Hepatic lipidosis (fatty liver disease) is a syndrome characterized by an accumulation of excessive amounts of lipid (fat) within the cells of the liver, abnormal bile flow within the liver, and impaired liver function. Severe impairment of liver function may affect the liver's ability to detoxify the blood. As toxins accumulate, they can affect the mental status of the cat, leading to mental dullness, severe depression, and seizures. Hepatic lipidosis can occur as a primary event, or it can occur secondary to other disease processes, such as diabetes. It is the most common liver disease encountered in cats.

Adult cats of either sex can be affected. Any breed of cat is susceptible. Middle aged to older cats are most likely to be affected. Hepatic lipidosis can be a serious disease. Even with aggressive therapy, a significant number of cats die from the condition.

The cause of hepatic lipidosis remains unknown. Obesity is thought to be a predisposing factor, as most (but not all) affected cats are obese at the time of disease onset. A period of anorexia (decreased appetite), occurring as a result of a stressful event (such as the addition of a new pet or family member, or a sudden change to a less palatable diet) can trigger the onset of hepatic lipidosis.

What To Watch For

Anorexia

Loss of muscle mass

Vomiting

Drooling

Jaundice (yellow tint to the whites of the eyes and possibly the skin inside the ears)

Severe depression

Possible seizures

Diagnostic Tests

The diagnostic tests needed to confirm the presence of hepatic lipidosis and exclude other liver disorders include:

Complete medical history and physical exam. This includes examination of the gums, whites of the eyes, and other part of the body for jaundice (yellow discoloration).

Blood tests and urine analysis to confirm that the liver is affected

Bile acid test to assess how well the liver is functioning

Abdominal x-rays to evaluate the liver

Abdominal ultrasound. This is a painless procedure in which a probe is held against the abdomen and is used to detect valuable information about the health of the liver.

Fine-needle aspirate of the liver. This technique allows for a small sample of liver cells to be obtained and evaluated.

Liver biopsy. Obtaining a biopsy specimen (a small piece of the liver) is the definitive test for making a diagnosis of hepatic lipidosis.

Treatment

Dietary therapy is the mainstay of treatment. Affected cats may need to be force fed, or fed through a tube in the nose, esophagus, or stomach. Hospitalization is usually required for the first few days. Treatment for hepatic lipidosis may also include some or all of the following:

Medication to control vomiting

Drugs that help control gastrointestinal bleeding for cats that develop stomach ulcers

Medications that help control the mental signs of hepatic lipidosis in severe cases

Blood transfusion if the impaired liver cannot normally regulate blood clotting

Appetite stimulants

Drugs to improve bile flow within the liver

Home Care and Prevention

Follow all feeding instructions very carefully, as dietary therapy is the most important aspect of therapy.

If a nasal, esophageal, or stomach feeding tube has been inserted, follow all instructions as to the care and maintenance of this tube, and report any problems to your veterinarian immediately.

Give all medications and dietary supplements as directed.

Although the actual cause of the disorder is unknown, obesity and anorexia have been noted to be associated with the onset of disease. Therefore avoid overfeeding your cat to prevent obesity and avoid stressful situations that may cause a cat to suddenly stop eating, such as the addition of a new pet or family member, or suddenly changing your cat's diet.