What is feline hepatic lipidosis?
Feline hepatic lipidosis is a condition seen in cats in which the liver accumulates a large amount of fat and the liver cannot function normally. It is the most common form of liver disease seen in cats, and it unique only to our cat patients.
Why does hepatic lipidosis occur?
A sudden loss of appetite or sudden cutback in caloric intake is a big trigger for feline hepatic lipidosis. We most often see this condition when a cat stops eating, especially an overweight cat. Your cat may stop eating for a number of reasons such as stress, illness, concurrent liver disease or injury. We also tend to see this condition when there is a change in the cat’s food and the picky kitty simply refuses to eat the new diet. It is very important as a cat owner to be alert for a change in your cat’s appetite and monitor it daily. If your kitty refuses to eat altogether, you need to get her to the veterinarian immediately.
After a short time without food or adequate daily calories, a few days at most, a cat’s body will begin sending fat cells to the liver to convert to energy. The problem begins because cats’ bodies cannot metabolize fat efficiently at all and their liver starts to fail.
It is important to remember your cat is designed by nature to kill small prey and eat it several times a day. Cats were not built to eat large meals or nibble constantly throughout the day.
Cats also need a mostly carnivorous diet and are designed to be very active, lean animals; their bodies were never meant to store a lot of fat. This explains why cats’ livers cannot handle the fat mobilization that occurs in response to lack or insufficient quantities of food. The buildup of fat cells in the liver prevents normal functioning. Needless to say, if left untreated, the liver ultimately fails and tragically, cats may pass away from this condition.
What are the clinical signs associated with hepatic lipidosis?
How will your veterinarian diagnosis hepatic lipidosis?
A thorough history as well as clinical signs and a physical exam will help clue your veterinarian into the diagnosis. The diagnosis is also supported by blood tests such as a complete blood count and chemistry panel. The chemistry panel will indicate that the liver is damaged. The liver enzymes ALP, ALT and AST will be elevated. The bilirubin (a breakdown product of red blood cells, which is normally eliminated by the liver) can be increased above normal as well. High cholesterol and ammonia levels are common. The results of a bile acid test would be abnormal. Some cats may be anemic, and have decreased clotting ability in their blood. Radiographs and ultrasound may further support the diagnosis of hepatic lipidosis. If you veterinarian suggests radiographs of the abdomen, they want to see if the liver is enlarged. The best way to definitively diagnose hepatic lipidosis is through a biopsy of the liver or a fine needle aspirate of the liver.
How is hepatic lipidosis treated?
The keys to successful management of cats with hepatic lipidosis are early diagnosis and intensive nutritional support and here at the Veterinary Center of Hudson we do just that.
Change in Diet: Cats will need to have nutritional support for 3-6 weeks. Your cat will be fed a high-protein, calorie-dense food.
Feeding Tubes: In almost all cases, a feeding tube needs to be placed. This tube can be inserted through the side of the cat into the stomach, through the nose and into the stomach, or into the esophagus and down to the stomach. The type of tube used depends on the size of the cat, the seriousness of the illness and the preference of the veterinarian and owner.
Fluids and Electrolytes: Many cats with hepatic lipidosis are dehydrated. If your cat has had significant vomiting, the potassium level in the blood is often low and needs to be supplemented.
Vitamin Supplementation: The liver is responsible for making the factors that help blood to clot. It needs vitamin K to do this. Normally, the liver stores vitamin K so it is readily available. Cats with hepatic lipidosis may need supplemental vitamin K to correct a coagulation problem. A multiple vitamin supplement is also recommended. Thiamine deficiency can occur as a result of long periods of anorexia, so thiamine supplementation is of particular importance.
L-Carnitine is a supplement helpful in transporting fats. Taurine is an amino acid that helps bind certain types of toxic bile acids for their removal from the body. It is usually deficient in cats that have not been eating properly and short term (7-10 days) supplementation is a good idea for cats with lipidosis.
Gastrointestinal Medications: Certain drugs such as famotadine (Pepcid) are often used to prevent ulceration of the stomach or intestine. Medications such as metoclopramide are often given to decrease vomiting and stimulate the movement of food through the stomach and intestine.
What is the prognosis for cats with hepatic lipidosis?
Even with intensive care, approximately 35% of cats with hepatic lipidosis pass away from the disease. Cats who do recover generally do so in 3-6 weeks, however, some may need continued nutritional support for months. Generally, the damage to the liver is reversible, and the condition rarely recurs.
** If you have any questions or concerns regarding your cats or other pet’s health please call 234-380-8624 and schedule an appointment with either Dr. Shaker or Dr. Bestic! For more information please visit www.vetcenterofhudson.com