Can a cat recover from hepatic lipidosis?

With quick aggressive treatment about 90% of cats with hepatic lipidosis (fatty liver disease) survive but without it, the survival rate goes down to 10 to 15%. What is the cause and what is the treatment? You will need to see a vet about this so you can book the appointment before you read this if the signs (see below) indicate hepatic lipidosis.

Underlying cause?

One well-known veterinarian/author1 believes that high carbohydrate diets by which she means dry cat food diets provided full-time “assault the sugar-controlling functions of both the liver and the pancreas, and such diets cause the obesity that predisposes the overweight cat to hepatic lipidosis”. That is one theory but beyond being overweight, hepatic lipidosis occurs when the liver is clogged up with excess fat which leads to failure of its normal functions. This is the accumulation of fat inside the body which you don’t see but which does all the damage.

Being overweight predisposes the cat to hepatic lipidosis because if they stop eating for any reason for longer than a few days hepatic lipidosis becomes likely. And as the cat starves fat stored in the body is released and it travels to the liver through the bloodstream in a normal response to survival.

The fat is processed into protein-wrapped packages and transported through the bloodstream to tissues in the body where energy is required. In overweight cats too much fat floods the liver when protein for this packaging process is unavailable and the fat build-up disrupting the liver’s function.

This makes the cat lose their appetite even more and even if the original cause of loss of appetite has passed the cat has a loss of appetite and so it is a downward cycle which needs to be broken with urgent veterinary treatment.

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Cats with hepatic lipidosis don’t want to eat so you have to break that downward cycle through force-feeding of protein and calories.

Early intensive fluid replacement and forced feeding can reverse the process. Veterinarians will use a feeding tube to provide sufficient protein and calories for the liver to begin to do its job of moving fat through the body. When the cat retains their appetite, they may eat normally with the feeding tube in place.

Assisted feeding required for cats with hepatic lipidosis. Click for a larger image. Image: Tufts University
Two useful tags. Click either to see the articles: Toxic to cats | Dangers to cats

A veterinarian may also prescribe appetite stimulants, but they only work if the cat is still eating at least a bit on their own.

According to my book on home veterinary treatment2, fluids should be free of carbohydrates and cats with this condition need high quality protein and extra vitamins and nutrients including the amino acids: carnitine, taurine and arginine.

There is no doubt in my mind that you simply have to see a veterinarian urgently and, in most cases, special diets and formulas are required.

The veterinarian may also provide supportive supplements such as milk thistle and S-adenosylmethionine.

Milk thistle for cats (2022) – potential herbal remedy

Poor appetite

Cats who develop hepatic lipidosis have a history of poor appetite or their food is restricted for days and weeks before the caregiver notices the signs. Jaundice is a major sign which is a yellowing of the skin. It’s caused by the accumulation in the skin of waste substances i.e., bile pigments normally processed by the liver.

Before you see jaundice there will be other severe signs of illness such as lethargy, vomiting, diarrhoea and clear signs that the cat is feeling very sick.

Is your Cat Anorexic or Just Being Picky?

Timescale to recovery?

This may take 2-3 months. It requires home nursing care and a dedicated human caregiver. If the cat survives the first four days of intensive treatment, there is an 85% chance of them going on to a full recovery. However, if pancreatitis is also present the prognosis is not good.

1. Elizabeth M Hodgkins DVM.

2. Cat Owner’s Home Veterinary Handbook Third Edition.

Useful tag. Click to see the articles: Cat behavior

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