When your hefty cat begins a seemingly self-induced diet, you may rejoice that they may finally lose those extra pounds. However, overweight cats whose appetite has suddenly decreased or is nonexistent can suffer from hepatic lipidosis (i.e., fatty liver disease), a serious, potentially fatal disease that is one of the most common acquired liver diseases in cats that every feline owner needs to know about and understand.

Since hepatic lipidosis can become an emergency situation, our West Vets ER team wants to clear up any confusion about this serious condition. Here are our answers to common questions about feline fatty liver disease.

Question: What is hepatic lipidosis in cats?

Answer: Hepatic lipidosis is a liver condition unique to cats that most commonly develops in overweight or obese, middle-aged cats. However, any cat who has been inappetent for a period can develop fatty liver disease. 

In cats, the liver plays a crucial role in triglyceride and protein synthesis, food digestion, and energy supply, and when they do not eat properly, the body shuttles fat to the liver to convert to energy. As the influx of fat stores overwhelms the liver, the fat is stored in and around the liver cells, further impairing liver function.

Q: What causes hepatic lipidosis in cats?

A: Inappetence is the major contributor to hepatic lipidosis development. If your cat does not eat for three or four consecutive days, their body will try to convert fat to energy and their liver will be overburdened. Identifying the cause of your cat’s anorexia is key to successful treatment and future prevention, as an underlying cause most often triggers the initial inappetence.

Conditions that can cause anorexia in cats include:

  • Dental disease
  • Diabetes
  • Inflammatory bowel disease
  • Pancreatitis
  • Respiratory disease
  • Kidney disease
  • Liver disease
  • Stress
  • Cancer

Q: What signs will I see if my cat has hepatic lipidosis?

A: Hepatic lipidosis will be preceded by an inappetent period. If your cat has not eaten well for a few days, they likely will develop other clinical signs that indicate fatty liver disease, including:

  • Rapid weight loss—often more than 25% of total body weight
  • Jaundice (i.e., icterus)
  • Vomiting
  • Lethargy
  • Weakness
  • Diarrhea
  • Dark urine
  • Abnormal bleeding or bruising
  • Bending down the neck and head (i.e., neck ventroflexion)

Q: How will my veterinarian diagnose hepatic lipidosis in my cat?

A: When your primary care veterinarian or our West Vets ER veterinarian hears that your cat has not been eating and has lost significant weight, hepatic lipidosis will top the potential diagnoses list.

Blood tests that show poor liver function help confirm the diagnosis, but a fine needle liver aspirate is needed to definitively say your cat has hepatic lipidosis. This aspirate can be accompanied by an abdominal ultrasound, which will also show widespread abnormalities throughout the liver. Examination of the liver aspirate should reveal cells full of fat.

Other diagnostic tests may be conducted to determine why your cat initially stopped eating, because knowing and treating the cause is critical for recovery.

Q: How will I treat hepatic lipidosis in my cat?

A: Treating hepatic lipidosis in your cat sounds as simple as feeding them, but getting a sick cat to eat is challenging, especially when they feel nauseous because of their liver disease. Trying to force feed your nauseous cat can result in food aversion, and cats with fatty liver disease often need a particular blend of nutrients to recover. 

The best way to ensure your cat gets what they need with minimal distress is a feeding tube. A nasogastric feeding tube that can easily be slipped into your cat’s nose works only for a few days, and cats with hepatic lipidosis require tube-feeding for at least a month or two, so an esophagostomy tube is a better long-term solution.

Once the feeding tube is placed, we will gradually reintroduce food to your cat. We may also prescribe medications or place an intravenous (IV) catheter to reduce nausea, support liver function, address dehydration, and correct electrolyte imbalances. 

At home, you will need to feed your cat through the esophagostomy tube, possibly for six to eight weeks, until they begin to eat on their own again. Every few days, you can offer your cat a small amount of their favorite food to see if they will eat any. Once your cat has been eating well on their own for several days, your veterinarian will remove the feeding tube.

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

A: The earlier hepatic lipidosis is identified and treated, the better your cat’s prognosis. With early, aggressive treatment, most cats survive an hepatic lipidosis episode and rarely suffer a relapse. Identifying and treating the underlying cause of your cat’s inappetence is critical.

If your cat hasn’t eaten in a day or two, you must seek veterinary care before the problem worsens. Give our West Vets ER team a call to schedule an after-hours appointment for your inappetent cat.