Cat with high bilirubin needs an ultrasound

QA few days ago my 11-yearold cat stopped eating after a history of chronic hairballs. She also has a small mass on her lower left lip that has been there for awhile. She has also gotten very lethargic, so I brought her in to her doctor, who noticed a fever and did blood tests that revealed a high level of bilirubin in her blood and urine. My cat has a history of a heart murmur and high blood pressure and takes amlodipine for it. The cat was started on antibiotics pending the blood test results. I got a call the next day and was informed about the bilirubin changes. What is bilirubin? It was explained to me but I’m still not clear. I was informed that there could be various issues going on, and the cat should have an ultrasound, which I now have scheduled. What could be going on? She is not an old cat but seems pretty sick.

ABilirubin is a substance found in bile and is made when red blood cells eventually break down after about 120 days in the body circulation. It leaves the body in the feces and give feces its natural color. When bilirubin levels are elevated, it is because there is a likely inability to get rid of it through normal mechanisms and usually indicates a problem. There are many possibilities in cats including pancreatitis, lymphoma, bile duct obstructions, liver problems like hepatic lipidosis or fatty liver, cholangiohepatitis, which also involves the gall bladder, and more. I do not believe that the lip growth is contributory at all. I concur that an ultrasound is probably necessary at this point, and medication alone may not resolve your cat’s problem. Surgery may be indicated as well. If addressed quickly enough, your cat should be fine unless you are dealing with a cancerous situation. Good luck.