Hepatic Lipidosis (Fatty Liver Disease)
Hepatic lipidosis is a condition in cats that occurs when the cat stops eating. There are a number of stressors that can result in a cat not eating (moving, new cat or person in the house, or general illness) or it can be due to an underlying disorder of the liver (such as a tumor). The body can tolerate 2-3 days without food, but if the cat does not return to eating, fatty liver disease will occur. As the cat’s system goes into a starvation mode it sends reserve fat stores to the liver to be used for glucose production. The liver becomes overloaded, begins to swell, and fatty liver disease results. The inflammation in the liver can also place pressure on the ducts responsible for transporting bile from the liver into the gall bladder. This causes bile to back up into the bloodstream and will result in a yellow color to the skin, eyes and gums.
*Yellow tint to the skin, or eyes
*Decreased activity level/ hiding
*Bloodwork (increased liver enzymes and bilirubin)
The treatment for hepatic lipidosis is food! It is very important to provide the body with useable energy sources. Many cats with this disease are so sick that they do not want to eat. Therefore, it may be necessary to use additional interventions.
Feeding tube (E-tube)
This tube is placed in the esophagus (throat) from the side of the neck and it stops just before entering the stomach. This allows an adequate amount of food to be delivered each day at home, and also provides a way to easily administer medications. The tube can stay in place for 2-3 months until your cat is eating sufficient amounts of food. Your cat will also be able to eat food with the tube in place. Bandage changes are recommended every 2 weeks.
These are given under the skin and help to rehydrate your cat as well as flush the body of the toxin buildup from liver by-products.
There is often infection in the bile ducts and liver and antibiotics are needed to combat the infection.
Vitamin B complex/ Folic Acid/ Vitamin K1
These are administered daily and are often given in the fluids that go under the skin. The liver is the source for storage and activation of B vitamins. When it is inflamed, your cat will become deficient in them. Intestinal absorption of vitamin K1 is decreased due to less food intake and your cat will benefit from supplementation.
This medication helps to thin the bile which then allows it to flow through the ducts more easily.
Denosyl or Denamarin
These nutraceuticals contain antioxidants and help support liver function while your cat recovers. These medications are not started until your cat has a decrease in vomiting as they can cause increased vomiting in the beginning.
Progress can be slow in cats with hepatic lipidosis. They will often vomit when the tube feeding is initialized; however, anti-nausea medications in addition to feeding small amounts of food are helpful in management of the vomiting.
Your cat will be examined weekly for the first few weeks to ensure the liver enzyme values are returning to normal. Once stabilized, your cat will be examined every 2 weeks to monitor progress. The feeding tube is ready to be removed when your cat has been eating well on his/ her own for 3 days. Sometimes cats will pull out the feeding tube themselves. If this happens, he/ she should be watched for interest in and eating of food before replacing the feeding tube.
The underlying cause of hepatic lipidosis cannot be determined by blood tests and clinical signs alone. In order to determine if the cause is something other than simply not eating, an ultrasound with a fine needle biopsy is required.
Cats who have had hepatic lipidosis at one time are more at risk for developing the condition again. Owners need to be aware and watch for subtle signs to catch the development of the disease early.
Although challenging, hepatic lipidosis is a treatable disease and many cats completely recover with patience and time.