• Hepatic lipidosis, or fatty liver disease, is the most common liver disease of cats in North America.
  • It is caused by inadequate food intake or by diseases that may cause a cat to lose its appetite.
  • Diagnosis may require blood tests, abdominal radiographs (x-rays), abdominal ultrasonography, and a liver biopsy.
  • Treatment requires intensive feeding, often through a feeding tube, which may remain in place for several weeks or months.
  • Many cats require initial hospitalization, followed by home care and periodic blood tests.

What Is Hepatic Lipidosis?

Hepatic lipidosis, also known 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 liver cells, causing liver dysfunction.

What Causes Hepatic Lipidosis?

The cat’s unique metabolism requires food on a daily basis. Any time a cat doesn’t eat for a few days, fat may be deposited within liver cells. A cat may lose its appetite 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, the cat often refuses to eat anything, even the most delectable treat.

In many cases, cats lose their appetite because of underlying diseases, such as diabetes, pancreatitis (inflammation of the pancreas), inflammatory bowel disease (IBD), kidney disease, or heart disease.

What Are the Signs of This Disease?

Cats with hepatic lipidosis are usually middle aged and often female. Typically, they are overweight and 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 appetite without help. If left untreated, these cats will often die.

How Is Hepatic Lipidosis Diagnosed?

Your veterinarian may recommend a number of blood tests to help diagnose if your cat has hepatic lipidosis and to determine if there is an underlying disease that may be causing it. Cats with fatty liver disease typically have elevated liver enzymes, a change that can be detected through blood testing. Another blood test, called a bile acids test, may also be recommended, so the veterinarian can assess how well the liver is functioning.

Abdominal radiographs, or x-rays, typically show an enlarged liver in cats with this disease. Your veterinarian may also recommend abdominal ultrasonography.

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.

How Is This Disease Treated?

Most cats with hepatic lipidosis are extremely dehydrated and require initial hospitalization and fluid therapy. The most critical aspect of treatment, however, is ensuring that the cat receives adequate nutrition. Depending on your cat’s condition, you may be able to try force-feeding your cat high-protein, high-calorie gruel through a syringe. However, most owners have little success with this approach, and it may cause the cat undue stress.

In most cases, the veterinarian will recommend that a feeding tube be placed 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. Your veterinarian may recommend placing a wider tube through the cat’s neck, into the esophagus and stomach, or through the abdominal wall directly into the stomach. These feeding tubes are fairly well tolerated and need to remain in place until the cat is eating on its own, which may take several weeks or even months.

Your veterinarian will recommend a diet for tube feeding and calculate the exact amount of food your cat should receive daily. It’s important that you follow these recommendations closely to help your cat’s liver return to its proper function.

Before and after each feeding, the tube should be flushed slowly with warm water. The food should also be warmed slightly and administered slowly, to prevent vomiting. Your veterinary care team will show you how to care for the feeding tube at home and how to administer food and water to your cat.

Your veterinarian may recommend other medications, such as appetite stimulants, antivomiting medications, and antibiotics. There are several supplements that also may be helpful.

If your veterinarian has diagnosed other diseases in addition to hepatic lipidosis, these conditions will require treatment as well. The prognosis is best for cats diagnosed with hepatic lipidosis only.

When you are tube-feeding your cat at home, your veterinarian will schedule recheck examinations with periodic blood tests to monitor your cat’s progress. Once your cat is eating on its own, the feeding tube may be removed.