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Hepatic lipidosis in cats

Ilga D. Drozdetskaya
Ilga D. Drozdetskaya
Veterinary Gastroenterologist of the "Two Hearts" Clinic, head of educational projects for veterinarians and pet owners of MTU VetClub
Hepatic lipidosis in cats

Many of the early warning signs of a developing disease in a pet are often overlooked. Periodic gastrointestinal disturbances such as vomiting and diarrhea, decreased appetite, or refusal to eat¹ can be signs of a health issue in cats. 

It is important to note that even short periods of starvation, lasting from 1 to 4 days, can cause acute liver dysfunction and even death in cats. This may occur due to developing hepatic lipidosis caused by starvation. A visit to the veterinary clinic and prompt therapy can save your pet's life. It is important to act quickly.

What is lipidosis?

Fatty liver disease, also known as hepatic lipidosis, is a common non-inflammatory disease of the feline hepatobiliary system. It can be fatal.

Excessive accumulation of triglycerides (fats) in liver cells causes the pathology. This leads to an increase in cell size, liver mass, and impairs its functions. It also causes intrahepatic cholestasis (impaired passage of bile through the bile ducts) to develop. Obese and overweight cats are more prone to this condition and tend to experience a more severe form of hepatic lipidosis.

What causes hepatic lipidosis to develop?

Prolonged starvation triggers the pathologic process. The concept of duration is individual for each animal and each case: starvation for 4 or more days is considered critical, but in practice veterinarians encounter hepatic lipidosis in cats starved for only 1-2 days.

Lipidosis is categorized as primary, commonly referred to as 'idiopathic,' meaning that the cause is not fully understood. In this case, food refusal may occur due to stress or a sudden change in diet.

Secondary lipidosis develops as a result of other systemic pathologies. What are these pathologies?

  • Pancreatitis
  • Diabetes mellitus
  • Cholangiohepatitis
  • Kidney disease
  • Endocrine diseases
  • Oncological Diseases
  • Viral infections, etc.

How does lipidosis manifest itself clinically?

In fact, the only sign of liver disease the owner may notice is jaundice. 

If you notice that your cat has yellowing of the eyes, skin (visible on the ears and abdomen), or gums, it is important to contact a veterinarian immediately. Jaundice can be caused by a variety of liver and bile duct diseases, which can be life-threatening to your pet.

Regarding other symptoms that may be observed in a cat with lipidosis, they are usually nonspecific and may include:

  • Decreased appetite, refusal to eat
  • Weight loss for no apparent reason
  • Excessive weight loss
  • Decreased activity
  • Vomiting and/or diarrhea
  • Lethargy, apathy, weakness
  • Enlarged liver

If the animal's general condition changes, it is important to take the cat to a veterinarian as soon as possible.

How is lipidosis diagnosed?

At the appointment, the veterinarian will take a detailed history of the patient, perform an examination, and prescribe a diagnostic test. Diagnosis may involve various methods and investigations depending on the initial findings and the patient's condition.

  1. A general clinical blood test. Always performed to evaluate the number of leukocytes, red blood cells, platelets, hematocrit, and leukocyte formula.
  2. Blood chemistry. The evaluation primarily focuses on indicators characterizing the hepatobiliary system, but also includes monitoring of other indicators that may detect primary diseases such as chronic kidney disease.­­
  3. Ultrasound examination of abdominal organs. The assessment includes evaluating the structure and size of the liver, as well as checking for any changes in other organs, the presence or absence of free fluid, and any other associated complications.
  4. Coagulogram. This test may be performed if a complication in the form of coagulopathy is suspected.
  5. Liver biopsy. This diagnostic method enables cytologic and histologic analysis of cells or tissue from an organ.

How is lipidosis treated?

The treatment of cats with acute lipidosis typically necessitates the patient's admission to the intensive care unit until their condition stabilizes. The length of stay is difficult to predict as it depends on various factors such as the severity of the patient's condition at the time of referral, the degree of liver damage, and the presence of complications or other pathologies.

The goal of therapy is to manage the underlying disease, if present, or to stabilize the patient's general condition if idiopathic lipidosis is suspected.

One of the primary objectives of treatment is to promptly restore the patient's ability to eat.

Treatment may include different options depending on the severity of the condition.

  • Intravenous infusion therapy is used to restore fluid and electrolyte balance.
  • Antiemetics
  • Vitamins (Thiamin, B12, Vitamin K)
  • Antibiotics
  • Antioxidant therapeutics (vitamin E, SAMe), amino acids (taurine, ademethionine)
  • Tube feeding (esophagostomy, gastrostomy)
  • High Protein Diet

The determination of which drugs are necessary for the therapy of a particular patient is made by the doctor, based on the animal's condition and test results.

It is important to remember that the overall recovery period for a pet with lipidosis is quite long - up to 2-3 months after discharge from the hospital.

Can liver lipidosis be prevented?

Controlling your pet's body weight is crucial to prevent overweight and obesity.

It is important to closely monitor the general condition of the cat and regulate its appetite.

As highly stressed animals, it is important to prevent possible stressful situations for cats.

And, it is important to regularly examine your pet to detect any signs of chronic diseases.


[1] The Cat. Clinical Medicine and Management, Susan E. Little, 2011.

[2] Cowell and Tyler's Diagnostic Cytology and Hematology of the Dog and Cat, Amy C. Valenciano and Rick L. Cowell, 2020.