pintas which include blood sampling, x-ray imaging, and ultrasound.
- A complete blood count (CBC) indicated slight anaemia (with a hematocrit of 29%) and increased white blood cell count.
- Markedly increased liver parameters (ALT, ALKP) were noted.
- Xray – We performed then an abdominal radiograph that showed the presence of a circular mass with a tissular opacity of 9 cm x 5cm located in the cranial ventral portion of the abdomen. A thoracic radiograph was done after the abdominal finding to explore a possible intrathoracic metastatic spread and no abnormalities in the pleural space, nor the lung surface was identified. (as seen in Picture 1)
- Ultrasound – An abdominal ultrasonography was performed under sedation. Ultrasound is non-invasive and provides very good quality images for all abdominal organs, in particular, the liver parenchyma. The main finding was a big heterogeneous rounded mass (as seen in Picture 2) connected to the right liver lobe. The mass is measuring 9 cm in length and is pushing the right kidney. No sign of haemorrhage was detected. The other abdominal organs (spleen, kidneys, gastrointestinal tract, and urinary tract) were found normal.
Fine Needle aspiration Biopsy
To obtain a proper diagnosis and determine the nature of the liver mass, a biopsy under ultrasound guidance was performed. This procedure is done under sedation. Three samples were obtained and sent to a laboratory for interpretation (IDEXX laboratory – UK). The diagnosis was found to be a “Hepatocellular carcinoma”. This is a type of liver cancer. (as seen in Picture 3)
Surgery (hepatic lobectomy)
Pintas was pre-oxygenated. Anaesthesia was induced with medetomidine 5 μg/kg and butorphanol 0.25 mg/kg followed by propofol at a dose of 1.5 mg/kg. An endotracheal tube was placed and Pintas was maintained under anaesthesia with gas anaesthetics (a mix of Oxygen and Isoflurane).
A ventral midline approach to the abdomen was performed to expose the liver and the mass. Smooth dissection around the mass was performed and a ligature was placed to isolate the big mass from the rest of the liver. This step took approximately 40 minutes. The mass was excised completely. Pintas was kept under strict monitoring of his respiratory rate, heart rate, oxygen saturation, and non-invasive blood pressure and recovered uneventfully.
Discussion about Liver Tumors
Hepatocellular carcinoma in cats remains rare compared to other species (dogs and humans). There is a wide range of liver tumors in dogs and cats. Some are benign and others are malignant. The diagnosis relies on imaging techniques (mainly ultrasonography) and biopsies.
Common clinical features associated with liver tumours include weight loss (95%), loss of appetite (53%), lethargy (32%), diarrhea (21%), vomiting (21%) and palpable abdominal mass (21%) during a clinical examination.
Prognosis: It is rare for hepatocellular carcinoma to spread in other organs, so surgical resection results in improving the well-being and the survival time of cats ranging from 1 to 6.5 years despite advanced age at initial diagnosis. Picture 4 shows the actual 9cm hepatic mass removed from the liver lobe of Pintas.
Written by:
Dr. Mehdi Mzabi, ABVC Veterinarian and Marie Therese Alkassis, ABVC Vet Assistant
References: 1. Clinical Characteristics of Hepatocellular Carcinoma in 19 cats from a Single Institution (1980–2013) – S. Goussev, et al.- J Am Anim Hosp Assoc 52: (2016) 36–41 2. Non-lymphomatous hepatobiliary masses in cats. Lawrence HJ, et al.- Vet Surg 23: (1994); 365–368. 3. Small Animal Clinical Oncology. 4th ed. Liptak J, et al.- WB Saunders; 2007. 4. Hepatic neoplasia in the dog and cat. – Hammer AS, et al. -Vet Clin North Am Small Anim Pract 25: (1995);419–435. 5. The diagnosis and treatment of hepatocellular carcinoma. – J. Hartke et al. – Seminars in Diagnostic Pathology 34: (2017) 153–159.
