Fatty Liver Disease in Cats

Fatty liver disease (hepatic lipidosis) in cats occurs most frequently when an overweight cat has a dramatic decrease in the amount of food they eat over the course of days to weeks.  Often times there is an underlying medical condition, such as pancreatitis, that will cause them to become sick and not feel like eating.   In other situations, a cat will become stressed over changes in their environment, such as a new puppy in the house, and eat less.  With either scenario a cat will become very ill if they develop fatty liver disease. Fatty Liver Disease in Cats

Clinical signs of Fatty Liver Disease in Cats

The first clinical sign of fatty liver disease is a decrease in appetite and decrease in energy level.  Often times cats will hide and become less interactive during this stage of disease.  The clinical signs might go unnoticed because the clinical signs might be subtle.  As the disease progresses over days to weeks the clinical signs will become more noticeable.  Cats will often times stop eating completely.  They also can start vomiting and become jaundiced.  This happens because they have gone into liver failure.  At this point they still can be treated but their prognosis is guarded to poor without proper treatment.  It is important to keep in mind that cats can develop other forms of liver disease, such as lymphoma or cholangiohepatitis, that can cause the same clinical signs.

Diagnostic Testing for Fatty Liver Disease in Cats

The diagnosis of fatty liver disease in cats should be made by physical examination, blood work, ultrasound of the liver, and cytology of the liver. A fine-needle aspirate of the liver is a relatively simple procedure that often times can be done in a cat without  sedation or anesthesia.  A needle is guided into the liver and cells are extracted with a needle and syringe.  These cells can be analyzed to determine if a cat has fatty liver disease.  A biopsy of the liver is more difficult to perform, requires anesthesia, can cause life threatening bleeding, and is not necessary to diagnose fatty liver disease.   However, it is necessary to take a biopsy of the liver to diagnose other forms of liver disease, such as cholangiohepatitis.

Treatment of Fatty Liver Disease in Cats

The primary treatment for fatty liver disease in cats is food.  Appetite stimulants and other medications generally don’t work well enough.  The only way to consistently get enough food in a cat with fatty liver disease is by placing a temporary feeding tube.  To do this requires general anesthesia.  The two most common feeding tubes used to treat fatty liver disease in cats are an esophagostomy tube and a percutaneous endoscopic gastrostomy tube.   If the cat with fatty liver disease is getting enough calories through the feeding tube the metabolic process that causes fatty liver to occur will stop.  This will allow the liver to recover and the cat to feel better and start eating on their own.  A cat with fatty liver disease will often need to be treated with other medications, such as gastric protectants, intravenous or subcutaneous fluids, liver supplements, and possibly certain vitamins.   Within the first 1-2 weeks of starting tube feedings a cat with fatty liver disease most likely will start to eat on their own.  The prognosis is often good with fatty liver disease in cats if the appropriate treatment is started before the cat becomes too sick.

If you are concerned about chronic liver disease in your dog, click here. To learn about liver shunts in dogs and cats, click here.

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Dr Peter Nurre

Peter Nurre, DVM, Diplomate ACVIM (internal medicine) is a board- certified veterinary internal medicine specialist. His professional interests include internal medicine and cardiology.

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