Cat with lethargy and anorexia

About the Case

Hepatic lipidosis is most common in obese, nutritionally stressed, spayed female cats that present with vomiting, anorexia, weakness, weight loss, jaundice, and hepatomegaly. The cause of accumulation of triglycerides in hepatocytes is likely multifactorial, secondary to multiple metabolic derangements. This condition may be secondary to primary disease processes such as diabetes mellitus, acute pancreatitis, cholangiohepatitis, small intestinal disease, hyperthyroidism, renal disease, and others. Less often, the condition is idiopathic. Regardless of cause, the disease can be fatal if not identified and treated early. Identification of an underlying primary disease is important to determine the best course of treatment and prognosis. Abdominal ultrasound and fine-needle biopsy followed by cytologic evaluation are diagnostic for hepatic lipidosis with cholestasis. Other primary liver conditions, especially infiltrative diseases (cholangiohepatitis, lymphoma, etc.) may also be diagnosed by cytology. Treatment to correct metabolic derangements in electrolytes and hydration are key, followed by re-establishing nutritional intake either orally, by nasogastric tube, or by percutaneous endoscopic gastrostomy (PEG) feeding tube. Other vitamin supplements such as vitamin K1 or B vitamins may be useful as well.

Read more about Feline Hepatic Lipidosis, Nutrition in Hepatic Disease in Small Animals, Hematology in Hepatic Disease in Small Animals, Enzyme Activity in Hepatic Disease in Small Animals, Feline Cholangitis/Cholangiohepatitis Syndrome in The Manuals.


References

Kuzi S, Segev G, Kedar S, et al. Prognostic markers in feline hepatic lipidosis: a retrospective study of 71 cats. Vet Rec. 2017 Nov 11:181(19):512. doi: 10.1136/vr.104252

Valtolina C, Favier RP. Feline Hepatic Lipidosis. Vet Clin North Am Small Anim Pract. 2017 May;47(3):683-702. 10.1016/j.cvsm.2016