What is Hepatic Lipidosis?
Hepatic lipidosis in cats is a liver condition mainly affecting overweight animals. It occurs when a cat stops eating, causing the body to rely on fat reserves for energy. This process overloads the liver, which becomes unable to efficiently process fats, leading to excessive fat accumulation and liver failure.
When the liver fails to function properly, toxins accumulate in the blood, causing general discomfort. Affected cats often lose further appetite, lose weight, experience vomiting, and dehydration. Severe cases can result in neurological complications, coagulation disorders, and increased mortality risk.
Causes of Hepatic Lipidosis
The condition may arise without a clear cause but is often linked to an underlying issue causing anorexia. Potential causes include:
- Liver diseases (tumors, inflammation, infections, gallstones)
- Intestinal diseases (obstructions, tumors, inflammatory infiltrates)
- Pancreatitis
- Urinary diseases (renal failure, infections)
- Neurological conditions
- Viral or parasitic infections (FIP, FeLV, FIV, toxoplasmosis)
- Hyperthyroidism
- Poisoning
Diagnosing Hepatic Lipidosis
Diagnosis involves evaluating symptoms observed by the owner and a physical examination, particularly noting jaundice (yellowing of the skin) and ascites (abdominal fluid accumulation). Tests recommended for confirmation include:
- Complete blood panel (including thyroid hormone levels in cats over 6 years)
- Bile acid measurement
- Urinalysis
- FeLV and FIV screening tests
- Abdominal X-rays and ultrasound
- Liver biopsies, often necessary for definitive diagnosis
Treatment for Hepatic Lipidosis
The liver has a high regenerative capacity if the underlying cause is treated. Treatment focuses on:
- Correcting dehydration and electrolyte imbalances
- Stopping fat breakdown through sufficient feeding
- Supporting liver function and preventing complications
- Controlling infections and associated issues
Nutritional Management
Stopping the breakdown of fatty tissues requires appropriate and regular feeding. The cat must receive calorie-rich food in sufficient quantities. If the cat refuses to eat voluntarily, feeding tubes (esophageal or gastric) placed under anesthesia are often recommended.
Advantages of Feeding Tubes:
- Ensures adequate nutrition
- Allows progressive reintroduction of food through small meals
- Simplifies medication administration
Refeeding Protocol:
- Day 1: 25% of nutritional needs
- Day 2: 50%
- Day 3: 75%
- Day 4: 100%
If poorly tolerated, increase the portions more slowly (+10% per day). Wait at least 2 hours between meals to prevent gastric complications.
Tube Maintenance:
- Blend and strain food to avoid blockages
- Rinse tube with 5 ml warm water before and after each meal
- If blocked, use a small amount of cola
- Consult a veterinarian if persistent blockages occur
Alternatives to Feeding Tubes
If tube placement isn’t possible, syringe feeding can be an alternative, maintaining the same meal size and frequency. However, this method can stress the cat and increases aspiration risk.
Complementary Treatment
- Intravenous fluid therapy for dehydration
- Broad-spectrum antibiotics to prevent infections
- Antinausea and antivomiting medications
- Vitamin K to prevent coagulation disorders
- Hepatoprotective medications
- Physical stimulation and social interaction for improved well-being
Prognosis and Follow-up
The prognosis for hepatic lipidosis in cats varies based on severity and treatment responsiveness. Primary hepatic lipidosis has an 80-85% survival rate with aggressive treatment involving feeding tubes. Without intervention, survival drops below 15%.
When an underlying cause exists, prognosis is more guarded (approximately 50%). Regular evaluations are crucial to adjust diet and treatments according to the cat’s progress.
If your cat shows signs of hepatic lipidosis, promptly contact your veterinarian to ensure optimal care.
