Hepatic Lipidosis
“Fatty Liver”
This is a condition unique to cats. It represents one of the most common reasons of liver failure
for them. So, what is hepatic lipidosis? To explain the disease let’s first look at the evolution of
cats. Cats evolved as predators of small birds and rodents, eating multiple meals per day. They
are also completely carnivorous. By chasing, catching, and eating several small meals a day they
were always meant to be lean and not have any opportunity to develop excessive stores of fat.
This all changed when we began to domesticate cats. The modern house cat has a relatively
sedentary lifestyle with every opportunity to become overweight. A very big problem occurs,
when these heavy cats quit eating whether due to illness, food change, or environmental
changes. Normally in starvation mode the body moves its fat deposits to the liver for processing
into lipoproteins used to help support regular body function. The problem is that the feline liver
is not set up to handle huge amounts of fat. The infiltration of fats causes the liver to fail.
The hard part about treating hepatic lipidosis is that in order to recover the cats must take in
calories, but liver failure results in extreme nausea so the last thing these cats want to do is eat.
Symptoms can also include jaundice which is yellowing of the skin or eyes, and abnormal levels
of liver enzymes on blood work. The most important values on the blood tests are those for
Alkaline Phosphatase (ALKP) this enzyme should never be elevated in cats, Bilirubin, and
Alanine Aminotransferase (ALT). These values need to be checked regularly throughout
treatment.
Treatment for this condition requires bringing the cat out of a state of metabolic starvation. To
do this the cats must be given a high protein food either by force feeding or placement of a
feeding tube. Feeding amounts need to follow your doctors recommendations exactly on the
first day cats need to begin by eating 1/3 to ½ of their daily calorie requirement. Day 2 that is
increased to 2/3 of the requirement, with small increases until the cat is eating their daily
calorie requirement. Whether force feeding or feeding through a feeding tube, this forced
calorie intake often needs to be performed for 4-6 weeks to allow time for the liver to fully
heal.
Other problems can occur whether from the initial starvation or during the reintroduction of
foods to the cats body. Low potassium is a very common problem with the “fatty liver” cat.
Initially this is caused by fact that the cats is not taking in new potassium and is using up all that
is left. However when food is introduced into the system the pancreas releases insulin in hopes
of storing these calories. The release of insulin also drives the circulating potassium into cell and
out of circulation. This sudden drop can make cats very weak causing a drooping neck,
listlessness, an inability to urinate normally along with a variety of other symptoms. The release
of insulin also drives phosphate into cells. Since phosphate helps to maintain the structure of
the red blood cells, these blood cells can rupture from the depletion this can lead to severe
anemia. For these reason cats are often hospitalized for the first 3 days of nutritional support
for monitoring.
When aggressive nutritional support is given survival and recovery rates for Hepatic Lipidosis
approaches 90%. However, without nutritional support most cats will succumb to the disease.
Other ways to help support the liver during treatment:


SAMe-an antioxidant that has shown promise in supporting liver function.
 Milk Thistle-along with SAMe helps support liver function.
 Antibiotics-help to keep bacteria from over growing in the intestinal tract.
Vitamin K-helps supplement the Vitamin K that is unable to be recycled in the liver. This
is very important to clotting functions in the body.