Hepatic Lipidosis

Hepatic lipidosis is a liver condition of cats also known as “fatty liver disease”. Fatty liver disease can result from diabetes, pancreatitis, or another condition, but in most cats it occurs when they stop eating for a period of time. Signs of hepatic lipidosis include refusal to eat, weight loss, digestive upset, and jaundice (yellow discoloration of the skin). Cats with this disease are very sick and require hospitalization for IV fluids, medications, and often a feeding tube. In addition, whatever caused the disease must be treated. With treatment, the disease is often reversible. Left untreated, it’s a killer.

Overview

Hepatic lipidosis, also known, unappetizingly, as “fatty liver disease,” is the most common liver disease of cats in North America. As the name implies, fatty liver disease is a condition in which fat accumulates inside the liver cells, thereby causing liver dysfunction.

The cat’s unique metabolism requires food every day. Any time a cat doesn’t eat for a few days the normal metabolic pathways are altered and fat may be deposited within liver cells as a result.

A cat may lose its appetite or stop eating for any number of reasons, such as an abrupt diet change, stress (e.g., a new pet in the house), or if someone forgets to feed it. Once this occurs and hepatic lipidosis is well underway, the cat often refuses to eat anything, even the most delectable treat.

Underlying diseases such as diabetes, pancreatitis (inflammation of the pancreas), inflammatory bowel disease (IBD), kidney disease, or heart disease can cause a cat to lose its appetite and develop hepatic lipidosis. Aggressive weight-loss plans (amounting to starvation) have also been accused of initiating this process.

Symptoms and Identification

Cats with hepatic lipidosis are usually middle-aged and often female. Typically, they have been overweight and suddenly begin to lose weight rapidly.

Signs of fatty liver disease include:

  • Anorexia (loss of appetite)
  • Weight loss
  • Lethargy (loss of energy)
  • Vomiting
  • Diarrhea or constipation
  • Jaundice (yellowing of the skin, whites of the eyes, or gums)

Most cats with hepatic lipidosis are extremely sick and will not regain their appetites without help. If left untreated, these cats will usually die.

There are a number of blood tests to help diagnose hepatic lipidosis and determine whether an underlying disease is to blame. Cats with fatty liver disease typically have elevated liver enzymes, a change that can be detected through basic blood testing. Another blood test, called a bile acids test, may also be recommended. This allows the veterinarian to assess how well the liver is clearing the body’s toxins.

Abdominal radiographs (X-rays) typically show an enlarged liver in cats with this disease. Abdominal ultrasonography (ultrasound) is also incredibly helpful in these cases, to check for cancer or other disease processes can cause liver enlargement.

The clearest way to diagnose hepatic lipidosis is with a liver biopsy. In some cases, a needle may be used to take a small sample of the liver. This procedure is relatively painless for the cat and can often be done during the ultrasound examination. However, the sample is relatively small, so diagnosis may be difficult. In such cases, the cat may need to be anesthetized so the veterinarian can surgically open the abdomen and obtain a slightly larger sample of the liver tissue.

Additional tests may be required to determine if other diseases led to the cat’s loss of appetite. These diseases must be treated to ensure resolution of hepatic lipidosis.

Affected Breeds

There is no known breed predilection for hepatic lipidosis in the cat. Overweight cats are predisposed.

Treatment

Most cats with hepatic lipidosis are dehydrated and require hospitalization and fluid therapy. The most critical aspect of treatment, however, is ensuring that the cat receives adequate nutrition. Depending on a cat’s condition, force-feeding cats high-protein, high-calorie gruel through a syringe at home may be possible. However, most owners have little success with this approach, and it may cause the cat undue stress, thereby exacerbating the condition. Hospitalization is required for almost all patients.

In most cases veterinarians will recommend placement of a feeding tube to ensure that the cat receives proper nutrition. A very narrow tube may be inserted down the cat’s nose and into the stomach, so that a liquid diet may be administered into the tube using a syringe. However, some cats will not tolerate this, and the narrow tube limits the amount and type of food that can be administered. Placing a wider tube through the cat’s neck, into the esophagus and stomach, or through the abdominal wall directly into the stomach may be a better option. These feeding tubes are fairly well tolerated and need to remain in place until the cat is eating on his own, which may take several weeks or even months.

Other medications, such as appetite stimulants, anti-vomiting medications, and antibiotics may also be required. There are several nutritional supplements that may also be helpful.

If your veterinarian has diagnosed any other underlying conditions in addition to hepatic lipidosis, these conditions will require treatment as well.

Prevention

The best means of prevention for hepatic lipidosis is to remain vigilant in assessing a cat’s weight, feeding, and litterbox habits. Cats that skip more than a few meals or experience significant declines in the amounts of food they are eating should be examined by a veterinarian. Also, any rapid weight loss, even if it initially seems desirable, should be a signal to seek veterinary attention.

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