Hepatic Lipidosis

What is hepatic lipidosis (HL)?

Hepatic lipidosis (HL), or “fatty liver disease,” is the most common, potentially lethal liver disease in cats. HL is preceded by anorexia or weight loss, and the body’s starvation response mobilizes fat to the liver. Obese cats are more prone to HL. More than 90% of cats with HL have an underlying condition, such as inflammatory bowel disease, cholangiohepatitis, pancreatitis, environmental stressors, diabetes, respiratory infections, kidney disease, hyperthyroidism, or cancer.  

What are common HL signs in cats?

Early signs include:

• Reclusive behavior
• Unkempt haircoat
• Inappetance
• Weight loss

Intermediate to advanced signs include: 

• Vomiting
• Diarrhea
• Yellow gums and skin
• Drooling
• Weakness
• Collapse

How is HL managed in cats? 

HL management in cats depends on identifying and treating the underlying condition. Treatment includes aggressive nutritional support, and intravenous fluids to correct dehydration and electrolyte imbalances. If caught early, appetite stimulants may help, but HL usually requires surgical feeding tube placement to provide adequate nutrition and reverse the starvation process. The feeding tube is left in place for at least two weeks, or until the cat starts to eat voluntarily. Medications to cleanse the liver, supplements to protect cells from damage, vitamins, anti-nausea medication, or antibiotics are often recommended. An estimated 25% of cats require a blood transfusion. Cats with HL need regular veterinary visits and diagnostic tests to monitor their status and prognosis. Discussing a personalized management plan with your veterinarian is important for the best outcome for your cat. 

What is the prognosis for cats with HL?

The prognosis for cats with HL depends on the underlying condition and disease severity. Without aggressive nutritional support, the mortality rate for cats with HL can be more than 90%. Early intervention and tube feeding reduces the mortality rate to less than 40%. Cats with concurrent pancreatitis have a poorer prognosis.

Management tips for cats with HL  

At-home needs include:

• Easily accessible food, water, and litter box, and a comfortable location
• A palatable prescription diet 
• Consistency with prescribed medications and supplements
• Feeding small amounts of warmed food and water multiple times per day
• Maintaining feeding tube cleanliness and patency 
• Monitoring appetite, drinking, urination, vomiting, and diarrhea

For end-of-life care:

• Try to keep your cat safe and comfortable
• Ensure adequate nutrition and hydration
• Monitor for pain or discomfort
• Evaluate your cat’s quality of life with our scoring tool
• Track progression of their health with our calendar

In a crisis situation:

Contact your veterinarian immediately if your cat has uncontrollable vomiting or diarrhea, is weak or lethargic, collapses, or vocalizes in pain.

Before your cat‘s condition becomes unmanageable, or they begin losing their quality of life, beginning end-of-life care discussions is vital. Learn more about pet hospice, in-home euthanasia, and our teleadvice service, or contact a Lap of Love veterinarian in your area, so you can feel fully prepared for this difficult time.