Diet recommendations for cats with liver disease vary depending on the underlying liver disease. Similar to dogs, cats can develop inflammation, infection, and cancer in their liver. Diets that are specially formulated for liver disease in cats often have high quality and highly digestible proteins in moderate quantities to minimize the chance of hepatic encephalopathy (neurologic impairment secondary to liver failure) while maintaining liver function. Other things to look for in prescription liver diets are L-carnitine, which is an amino acid that helps maintain normal fat metabolism in the liver, reduced sodium to minimize fluid retention that can occur with liver failure, and antioxidants to minimize cell oxidation.
A common form of liver disease found in cats is hepatic lipidosis (“fatty liver disease”). This type of liver disease typically develops in overweight cats with reduced caloric intake. Often times there are underlying medical problems, such as pancreatitis, that cause their appetite to be suppressed. The most important diet consideration for cats with fatty liver disease is adequate calories. This typically can not be achieved by simply feeding a cat, or with the aid of appetite stimulators. Often times to adequately achieve the required caloric requirements for a cat with fatty liver disease a veterinarian must place a feeding tube.
The feeding tube options are nasoesophageal, esophagostomy, or gastrotomy. A nasoesophageal tube is typically the easiest for a veterinarian to place. However, it is often only used in a veterinary clinic and the lumen diameter is very small so it can be difficult to administer anything other then liquid. An esophagostomy tube can be placed in a cat during a short general anesthetic procedure. The tube exits from the side of the cat’s neck and extends through most of the esophagus. A gastrotomy (stomach) tube placement requires general anesthesia and is more involved to place then an esophagostomy tube. It can be placed during abdominal surgery, or with the guidance of an endoscope. It goes directly into the stomach and has a port on the side of the body. Both the esophagostomy and gastrotomy tubes are easy to use and allow the cat to receive an adequate amount of calories.
A cat with fatty liver disease does not necessarily need a prescription liver diet. The most important aspects of a diet for a cat with fatty liver disease are the following: high caloric density, palatable, and able to be tube fed. It can take weeks to resolve fatty liver disease but with proper nutrition a cat has a good chance to recover.