Fatty Liver Disease (Feline)

by Petside Team

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Feline fatty liver disease or hepatic lipidosis is a potentially life-threatening syndrome in cats caused by excessive accumulation of lipid (fat) in the cells of the liver and resulting in evidence of liver insufficiency or failure.

Common name: Fatty liver disease/ syndrome Scientific name: Hepatic lipidosis

Diagnosis

Signalment Feline fatty liver disease, or hepatic lipidosis, commonly occurs in obese, middle-aged to elderly cats, though it can occur at any age. Most affected cats have a history of recent rapid weight loss, due to loss of appetite or underlying disease processes. Some studies have shown increased incidence in female cats, while other studies have shown no sexual predisposition.

Incidence/prevalence Although the exact incidence is not known, hepatic lipidosis is the most common liver disease in cats in North America.

Geographic distribution No geographic predispositions are known.

Clinical signs (primary, most to least frequent, scientific term, synonyms) Anorexia (loss of appetite), Weight loss, Icterus (jaundice‚Äîyellowish discoloration of the skin).

Clinical signs (secondary, most to least frequent, scientific term, synonyms) Vomiting, Causes (scientific, common term), Liver disease, Anorexia.

Organ systems affected (most to least affected) Liver, Gastrointestinal tract, Integument (jaundiced skin), Diagnostic tests, Serum chemistry, Blood coagulation tests, Serum electrolytes, Liver biopsy , Ultrasound and radiography, Differential Diagnosis, Other liver disorders (inflammatory, infectious, neoplastic, etc.), Hemolytic anemia.

Overview

Feline hepatic lipidosis or fatty liver disease is a potentially life-threatening condition and is the most common liver disease in cats. It is most frequently seen in obese, middle-aged to older cats, though it can occur at any age.

Hepatic lipidosis is caused by excessive accumulation of lipid (fat) in liver cells due to increased mobilization of body-fat stores. Excessive lipid mobilization may occur due to an underlying, undiagnosed disease condition (e.g., infection or neoplasia), or it may occur in situations where external stressors (e.g., diet change, household change, boarding, etc.) result in a cat's refusing to eat for several days.

In either event, body fat is mobilized to the liver, where it accumulates in liver cells. As the amount of lipid in the hepatocytes increases, the cells can no longer perform their normal functions, and evidence of liver insufficiency develops. If the lipidosis progresses, eventually liver failure occurs.

Initial signs of fatty liver disease in cats are non-specific and consist primarily of anorexia (loss of appetite) and weight loss. As liver injury progresses, cats become icteric (jaundiced), lethargic and dehydrated, and may develop vomiting, diarrhea, disorientation, incoordination, seizures and increased tendency to bleed. In some cases, severe alterations of blood-clotting factors and serum electrolytes lead to potentially fatal bleeding or abnormal function of other organs, such as the heart or kidneys.

Treatment

Home Care Cats with hepatic lipidosis will rarely recover with home care alone. Encouraging eating by offering tempting foods or heating foods may be attempted in anorexic fat or obese cats to help avoid the development of hepatic lipidosis.

Cats returning home from veterinary care will need to be maintained on a good-quality cat food, and their food intake will need to be monitored closely.

Professional Care Most cats with fatty liver disease or hepatic lipidosis will need aggressive veterinary intervention. Blood work to measure liver enzyme values, blood-clotting ability, serum electrolytes and other parameters will be needed to assist in diagnosis.

A liver biopsy is often recommended to confirm the presumptive diagnosis and rule out other potential causes of liver failure. Ancillary tests such as ultrasound and radiology may also be recommended.

Action Severely affected cats may need therapy, including intravenous fluids, vitamin K-1 (important to produce blood-clotting factors), blood transfusions and nutritional support. One of the most important measures in successful treatment of hepatic lipidosis is getting the cat back on a positive nutritional plane, through either force-feeding or placement of a feeding tube.

Cats with severe alterations of serum electrolytes or blood clotting may require that these parameters be corrected before a feeding tube can be inserted or a liver biopsy performed. Supplementation with L-carnitine, taurine and vitamin E has often been recommended in cats with hepatic lipidosis. Once the lipidosis is under control, diagnostics and treatment for underlying disease may be necessary.

Outcome Mortality rates from felinefatty liver disease or hepatic lipidosis range from 15 percent to 40 percent. Cats with underlying disease conditions may have a poorer prognosis.

References/Additional Readings

Center, Sharon. Hepatic Lipidosis in Cats. Proceedings of the 74th Annual Jack Mara Western Veterinary Conference, Las Vegas, NV, 2002.

Johnson, Susan E. Hepatic Lipidosis. In: C√¥t√©, Etienne, ed. Clinical Veterinary Advisor. St. Louis: Mosby, 2007; 493-495.

Author

Sharon Gwaltney-Brant DVM, PhD

DABVT, DABT

Diplomate American Board of Toxicology

Editor

Steven Hansen, DVM, MS, MBA

DABVT, DABT