The Skinny on Fatty Liver: Hepatic Lipidosis in Cats

Cats have a reputation for being fussy about food, and the slightest stressor often can convince them to go on a hunger strike. When cats go several days without eating, they are at risk for developing a condition called hepatic lipidosis—or fatty liver. Hepatic lipidosis can make an already sick cat feel significantly worse and can cause liver shutdown and death when left untreated. Fortunately, the Urgent Pet Care Omaha team can successfully treat around 90% of cats with fatty liver. Here is an overview of why the condition develops and how our team manages this disease.

What is hepatic lipidosis in cats?

Hepatic lipidosis (HL) occurs when cats go several days without eating or eat very little for several weeks. This mobilizes fat from their body stores, causing them to lose weight rapidly. To use fat for fuel, it must be processed in the liver. During HL, the liver cells become overloaded with fat and can no longer do their job of detoxifying the body.

The signs of HL often overlap with other diseases that may have caused the cat to stop eating in the first place. Signs include:

• Vomiting
• Diarrhea
• Lack of appetite
• Weight loss
• Yellow color to skin or eyes (i.e., jaundice)
• Lethargy
• Dark urine
• Bruising or bleeding

Which cats are most at risk for developing hepatic lipidosis?

Any cat can develop HL at any age, but some cats are statistically more likely than others to develop the condition. The main risk factor is obesity because overweight cats have more fat that is easily and quickly mobilized to the liver during times of low food intake. Underlying health conditions that cause poor appetite, such as inflammatory bowel disease or cancer, also put cats into a higher risk category. Situations in which cats can develop HL include:

• Behavioral stress
• Becoming trapped (e.g., in a closet or the garage) or getting lost
• Lack of appetite from underlying disease
• Rapid food changes

How is hepatic lipidosis diagnosed in cats?

If your cat comes to our urgent care facility with signs suggestive of HL, we will perform a complete physical examination and check a blood panel to obtain a minimum information database. We also will collect a thorough history to determine if reduced food intake has occurred, for how long, and why. If you don’t know why your cat has stopped eating, we may order additional tests to find the underlying cause and to confirm the HL diagnosis. Additional tests may include:

• X-rays
• Abdominal ultrasound
• Ultrasound-guided liver biopsy
• Urinalysis
• Endoscopy

How is hepatic lipidosis treated in cats?

HL must be treated aggressively to achieve a good outcome, which requires commitment from the pet owner. The main goal for initial treatment is to stabilize the cat’s condition using fluids, medications that protect liver cells and improve their function, and supplemental vitamins. For treatments to work, the cat must start eating again. Once the body is getting dietary fat, the liver can clear the excess fat from its cells through normal processes.

The majority of cats with HL will not eat on their own, so the veterinary team must place a feeding tube. The tube typically is placed through the skin of the neck into the esophagus so that food, water, and medications can be delivered directly without force-feeding the cat, which usually only makes things worse. The feeding tube must remain in place for at least a few weeks until the cat reliably eats on their own. Our veterinary team can teach pet owners how to use and maintain a feeding tube at home, but they still will need to bring their cat in periodically for incision checks and bandage changes. Additional treatments also may be needed if another underlying or co-occurring condition is identified.

What is the long-term outlook for cats who develop hepatic lipidosis?

Most treated cats recover well from HL, but they can relapse if they lose their appetite again in the future. Cat owners can prevent HL in high-risk cats by monitoring food intake and intervening when necessary, helping overweight cats lose weight slowly over time, and bringing cats in for routine care to identify and treat diseases that may lead to lack of appetite. Offering a variety of food textures to kittens can help them accept food changes more readily as adults.

Hepatic lipidosis can affect any cat. If your cat stops eating or develops signs that could indicate HL, contact the Urgent Pet Care Omaha team for convenient care for your feline when you need it most.