Hepatic Lipidosis in Cats: Everything a Pet Parent Should Know About Fatty Liver Disease in Cats

Hepatic lipidosis in cats, also called fatty liver disease in cats, is a serious condition that occurs when too much fat builds up in the liver, often after a cat stops eating.  

Without prompt veterinary treatment, hepatic lipidosis can become life-threatening, so any cat that is eating significantly less or refusing food should be evaluated by a veterinarian. 

What Is Hepatic Lipidosis in Cats?

Hepatic lipidosis is a common cause of liver failure in cats. 

Any cat can develop the condition, but it’s most seen in middle-aged cats who are (or were) overweight and haven’t been eating much recently. 

When cats don’t eat, they can lose weight quickly.  

As a result, large amounts of fat get sent to the liver and end up inside liver cells—sometimes so much fat that the cells can no longer function normally.  

This is hepatic lipidosis, which is sometimes also called fatty liver disease in cats. 

When cats stop eating, hepatic lipidosis can start developing within just a few days. Don’t let your cat go without food for more than a day before you call your veterinarian for advice. 

Aggressive treatment is usually needed to reverse hepatic lipidosis.  

If cats get the treatment they need, as many as 80% of cats with the condition can be expected to survive. 

Symptoms of Hepatic Lipidosis in Cats

Symptoms of hepatic lipidosis in cats include:  

• Poor or no appetite 
• Rapid weight loss 
• Jaundice 
• Vomiting 
• Lethargy and depression 
• Unusual behaviors, such as hiding 
• Weakness 
• Diarrhea 
• Constipation 
• Dark urine 
• Abnormal bleeding or bruising 

Symptoms of fatty liver disease in cats may also be combined. 

Causes of Fatty Liver Disease in Cats

Anything that stops a pet from eating can lead to hepatic lipidosis in cats.  

Some common causes of fatty liver disease in cats include: 

• Inflammatory bowel disease (IBD) 
• Cholangiohepatitis and other types of liver disease 
• Cancer 
• Pancreatitis 
• Environmental changes, such as a disruption in their normal routine, such as moving to a new home or adding a new family member that may result in stress 

When an underlying cause can’t be identified, a cat will be diagnosed with idiopathic hepatic lipidosis. 

How Veterinarians Diagnose Hepatic Lipidosis in Cats

A veterinarian may suspect that a cat has hepatic lipidosis after learning they haven’t been eating much and they’ve recently lost a lot of weight.  

A physical exam can also provide evidence, but diagnostic testing is necessary to differentiate hepatic lipidosis from other diseases that have similar clinical signs. 

Veterinarians will usually start with a basic panel of blood work and a urinalysis.  

Many cats with hepatic lipidosis will have high levels of bilirubin and very high levels of alkaline phosphatase (a type of liver enzyme) in their blood. 

When a cat has hepatic lipidosis, an abdominal ultrasound should reveal that the whole liver looks abnormal, rather than just a specific part. During the ultrasound, the veterinarian can use a needle to remove a small sample of liver cells (called a fine needle aspiration, or FNA). If they’re filled with fat, the diagnosis is confirmed. 

Additional testing may also be necessary, both to identify hepatic lipidosis in cats and to look for the health problems that may have led to it. 

Treatment of Fatty Liver Disease in Cats

Treatment for hepatic lipidosis focuses on nutritional support and hydration.  

Nasoesophageal tubes (small tubes placed through the nose into the stomach) may be used for initial nutritional support while the cat is hospitalized.  

The cat will generally be transitioned to an esophagostomy tube before being discharged and for at-home care.  

For this procedure, a veterinarian will briefly anesthetize your cat and place the tube into the esophagus through an incision through the skin of your cat’s neck. The tube is then sutured in place so that pet parents can use it for long-term feeding. Other types of feeding tubes may also be considered, based on the specifics of the case. 

Cats with hepatic lipidosis may also require treatment with B vitamins, vitamin K, and vitamin E. Fluid therapy with added magnesium, phosphorus, and potassium may be necessary as well. 

To support the liver, veterinarians often prescribe nutritional supplements and medications like S-adenosylmethionine, L-carnitine, milk thistle, silybin, and ursodiol.  

Additional treatments will be based on a cat’s symptoms and underlying health problems. 

Recovery and Management for Hepatic Lipidosis in Cats

A full recovery from hepatic lipidosis in cats is possible. 

Pets will usually be hospitalized at the beginning of treatment for hepatic lipidosis in cats. Veterinary staff closely monitor their condition and adjust their treatment as needed.  

Once they are stable, cats can continue their recovery at home. 

If your cat has a feeding tube, your veterinarian will provide you with all the training you need to feed your cat, give medications, and maintain the tube. 

Tube feedings typically continue for a month or two.  

Once a cat is no longer nauseated and has started regaining weight, it’s time to start offering them food by mouth.  

Your veterinarian will likely recommend gradually reducing the amount of food you provide through the tube to give your cat a chance to get hungry.  

The feeding tube can be removed once a cat is eating completely on their own. 

Talk to your veterinarian if you have any questions or concerns about your cat’s health or treatment plan.  

Prevention of Hepatic Lipidosis in Cats

To prevent hepatic lipidosis in cats, pet parents can take the following steps:  

• Ensure your cat eats each meal by monitoring their food intake and contacting a vet if they go 24 hours without food.  
• Maintain an optimal weight for your cat by feeding measured meals and minimizing treat intake.  
• Ensure your cat receives regular veterinary wellness care to identify health concerns early that may increase the risk for hepatic lipidosis.