Hepatic Lipidosis

Pet Tales
by Barry B. Burtis D.V.M.

Sally was called a 'full-figure' cat by her very caring owner. She said that was the most kind and gentle way to describe the fact that Sally, weighing just over 17 pounds, was at least 6 pounds overweight.

Sally lived a rather quiet, uneventful life until she was nine years old. The summer, after her ninth birthday, her owner took a 3 week vacation to England. It was a trip to celebrate retirement and it was the longest time she had ever been away from Sally. Sally was to stay in her own home and be cared for by a neighbour who would come in each day to visit her. It is usually the best way for cats to live when their owners are away.

The first week seemed to go quite well except for the fact that Sally was very shy, withdrawn and ran and hid every time her visitor arrived. This probably led to the calamity that occurred at the beginning of the second week. Sally disappeared. Her visitor searched everywhere in the house and although she was quite sure the door had been shut whenever she called, she searched the outside yard and garage as well. Never in her whole life had Sally been outside the house. However, though no more details are known, outside was where, somehow, she had gotten. Sadly, it was not confirmed until her owner arrived home nearly 2 weeks after Sally's disappearance and found her huddled beneath some lumber behind a garden shed. My, how different she now appeared. Her hair coat scruffy and unkempt, she was so much thinner and seemed very weak. Also, visible immediately, the inside of each of Sally's normally upright, pink ears was a stained yellow colour - almost as if they had been painted with iodine.

Sally was very jaundiced, her owner was told, when a veterinarian examined the forlorn and still frightened cat. Some blood tests were performed that confirmed she had liver problems. X-rays and an ultrasound examination of her abdomen revealed changes in the size and shape of Sally's liver. However, it required a liver biopsy to confirm that Sally was suffering from hepatic lipidosis. This disease is the most common cause of jaundice in cats, responsible for 50% of all cases.

Hepatic lipidosis or fatty liver is characterized by excess fat accumulation in the liver. It most typically occurs when a cat loses its appetite or fails to eat for several days to a week or so. Sometimes another disease is the reason for the change in eating. However, in at least 50% of cats identified with this disorder no other disease can be identified. In Sally's case it was literally the period of starvation she had survived for 2 weeks that led to the problem. No other underlying disease was found. Obesity before the time, increased the chances of her developing the disease.

Cats are unique in their tendency to develop this disease. Excessive amounts of fat are broken down from the cat's fat storage tissues during the fast. This fat is moved to the liver where it should be processed and sent out to other parts of the body. But, when this fails to happen because the rate of fat being exported, cannot keep pace with its arrival, liver cells become swollen with fat. Liver damage occurs as a result of this swelling and other processes that are initiated.

Unfortunately, once the disease develops cats feel ill and may not begin to eat again, even if the initial reasons for appetite failure are corrected. Symptoms commonly seen in cats with this condition are weight loss, lethargy, and vomiting in addition to the jaundice and loss of appetite, Sally experienced. Without rapid and aggressive medical treatment, 90% of cats with this disorder will die. 

Sally's treatment consisted primarily of aggressive feeding to supply her with her full caloric requirements. It is the only way to reverse the fat accumulation in the liver. Force feeding or encouraging appetite with new foods is seldom successful in affected cats. Sally had an esophageal feeding tube placed, through which she could be fed her daily food requirements, in a blended liquid diet. The use of long term tube feeding has changed the outcome in this disease from over 90% mortality to less than 30%. Sally's owner fed her via the tube for 6 weeks, in her home, with only occasional visits to the veterinary hospital. She began eating gradually increasing amounts of food, on her own, by the fourth week after tube placement. Two weeks later the tube was able to be removed. Sally proved once again that she was a survivor.

It is important to try and reduce the risk for this disease by keeping your cat a healthy weight and remember to report a loss of appetite in your cat to your veterinarian, promptly.