What is it?
The liver has several vital functions for life:
Cats have a vital need for proteins made by the liver, so when the liver is not functioning properly, malnutrition quickly develops. Hepatic lipidosis is a condition resulting from an excess of fat within the liver. It is commonly triggered when a cat stops eating. During a period of starvation, the body moves fat from its reserves to the liver. A cat’s liver has a limited ability to cope with large amounts of fat, so this sudden rush of fat reduces liver function. Hepatic lipidosis, or ‘fatty liver’ occurs when more than 50% of the liver cells become full of fat. Hepatic lipidosis is often a condition of middle aged, obese cats, but it can occur in any cat.
Why is it important?
Hepatic lipidosis may occur secondary to other illness such as cancer of the liver, liver damage due to paracetamol poisoning, pancreatitis, hyperthyroidism, inflammatory bowel disease, inflammation of the liver, and diabetes. 50-98% of cases are secondary to other diseases. The rest are idiopathic (cause unknown).
Reduced liver function can have serious, life threatening consequences. Hepatic lipidosis often requires intensive treatment in a veterinary practice or even a hospital facility.
What is the risk?
If untreated, hepatic lipidosis can develop into a condition called hepatic encephalopathy (HE) where toxins accumulate and cause inflammation around the brain, leading to seizures. Coma and death may then occur.
What happens to the cat?
The cat will not want to eat, often for 2-7 days. They will usually have some vomiting. Sometimes diarrhoea or constipation occurs. The cat may be jaundiced (yellowing of gums, skin, and the tissues surrounding the eyes) due to accumulation of bile pigments in the blood. The cat may become very sick and be showing signs of hepatic encephalopathy such as seizures, or pressing the head into corners or walls.
How does the vet know what is going on?
When the animal is examined in the clinic, they may have been off their food for several days. They may be jaundiced. Your vet will usually recommend blood and urine tests, ultrasound of the liver, and a liver biopsy, which will all help towards a diagnosis.
What can be done?
There are a range of treatment and management options, and in most cases several will need to be used together.
How can I protect my pet?
It is very important to feed your cat an appropriate diet which avoids them becoming obese. If your cat is vomiting, or stops eating for 24 hours or more, get them checked out by your vet as soon as possible, as early diagnosis and treatment are associated with better outcomes.
More than 60% of hepatic lipidosis cases will recover with intensive treatment.
Idiopathic (cause unknown) cases usually have a good prognosis with treatment. The prognosis for secondary hepatic lipidosis depends on the underlying disease. Recovery can take weeks to months. There are significant costs associated with hospitalisation and intensive treatment, and sadly it is sometimes an appropriate decision to euthanase cats who are seriously ill with this condition.