Alpine Animal Hospital
Debra M. Taylor, D.V.M.
Patti A. Tuck, D.V.M. Emily A. Lewis, D.V.M.
2202 E. M-32
Gaylord, MI 49735
(989)732-6427
(989)732-4561 Fax
Email: info@alpineanimalhospitalmi.com
www.alpineanimalhospitalmi.com
Feline Hepatic Lipidosis
(Fatty Liver Syndrome)
Hepatic lipidosis, also known as fatty liver syndrome (FLS), is one of the most common liver disorders of the cat. It
is also seen in horses, dairy cows and rarely in very young puppies. In dogs, however, it is not thought to cause a
significant illness. In humans, it is a serious disease which can occur with pregnancy.
Contributing Factors
In most cases, the cause remains undetermined (Idiopathic FLS). Obesity and a period of anorexia lasting at least
one week are common historical findings. Less commonly, the fatty liver syndrome occurs secondary to a disease
that might lead to anorexia, such as cancer or an infectious disease.
Prevalence
Idiopathic fatty liver syndrome is most common in cats that are overweight. Many of these cats have lost up to 25%
of their body weight when the liver problems are discovered. Also, most cats with idiopathic fatty liver are middle
aged and female.
Clinical Signs
In the anorexic cat, fat is broken down to supply energy for normal metabolism. As this fat is mobilized, it is
deposited in the liver. Without an adequate source of dietary protein, the fat cannot be removed from the liver. It
continues to accumulate until liver failure eventually results.
With time, the cat usually becomes icteric or jaundiced, as evidenced by a yellow color in the whites of the eyes or in
the skin. As toxins normally processed by the liver continue to build up in the blood, the nervous system becomes
affected. Depression, seizures, disorientation, and head pressing will occasionally occur.
Causes/Transmission
As noted above, for most cats, a cause is not determined. In a few cases, fatty liver develops secondary to a disease
that causes anorexia.
Diagnosis
Diagnosis of the FLS is made from blood tests for liver function and from a liver biopsy or fine-needle aspirate. The
latter involves inserting a very tiny needle through the skin and into the liver, removing a small number of liver cells,
and examining those cells under the microscope. The FLS cat will have a large amount of fat in and among the liver
cells.
Therapy
This disease is treatable, but aggressive intervention is necessary. The main thrust of treating FLS is geared toward
nutritional support of the cat until it begins to eat voluntarily. A consistently high quality diet will allow the liver to
resume functioning so it may remove the fat. This does not occur quickly; it takes an average of 6-7 weeks.
Therefore, a method of tube feeding must be used to allow you to feed your cat at home.
Several routes are available for feeding the cat. We have chosen to use the esophagostomy tube, which is a small
rubber tube that enters through the cat's skin in the neck. It goes into the esophagus so that food can be delivered to
the stomach. It does not go into the stomach because of complications that can arise.
A special food mixture, listed below, is syringed through the tube three to five times per day. This food is
formulated to meet the cat's nutritional needs; it should not cause vomiting or diarrhea. To feed your cat, follow
these steps:
1. Place 1 can of Feline p/d* + 10 oz of water + 2 oz of Wesson Oil* + 8 Tumil-K* tablets in a blender and run it at
the liquefy (fastest) speed until the food is uniformly mixed. After mixing, pour the food through a kitchen strainer.
2. Remove the cap from the feeding tube.
3. Using the syringes provided, inject the food into your cat's feeding tube using the following schedule:
____ ml ____ times per day for ____ days (FOR A TOTAL OF ____ ml PER 24 HOURS)
then
____ ml ____ times per day for ____ days (FOR A TOTAL OF ____ ml PER 24 HOURS)
then
____ ml ____ times per day for ____ days (FOR A TOTAL OF ____ ml PER 24 HOURS)
then
____ ml ____ times per day (FOR A TOTAL OF ____ ml PER 24 HOURS).
4. When the food has been injected, inject 5 ml of tap water through the tube so food does not remain in it; replace
the cap in the tube.
5. Any remaining food should be stored in the refrigerator. Before the next feeding, it should be warmed to body
temperature under hot tap water or in a microwave oven. If you heat it in a microwave oven, be sure to thoroughly
mix the contents prior to feeding because of uneven heating. Also, always check the temperature prior to feeding to
be sure that it is not too hot.
Persistence is essential. The average cat requires 6-7 weeks of feeding before it begins to eat. At least once weekly,
offer your cat a small amount of its favorite food so that you will know when its appetite returns. The
esophagostomy tube will not hinder chewing or swallowing. After your cat has been eating well for 3-4 days, it
should be returned to the hospital for tube removal. Removal of the tube is simple and does not require anesthesia;
however, you should not attempt to remove the tube yourself.
Persistence is essential. The average cat requires 6-7 weeks of feeding before it begins to eat. At least once weekly,
offer your cat a small amount of its favorite food so that you will know when its appetite returns. The
esophagostomy tube will not hinder chewing or swallowing. After your cat has been eating well for 3-4 days, it
should be returned to the hospital for tube removal. Removal of the tube is simple and does not require anesthesia;
however, you should not attempt to remove the tube yourself.
Prognosis
In most cases of idiopathic FLS, the prognosis is good if nutritional intervention is undertaken before the onset of
liver failure. When the underlying cause of the FLS is untreatable, the prognosis is not good.
Vomiting is an important sign in determining the prognosis. Although many cats with the FLS will vomit
occasionally, those that vomit repeatedly have a lesser chance of recovery. Repeated vomiting usually means that the
liver failure is very severe or that a disease of the pancreas (pancreatitis) is also present. Either may result in the cat
not recovering.
Transmission to Humans
There is no associated health risk for the owners of cats with hepatic lipidosis.
Prevention
It is possible for idiopathic FLS to occur again. It is helpful for owners to be observant of the cat’s food intake and
guard against stressors that might precipitate anorexia. Maintaining an ideal body weight and avoiding obesity in
affected cats is advisable.