Hepatic Lipidosis (Fatty Liver)

As was mentioned earlier, many reasons can cause a cat to stop eating or eat much less than it should. Eating 1/2-3/4 the normal amount of food for about 2 weeks can be enough for hepatic lipidosis to develop.

The typical course of events is like so:

• Cat is unwell and stops eating.
• After a while, owner notices food bowl is not emptying or that cat is losing weight and brings cat to the vet.
• At first, many owners are pleased to see that their overweight cat is losing weight before they realize there is something wrong.
• The vet's physical exam may reveal the cat is jaundiced. This can usually be easily seen in the scleras and the skin of the temples.
• The vet will run a blood test that will show an increase in liver enzymes (their increase in the blood means there is damage to the liver tissue) and may run a bile acid test (that tests liver function) that will also show higher than normal values.
• An ultrasound exam will show changes in the entire liver, meaning a disease that involves the whole liver (unlike a mass, for example).
• A fine needle aspirate or a biopsy of the liver will show hepatic lipidosis.

As mentioned above, this disease develops when the cat does not eat enough. Therefore, the main key of treatment is feeding.

Many cat owners want to try and feed their cat at home. This is not recommended for two main reasons:

1. Cats are not easy to force feed and they often associate the trauma of being force fed with the food, thus developing food aversion, meaning that even when they have an appetite they stay away from the food they were once forced to eat.

2. An average cat needs more than a can of food per day and that is practically impossible to force feed with a simple syringe.

Feeding, therefore, should be done with a feeding tube. In very critical cases, where anaesthesia is too risky, a nasogastric tube is inserted. This is a thin feeding tube that is inserted through the nose under mild sedation. The problem with this tube is that it is very hard to pass food through it due to its small diameter. It is usually used for a relatively short time until the cat is more stable and can undergo general anaesthesia for an esophagostomy tube. An Esophagostomy/Pharyngostomy tube is a wider tube that allows easier passage of food. This tube is inserted through the neck, while under general anaesthesia, and then bandaged in a way that does not bother the cat but allows easy feeding.

When feeding a cat with a feeding tube, the food must be room temperature (as cold food may cause vomiting) and fed slowly (as too rapid feeding may result in vomiting). The tube must be flushed with warm water before and after feeding.

Apart from feeding, the cat will receive different drugs (e.g. antibiotics), vitamins and supplements based on its condition.

With proper nutritional support the survival and recovery from hepatic lipidosis is close to 90%. Without it, most cats will die.