While chubby felines can be adorable, extra weight in cats can lead to significant health problems, such as hepatic lipidosis (i.e., fatty liver disease). Although this condition can occur in healthy-weight cats, the vast majority of cases are overweight or obese cats. Left untreated, or caught too late, hepatic lipidosis can prove fatal in cats, so take the time to learn more about this serious liver condition. Our Just Cats Clinic team answers common questions about hepatic lipidosis in cats, so you will immediately know how to treat your cat should they become inappetent, which is often the first indication of hepatic lipidosis.

Question: What is hepatic lipidosis in cats?

Answer: Hepatic lipidosis is a unique feline condition that occurs when excess fat accumulates in the liver, which is the organ responsible for metabolism and digestion of fats, along with various processes related to the red blood cells and many other bodily functions. While the liver can break down and digest a “normal” amount of fat, the feline liver cannot emulsify large fat amounts. When a cat does not eat enough protein, their body draws on their fat reserves for energy, but as the body strives to metabolize fat for fuel, the liver cannot keep up, becomes overwhelmed by triglycerides, and poor liver function is the result.

Q: Why do cats develop fatty liver disease?

A: Cats are mysterious creatures, and finding the exact cause of many feline health issues is difficult. Hepatic lipidosis is a case in point in that no singular fatty liver disease trigger has been found. Despite this, a decreased or nonexistent appetite seems to spur hepatic lipidosis development in cats. Anorexia can be caused by a multitude of reasons that fall in one of two categories—disease processes or environmental stressors. Additionally, cats who are overweight or obese prior to inappetence are at a greatly increased risk for developing fatty liver disease, because they lose too much weight too quickly. 

Disease processes that can make your cat feel nauseous or too unwell to eat include:

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

Stress, which often interferes with a sensitive cat’s appetite, can be induced by:

  • Changes in routine, environment, or family structure
  • Poor litter box hygiene
  • Intercat aggression or bullying
  • Inadequate resources or enrichment
  • Getting lost outdoors
  • Getting trapped inside
  • Boarding
  • Forcing a diet change to a poor substitute

Q: How will I know if my cat has hepatic lipidosis?

A: If your cat goes through a period of poor or no appetite, monitor them closely for the following hepatic lipidosis signs:

  • Rapid and significant weight loss
  • Drooling
  • Jaundice
  • Lethargy
  • Vomiting
  • Diarrhea
  • Bending of the neck toward the chest

Other clinical signs may be apparent because of a primary disease process—for example, a cat with kidney disease or diabetes may exhibit excessive thirst and urination.

Q: What diagnostic testing will confirm hepatic lipidosis in my cat?

A: A detailed history of your cat’s clinical signs, behavior, and health status at home is key to adding hepatic lipidosis to the differential diagnoses. Oftentimes, diagnostic testing to detect liver issues will be performed because the owner describes the cat with yellow skin and a stress-induced poor appetite.

Diagnostic testing typically includes blood work, diagnostic imaging, and cytology of a liver aspirate. These tests will reveal evidence of liver damage and dysfunction, and the presence of excessive fat in the liver.

Q: How is hepatic lipidosis treated in cats?

A: The key with hepatic lipidosis treatment is finding nutrition your cat will tolerate. At the beginning disease stage, cats generally not only refuse to eat, but may also initially struggle with a nasogastric tube. However, with intensive care, treatment can graduate to an esophagostomy tube that will allow for easy administration of a high-protein, calorie-dense diet as your cat recovers at home.

Affected cats may need additional treatments, including:

  • Feeding tube
  • Intravenous fluids to correct fluid, electrolyte, and metabolic imbalances
  • Anti-nausea medications
  • Liver health supplements
  • Vitamin and dietary supplements

Treating the initial underlying inappetence cause is also key to your cat’s full recovery.

Q: What is the prognosis for my cat with hepatic lipidosis?

A: Cats with hepatic lipidosis who receive an early diagnosis, intensive treatment plan, and control of the underlying disease have a good prognosis. However, cats also diagnosed with pancreatitis have a poor prognosis. A cat who fully recovers from hepatic lipidosis, which takes an average of three to six weeks, rarely relapses.

Any change in your cat’s appetite is a serious cause for concern and should not be ignored. If you notice that your feline friend seems reluctant to eat, schedule an appointment with our Just Cats Clinic team as soon as possible.