A condition unique to cats, hepatic lipidosis (i.e., fatty liver disease), primarily occurs if your feline friend is overweight or obese. However, because any cat can develop this potentially fatal condition, our Creature Comfort Veterinary Service team is providing you with information on how to spot this disease’s early signs, so you can ensure your cat receives immediate treatment, which can give your feline friend a good prognosis.

What is feline hepatic lipidosis?

Hepatic lipidosis is a common severe liver disease in cats. The liver is responsible for a range of bodily functions, including metabolism, fat digestion, coagulation factor production, and red blood cell decomposition. 

When the body is undernourished, fat reserves are moved to the liver to be converted into energy. As strict carnivores, cats are designed to subsist predominantly on proteins, so their bodies are not skilled at turning large amounts of fat into fuel. Excess fat accumulation within the liver’s cells ultimately interferes with the organ’s ability to function.

What causes feline hepatic lipidosis?

While the underlying cause of feline hepatic lipidosis is not completely understood, the initial trigger for this condition appears to be a period of inappetence, typically partial or complete anorexia for seven days or longer. Hepatic lipidosis most commonly affects middle-aged female cats who are overweight or obese.

In the majority of cases, a primary disease process causes inappetence and sets the stage for hepatic lipidosis. Diseases that can inadvertently lead to hepatic lipidosis include:

  • Kidney disease
  • Liver disease
  • Diabetes
  • Inflammatory bowel disease
  • Pancreatitis
  • Cancer

A primary disease process does not always lead to a cat’s inappetence. Less frequently, inappetence can be caused by the following environmental stressors:

  • Forced weight loss, with unacceptable food substitutions
  • Intercat bullying and aggression
  • Moving to a new home
  • Family structure changes
  • Boarding
  • Accidental confinement (e.g., getting locked in the basement or garage)
  • Becoming lost outside

What are feline hepatic lipidosis signs?

The first sign associated with feline hepatic lipidosis is a period of inappetence that can last from several days to weeks. The signs your cat exhibits depend on whether a primary disease process is occurring, such as the excessive thirst and urination that accompanies kidney disease. No matter the cause of your cat’s condition, once hepatic lipidosis sets in, your feline friend may exhibit the following signs:

  • Rapid and dramatic weight loss
  • Drooling
  • Jaundice (i.e., yellowing of the eyes, skin, and mucous membranes)
  • Vomiting
  • Diarrhea 
  • Muscle wasting
  • Depression
  • Downward flexion of the head and neck

How is feline hepatic lipidosis diagnosed?

Our Creature Comforts Veterinary Service team will ask you for a full history of your cat’s behavior, appetite, health status, and normal activities. After considering this information, our team may suspect that your cat has hepatic lipidosis and begin our diagnosis of the underlying cause for the condition. Potential stressors, such as moving, adding or losing a household pet or person, or an abrupt routine or environment change, are important to note, as are changes in your cat’s eating habits and appetite.

If we suspect your cat has hepatic lipidosis, we typically recommend blood work, imaging, and cytology to confirm the diagnosis. Blood work abnormalities that support a hepatic lipidosis diagnosis include:

  • Red blood cells of abnormal size
  • Red blood cell destruction
  • Nonregenerative anemia
  • Increases in liver enzymes
  • Increase in bilirubin levels
  • Clotting abnormalities

An abdominal ultrasound is typically the most useful imaging modality for confirming a hepatic lipidosis diagnosis because we can identify an increase in liver size and abnormalities in the liver, kidneys, gallbladder, pancreas, and other abdominal structures. During an ultrasound, we will take an aspirate of your cat’s liver to evaluate cells for the presence of fat, which is the most reliable way to confirm a hepatic lipidosis diagnosis.

How is feline hepatic lipidosis treated?

Feline hepatic lipidosis treatment is two-fold, consisting of providing the affected cat with appropriate nourishment and treating their underlying health issue. In many cases, our Creature Comforts Veterinary Service team will hospitalize your cat to provide them with initial therapy, helping ensure they are well on the road to recovery. Depending on the severity of your cat’s condition, treatment may consist of any of the following measures:

  • Intravenous (IV) fluid therapy to correct electrolyte and fluid imbalances
  • Thiamine, cobalamin, and B-complex vitamin supplementation
  • Antinausea medications
  • Tube feeding
  • Vitamin K1 treatment
  • Metabolic supplements
  • Liver health supplements

Our team will provide tube feeding and intensive nursing practices during your cat’s first few treatment days in the hospital. Once your cat is stabilized, we will release them, so you can continue tube feeding your furry pal at home, often for three to six weeks. A cat who survives a hepatic lipidosis episode rarely relapses, but early diagnosis and aggressive treatment are critical for helping ensure a good prognosis. 

If your cat has a decreased or nonexistent appetite for a few days, don’t wait, contact our Creature Comforts Veterinary Service team immediately. Early diagnosis and treatment for hepatic lipidosis offer an affected cat the best outcome.