What are Gallstones?
Though gallstones are rare in cats, the presence of large stones is a medical emergency as the stones can block the bile from being released and cause problems with the liver, digestive system and the kidneys.
The cat's gallbladder is a small, balloon-shaped organ that is located in the lobes of the liver. Its primary function is releasing bile into the digestive tract to aid in the digestion of food. Cholelithiasis is a condition that causes small stones, or choleliths, to form in the gallbladder. These stones are typically made of calcium carbonate mixed with other secreted substances and minerals.
Symptoms of Gallstones in Cats
Symptoms may be mild or not present at all until the gallstone blocks the flow of bile from the gallbladder. Typical symptoms include:
- Lack of appetite
- Weight loss
- Abdominal pain
- Jaundice, which will present with yellowing of the inner ears, whites of the eyes and mucous tissues
- Frequent changing positions or stretching
- Frequent wandering or pacing
Gallstones can be divided into two different types, which are categorized depending on the minerals that combine with calcium carbonate to form them:
- Black-pigment gallstones are composed of bilirubin polymers
- Brown-pigment gallstones are composed of calcium bilirubinate
Causes of Gallstones in Cats
There are several different reasons why cholelithiasis occurs in cats. These causes include:
- Malfunction of the gallbladder
- Bile sludging, which causes the bile to thicken and slow down
- Bacterial infection
- Nutritional imbalance, such as consuming too much calcium or cholesterol
Diagnosis of Gallstones in Cats
The veterinarian will need the cat's complete health history, which will include any history of gallstones, a detailed list of all of the cat's systems and an approximate date when the symptoms first began. Because many of the symptoms of gallstones are also present with more serious diseases, such as liver disease, gallbladder inflammation, bile duct inflammation and pancreatitis, these conditions will need to be ruled out.
A complete blood count, biochemical profile and urinalysis will be ordered by the veterinarian. These labs will look for the presence of an infection that could be causing the gallstones and help to rule out other conditions or diseases. Because most gallstones don't contain enough minerals to be detected on a radiograph, X-rays are rarely done but could be ordered if the veterinarian suspects another condition that is identifiable by an X-ray.
Ultrasound imaging will be done of the cat's abdominal area. The ultrasound will look for the presence of gallstones, inflammation of the liver, blockage of the bile duct, thickened gallbladder walls or an oversized bile duct tract. An ultrasound can detect gallstones that are two millimeters or larger in size.
Treatment of Gallstones in Cats
Small gallstones that aren't causing symptoms or digestive problems may not need any treatment. These stones are typically found during an ultrasound for another condition, such as pregnancy.
Antibiotics will be prescribed to the cat to clear infections or bacterial complications that are causing the gallstones to form. Antibiotics may also be prescribed before surgery in order to prevent infection from occurring after surgery. Ursodeoxycholic acid may be prescribed twice a day in order to dissolve small gallstones that aren't blocking the bile duct. S-Adenosylmethionine, or SAMe, may also be given in order to improve bile production and function of the liver.
In addition to medication, the doctor may recommend that the cat receives supplements intravenously. Vitamin K1 will be given to treat jaundice and vitamin E will help reduce inflammation in the liver and gallbladder.
If the gallstones are blocking the bile duct, are causing cystic duct obstruction or are causing gallbladder inflammation, surgery will be necessary. The veterinarian will determine the best surgery for the cat's individual situation. If gallstones have formed in the past, the veterinarian may elect to remove the gallbladder from the cat. If this is the first time gallstones have formed, the veterinarian may remove only the gallstones from the gallbladder or bile duct opening, retaining the gallbladder.
During surgery, the cat will be placed under general anesthesia. An incision will be made in the cat's abdomen and gallbladder. The gallstones will be removed before the gallbladder is closed with dissolvable sutures. Gallbladder surgery carries a risk of infection and of gallstones forming once again in cats who only have the gallstones removed rather than the entire gallbladder.
Recovery of Gallstones in Cats
With proper diagnosis and treatment, the prognosis is positive after gallstone treatment. The cat will need to follow up with the veterinarian two weeks and four weeks after surgery. The veterinarian will look for any signs of infection and remove sutures when necessary. An Elizabethan cone will need to be worn in order to prevent the cat from licking or biting its sutures. Any redness or pus at the incision site or fever may indicate infection. If these signs occur, the cat should be brought back to the hospital immediately.
Regular ultrasounds or blood tests may need to be done to monitor the function of the liver and the bile system. Because the gallbladder helps digest ingested fat, a low-fat, high-protein diet may be recommended by the veterinarian that will need to be continued throughout the cat's life.
Gallstones Questions and Advice from Veterinary Professionals
4 year old cat was vommitting and not moving around. Brought her into her vet who saw that her ALT levels were 1600. They sent her home and suggested the ER vet if she wasnt feeling better. I brought her to the ER vet that next night because she was trying to puke again and not moving. They kept her overnight for 3 nights, giving her liver enzymes, stuff for puking, appetite stimulus, and also vitamin K. THey did an ultrasound and needle test on the liver to test it. THey found the biliary tree was inflammed and there was minneralization in her gallbladder which was also seen on xray. Her ALT has gone down to 800, then 300, and now is at 240. She is now home and on 4 meds, one to help with appetite, one to stop vommitting, one antibiotic, and one for her liver. She is to get rechecked within 1-3 weeks depending how she is doing at home with blood work and another ultrasound. I feed her Natural Balance Limited Ingredient Venison and green pea dry food. I am wondering if you have any advice with a diet to prevent these gallstones from forming or to help them go away. She had sores in her mouth when she was young they thought was from allergies that is why i do the grain free and not poultry. But interested in trying that again or any alternative that can help.
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My cat has been in and out the vet with liver failure he’s been on medications since Saturday to see if bilirubin leaves have improved needless to say they are at a 12.2 but is eating and acting more normal she thinks he has stones
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Right now his vet is more concerned on getting him tomorrow for a steroid shot in them more bloodwork in a week or two I am really concerned on if my babies going to live or not
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6-year-old female cat was having problems urinating (pee small amounts only - sit long time trying - plus urinary frequency) none of the other symptoms mentioned were there. Vet did antibiotic shot first & when that didn't help, prescribed Veraflox and that didn't work either. Took x-ray that showed 1 large stone and 3 smaller ones and said cat needed surgery. Got surgery and vet says the stones will come back if I feed it anything other than "Royal Canin s/o + calm" canned food for the rest of her life. I'm 76 years old trying to live on social security $750 per month. I have $1,200.00 CareCredit bill (for her surgery, etc) that has to be paid off in 12 months; so I wanted to supplement with some other less expensive cat foods. Vet said that, if I give her any amounts of any other foods, those would totally negate results of Royal Canin and her stones would come back. I'm not sure I can manage to pay the $100 per month for that credit card bill but definitely can't afford another $50 per month on top of that for her special food. (she eats almost a can and a half of those 3 oz cans a day). Are there any alternatives? Can't afford the food or another surgery and can't imagine just letting her die (especially after spending 1200 dollars that I don't have to save her life).
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