In this video Dr. Karen Becker discusses a very common and potentially deadly liver disease: feline hepatic lipidosis, or fatty liver syndrome.
By Dr. Becker
Today we're going to discuss a very serious condition: feline hepatic lipidosis, which is also called fatty liver syndrome.
It's the most common liver disease in cats in the U.S.
It's also a disease that is unique to cats – it doesn't occur in any other animal.
Any breed of cat at any age is at risk for this disease, but what's interesting is that fatty liver syndrome is most commonly seen in middle-aged, fat cats that drop weight too quickly.
The condition can also be secondary to other feline diseases, but its occurrence is most often idiopathic, meaning we don't know exactly what causes it.
There are some triggers, however.
Why Does Feline Hepatic Lipidosis Occur?
A sudden loss of appetite or sudden cutback in caloric intake is a big trigger for feline hepatic lipidosis.
I most often see this condition when a client decides to change the cat's food and the picky kitty simply refuses to eat the new diet. So you need to be alert for a change in your cat's appetite and monitor it daily. If your kitty refuses to eat altogether, you need to get her to the veterinarian immediately. After a short time without food or adequate daily calories – a few days at most – a cat's body will begin sending fat cells to the liver to convert to energy.
And that's where the problem begins, because cats' bodies don't metabolize fat efficiently at all.
Keep in mind your kitty is designed by nature to kill small prey and eat it several times a day. He was not built to eat large meals or nibble constantly throughout the day.
Also, cats need an entirely carnivorous diet. So cats are designed to be very active, lean animals; their bodies were never meant to store a lot of fat. Evolutionarily, this explains why cats' livers can't handle the fat mobilization that occurs in response to lack or insufficient quantities of food.
The buildup of fat cells in the liver prevents normal functioning. Needless to say, if left untreated, the liver ultimately fails and tragically, cats can and do die from this condition.
Symptoms and Diagnosis
Symptoms of fatty liver syndrome include:
- Excessive drooling (caused by nausea)
- Weight loss
In the latter stages of the disease, we see lethargy, jaundice (yellowing of the skin), dramatic weight loss, and sometimes seizures.
Definitive diagnosis of feline hepatic lipidosis is made through a liver biopsy, which will reveal excessive amounts of fat within the liver cells. However, a reasonable and accurate diagnosis can also be made by taking a history (especially if the cat's eating habits have changed), and during a physical exam by checking for weight loss, muscle atrophy and/or jaundice.
Blood tests can also reveal problems with liver function, so it's possible to get a pretty accurate diagnosis just from the history, physical exam and bloodwork. Feline hepatic lipidosis is very treatable when caught early. Keep in mind it only takes a few days for anorexia to occur and for this condition to come along right after.
Sometimes your kitty might still be nibbling at her food, but not eating enough to sustain her body weight. It only takes about two weeks of a cat eating half her normal caloric intake for fatty liver disease to develop.
Treating Feline Hepatic Lipidosis
Nutritional support is the treatment for this disease. This unfortunately means force-feeding, often by tube, until the kitty's natural appetite kicks back in.
The tube-fed diet is liquid and should be balanced – it is often called a recovery diet for metabolic balance, and it is designed to place minimal stress on the liver.
Sometimes a feeding tube must be inserted into the cat's stomach through an incision in the side or through the nose or esophagus.
You'll need to feed your cat through this tube until he's voluntarily consuming food on his own again. It typically takes four to six weeks for recovery with nutritional support, but it can sometimes take as long as 18 weeks. So it's a long haul, but the good news is your cat can recover his health, in most cases.
During the force-feeding treatment, you'll also need to offer your cat small amounts of her regular food. I recommend at least once a day offering regular food, because as soon as your kitty is consistently eating on her own, within a matter of days the feeding tube can be removed.
You'll go back to your veterinarian and he or she will remove the feeding tube and also draw more blood to insure the liver enzymes are back to normal. Most cats go back to their regular lives after this treatment. Your vet will repeat bloodwork regularly until all values are normal.
I recommend you also talk with your holistic vet about liver detoxification supplements to help the liver regenerate itself.
Cats suffering from an advanced stage of hepatic lipidosis, with jaundice, seizures, or sometimes other secondary cascading metabolic problems, should be hospitalized. These kitties will need IV fluids to treat dehydration and promote the flushing action of the liver.
There are many reasons why cats lose interest in food. It's very important to find out the underlying reason and treat the cause before hepatic lipidosis has a chance to develop.
Sometimes painful dental problems or social or emotional issues (for example, adding a new cat to the family) will cause a kitty to stop eating. And sometimes there are several things occurring simultaneously, so the goal is to sort all that out to determine the cause(s) of your cat's lack of appetite.
Since we see this disease most often in obese cats who suddenly drop a significant amount of weight, needless to say, the best prevention is to not let your cat get fat in the first place.
And if your kitty is already heavy, it's extremely important not only that she lose weight, but that it's done very, very slowly.
I have some great videos on this site that help explain step by step how to help your overweight cat slim down in a way that won't be risky to her health.
Because of fear of hepatic lipidosis, veterinarians have stressed to cat owners the need for their pets to eat consistently. Unfortunately, many folks have decided the best way to accomplish this is to free-feed an all-day, all-kitty-can-eat-buffet of dry kibble .
But what free-feeding often does is make a cat obese, which of course predisposes him to the very disease the pet owner hoped to avoid.
A much better approach is to feed your cat species-appropriate nutrition in a set portion of calories served twice a day. It's much easier to maintain your cat's ideal body weight by feeding a precise number of calories in the morning and again in the evening.
If your cat suddenly refuses to eat, make an appointment with the vet right away. When a dog doesn't seem hungry, it's safe enough to wait a day or two before considering calling the vet. With kitties, anorexia warrants an immediate vet visit.
If your cat's appetite trails off and you notice she's just nibbling at her food, it's okay to monitor the situation for a day or two. But if within a couple of days she hasn't regained a healthy, normal appetite, it's time to make an appointment with the vet to check into potential underlying reasons for kitty's loss of interest in eating.
A Final Word about Cats and Calories...
I really can't stress enough the need for cats to consume adequate calories on a daily basis.
Many people mistakenly believe, 'If my cat gets hungry enough, he'll eat.' This isn't true, and it's a dangerous assumption.
Also, anyone who wants to transition a cat to a better quality diet (from dry to canned, for example, or from canned to raw) needs to do it very gradually to ensure kitty is getting the calories he needs every day.
Unlike humans, dogs, and in fact many other animals that can safely fast, cats cannot live without food for long. So it is important to keep a watchful eye on your pet's calorie consumption and contact your vet if you see his appetite falling off.