What Is Feline Hepatic Lipidosis?

How to treat fatty liver disease in cats

Cat Portrait
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Fatty Liver Disease, sometimes called Fatty Liver Syndrome (FLS), is an accumulation of fats (lipids) in the liver tissue. Although the disease is presently considered idiopathic (no known cause) it is thought that it might result from the way cats metabolize proteins and fats.

Disease Symptoms and Progression

  • A overweight cat stops eating for whatever reason
  • Lacking food, the body starts sending fat cells to the liver to process into lipoproteins for fuel.
  • Cats' livers are not terribly efficient at processing fat, and much of the fat is stored in the liver cells.
  • Left untreated, eventually, the liver fails and the cat dies.

The symptoms of the Fatty Liver Disease are similar to those of other feline diseases:

  • A previously overweight, cat suddenly becomes anorexic (quits eating) and loses weight;
  • The cat may salivate excessively or vomit.
  • The cat may become very lethargic and may show jaundice (yellowing of the skin) and icterus.

Anorexia and weight loss can also be symptoms of other diseases, such as liver cancer or pancreatic disease. Fatty liver disease can only be accurately diagnosed conclusively through tests. A complete blood profile may indicate increased liver enzymes, and the diagnosis can be confirmed with an ultrasound guided liver biopsy done under anesthesia, with a large needle through the skin.

Although primary FLS can be readily treated if caught early, when left untreated, the disease moves rapidly and is always fatal.

Fatty Liver Disease Is Reversible if Caught in Time

The treatment for Fatty Liver Disease is dietary and works quite well in reversing the condition if diagnosed early.

The idea is to feed the cat enough nutrients to reverse the metabolic malfunction that caused the condition in the first place. This is usually done with a feeding tube which is inserted into the esophagus or stomach by a veterinarian. Depending on the type and size of tube placed, a nutritionally balanced liquid formula, or canned food is syringe fed into the tube several times a day. This generally requires hospitalization at first, as many of these cats are dehydrated and may have electrolyte imbalances that also need to be addressed. In addition, when cats who have been off food for a period of time start getting fed again, they are at risk of developing refeeding syndrome which can exacerbate electrolyte imbalances and be fatal. After dehydration and electrolyte abnormalities are sufficiently managed, many cats can continue to get tube feedings at home. After a few weeks of the forced diet, the cat can be offered food normally to test his appetite, although the tubal feeding may need to be continued for several weeks until the cat's appetite has fully returned to normal.

Though it is sometimes done as a last resort, syringe feeding of food directly into a cat's mouth without a feeding tube is not recommended. In addition to putting the cat at risk of aspiration (inhalation of food into the lungs) force feeding an animal who is nauseous and does not want to eat, can lead to food aversion. This may prevent the cat from ever starting to eat on it's own again.

Fatty Liver Disease May be Secondary to Other Conditions

It is not unusual to see Fatty Liver Disease follow in a cat who is being treated for cancer, FIV, FeLV, or other serious conditions. This is likely to happen because a sick cat simply does not feel like eating, although there may be other factors involved.

Advanced Cases Need Additional Treatment

Cats presenting advanced symptoms (jaundice, seizures) will require hospitalization. Fluids may need to be injected to reverse dehydration, and if liver failure is present, the ensuing toxins will need to be dispersed. Other conditions which need veterinary intervention may also be present.

The good news is that with aggressive nutritional treatment, a cat can fully recover. some studies report greater than 80% recovery rate if a cat with FLS is treated aggressively and early enough.

Even if a cat has not yet developed FLS, a sudden and serious weight loss should be viewed seriously, and the cat should be encouraged (but not forced) to eat. Trying to tempt an anorexic cat to eat can be a frustrating experience, especially with an older cat, that might be easily stressed. You should always consult with your vet if your cat is not eating, however below are some tips that can help encourage your cat to eat.

Keep Them Well-Hydrated

Dehydrated cats quickly lose their appetites. In fact, anorexic cats are more often than not dehydrated. Try flavoring his water with a small amount of sodium-free chicken broth, or even giving watered-down chicken broth a small teaspoon at a time. An automatic water dispenser may also tempt him to drink more water, which will also help guard against urinary tract problems. If your cat steadfastly refuses to drink fluids, subcutaneous fluids can be prescribed by your veterinarian to give at home.

Warm up Canned Food

Older cats' olfactory senses may deteriorate to the point that they can't smell their food. Try warming a small amount of canned food in a microwave oven. If it's too hot, add some more food right out of the can until it's a little warmer than room temperature. Then hold the dish right under his nose and let him get a good sniff. Alternatively, mix a small amount of hot water in the food and stir until it forms a sort of "gruel." Sometimes a senior cat's teeth and/or mouth may be sore, and they'd prefer a much softer food they can lick, rather than "chew."

Cat eating canned food
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Human Baby Food

Plain meat is preferable, and make sure it doesn't contain onions or garlic. Try a number of flavors until you hit on one your cat likes.

Try a New Food

  • Even if your cat has been on a premium quality diet, forget the labels for the time being, and look for "stinky" foods that might whet that ailing appetite.

Use "Add-Ons" to Enhance the Flavor

  • Try Tuna Juice: Although tuna is not generally recommended in quantity for cats, try adding some tuna juice to his regular food to spice up the taste. Use the water from albacore tuna, rather than the pink varieties.
  • Clam Juice
  • Sardines, minced fine
  • Kitty Kaviar: This is available from most larger pet food stores. It is made of dried bonito, or tuna, and is irresistible to cats. Dried bonito flakes are also marketed under Seagate Pet Gold Dried Bonito Flakes. You can also purchase dried Bonito flakes in bulk at some health food stores, or Asian markets which are more economical.
  • Tuna Dash: Dried powdered tuna.
  • Jack Mackeral: Either chop up over his food or offer separately.
  • Oregano can mimic the smell and flavor of catnip and entice a cat to eat.

The point is that "desperate times call for desperate means," and right now, your main consideration is not in what your cat is eating, so much as actually getting him to eat something.

Any cat, particularly an older one, that stops eating and loses weight rapidly should be taken to the veterinarian immediately because anorexia and weight loss can be symptoms of a number of other diseases. Discuss these suggestions with your veterinarian, since each cat has a different health history. Your veterinarian can also prescribe appetite stimulants and antinausea medications if needed.

If you suspect your pet is sick, call your vet immediately. For health-related questions, always consult your veterinarian, as they have examined your pet, know the pet's health history, and can make the best recommendations for your pet.