Hepatic lipidosis, more commonly known as fatty liver disease, is the most frequently seen form of severe liver disease in cats. The liver has many complex functions, including the production of chemicals necessary for digestion and the detoxification of the body. It also plays an important role in metabolism. Because of its vital importance, the body has no way of compensating when the liver fails.
While hepatic lipidosis is considered idiopathic, which means that the cause is not known, it is almost always preceded by anorexia, a cat’s nearly total avoidance of food. When a body is undernourished or starved, it starts to metabolize its own fat reserves for energy. Cat’s bodies are not able to convert large stores of fat. When a cat is in starvation mode, the fat that is released to the liver is not processed efficiently and is simply stored there, leading to a fatty and low functioning liver.
Hepatic lipidosis is usually a secondary cause of an underlying or already present condition such as obesity, diabetes, cancer, hyperthyroidism, pancreatitis, kidney disease, or another type of liver problem. Cats who are already overweight are more prone to this condition than normal weight cats.
- Anorexia. A previously healthy cats stops eating. Whenever a cat goes for more than 24-48 hours without food, this is cause for concern.
- Vomiting and/or diarrhea
- In the latter stages, yellowing of the skin, eyes, and mucuos membranes
Diagnostics will include a complete blood count, blood chemistry and urinalysis. Typically, blood test will show an elevation of liver enzymes and bilirubin, and may also reveal abnormally sized red blood cells. High levels of bilirubin may also be present in the cat’s urine. X-rays and ultrasound may show an enlargement of the liver. Your vet may also want to obtain biopsies of liver tissue.
The goal of treatment is to nourish the cat immediately by giving IV fluids, vitamins and concentrated nutrition. The cat may initially be hospitalized for a few days. While syringe feeding may be possible, in most cases, cats require a feeding tube. While many cat guardians balk at the idea of a stomach tube, it is usually a better solution than force-feeding via syrings, especially since in most cases, force feeding will need to continue for a period of 3-6 weeks, even once the cat is recovering at home. Lisa Pierson, DVM has an excellent article on Feeding Tube for Cats on her website.
At the same time, it is also critical that the underlying cause of the hepatic lipidosis is identified, so appropriate treatment can be initiated without delay.
If diagnosed early, and if the cat survives the first few days of aggressive treatment, the prognosis for a full recovery is excellent. If left untreated, the condition is fatal. The good news is that most cats who survive an episode of hepatic lipidosis usually don’t have a relapse.
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