 Hepatic lipidosis, defined as an excessive fat buildup in the liver, is a prevalent cause of possibly reversible liver failure in cats. The liver is in charge of several critical activities, including glucose and fat metabolism, protein and vitamin synthesis, vitamin and iron storage, the creation of chemicals required for blood coagulation, and the removal or breakdown of toxins. The typical lipidosis cat is middle-aged, was formerly fat but has lost at least 25% of its original body weight, has a low appetite, and may have an evident unsettled stomach. Cats with severe liver illness may also suffer from electrolyte imbalances or vitamin shortages. There is usually a bleeding propensity in lipidosis, which might make obtaining a biopsy sample relatively hazardous. A fat infiltration aspirate is typically diagnostic, particularly when ultrasonography reveals that the whole liver has a fatty texture. Liver disease. As the liver is involved in many crucial functions, a cat with liver disease may show a wide variety of symptoms. These may include lethargy, anorexia, loss of appetite, weight loss, weakness, jaundice, vomiting, diarrhea and behavioral changes. Hepatic lipidosis. Hepatic lipidosis is just one of many liver diseases which can cause the clinical signs indicated above. It can be the primary problem or secondary to another disease process. Several primary disease processes include inflammatory bowel disease, other liver diseases, cancer, pancreatitis or social interaction problems. Factors that may be associated with the onset of hepatic lipidosis include stress, obesity, anorexia, diet change, nutritional deficiencies, diabetes and hyperthyroidism. The typical cat with hepatic lipidosis has recently lost a significant amount of body weight, has a poor appetite, and is middle-aged and overweight. Live amounts of fat are broken down from the cat's peripheral fat storage during periods of fasting or decreased food intake. This fat is then transported to the liver. The liver should then process this fat and export it to the rest of the body in a new form. In cats that develop hepatic lipidosis, this process is impaired and the rate of fat export from the liver is much slower than the rate of fat intake, resulting in fat accumulation within the liver cells. Damage to the liver is caused by swelling of the liver cells with excessive fat. At a minimum, impairment of liver function occurs, and in those cats with severe disease, overt liver failure results. Diagnosis. The suspicion that a cat is suffering from liver disease is confirmed by physical examination, a thorough history including diet and medications, comprehensive blood work, and abdominal ultrasound. The definitive diagnosis of hepatic lipidosis requires visualization of fat globules in the liver cells, this can only be accomplished through needle aspiration or biopsy of the liver. Hello. This video is sponsored by Beemix Pets. Are you looking for high quality cat collars at an affordable cost? Check out, BeemixPets.com. Use coupon code KittenLife, to get 20% off. Treatment. Regardless of the cause, the basic treatment for hepatic lipidosis is the same. Many cats will be dehydrated and completely anorexic when brought to the hospital. Intravenous fluids are used to correct dehydration. Most cats with hepatic lipidosis refuse to eat, yet the only way to reverse the process of fat accumulation within the liver is through aggressive feeding. This supplies your cat with his or her full caloric requirements. Force feeding your cat is an option, but most cats are not very cooperative, and meeting their caloric requirements is difficult at best. Cats also seem to develop food aversions quite easily, and the unpleasant experience of force feeding may further delay your cat's return to self-feeding. Placement of a feeding tube into the stomach or neck, respectively, is the most satisfactory method to manage feedings. The percutaneous gastrostomy tube is placed using an endoscope and requires a short duration of anesthesia. An esophagostomy tube also requires anesthesia. This tube is placed into your cat's esophagus through a small hole in the neck. Some cats require supportive care, including vitamin K to help them clot their blood, for a period of time before they are stable enough to undergo these procedures. Both options allow the cat to receive the full caloric requirement with a minimum of stress and fuss. A specially formulated recovery diet can be fed through the feeding tube for as long as it takes your cat to recover from hepatic lipidosis. If necessary, the feeding tube can safely remain in place for several weeks to months. A feeding tube allows your pet to return home where you can perform the feedings and give medications in a less stressful environment. The expected hospitalization for a cat presenting with severe hepatic lipidosis can be up to 7 to 10 days. During this period of time, we will correct the dehydration, monitor for any electrolyte abnormalities that may occur, and begin the reintroduction of food. As these blue pearl pet hospital, Renton, Washington, vets with feline patient cats have not eaten for some time, reintroduction of food must be done slowly so as to not overwhelm their system. Once your cat is stable, off intravenous fluid therapy, and receiving most of his or her calculated caloric requirements we will set up a time for your cat to go home. During the discharge appointment, we will go through any medications your cat may require, demonstrate how tube feedings are done, and answer any other questions you may have. Results. You will be expected to bring your cat in to see your veterinarian for regular re-checks. These might be more frequent in the beginning and will decrease in frequency as your cat recovers. Some feeding tubes require bandaging that will need to be changed every couple of days. Many owners learn to do these bandage changes at home and monitor for infections. As liver function recovers, appetite will gradually improve. The expected recovery time is typically 6 to 12 weeks, with an average time of 8 weeks. When your cat is totally self-feeding for 2 weeks without any weight loss, the feeding tube can be removed. Recurrence of primary hepatic lipidosis is rare, and many cats that survive go on to live normal lives. Some cats have other contributing diseases that require specific long-term treatment. For more information on this subject, speak to the veterinarian who is treating your pet. Re-feeding injury. When a patient has been in a starvation state for a while and then begins to eat, some serious metabolic problems may occur in the first few days as metabolism changes. When food is delivered, the pancreas releases insulin in an attempt to store the calories. Unfortunately, insulin also drives circulating potassium inside cells, and cats with hepatic lipidosis are often depleted of potassium to start out with. This sudden drop in potassium can make a cat quite weak, causing drooping neck, listlessness, urine retention or inability to urinate normally, heart muscle depression, and more. Similarly, insulin will drive phosphate into cells in a similar way, leaving the bloodstream depleted. Red blood cells will not have enough phosphate to maintain their own structure, they burst, causing severe anemia. If the blood phosphate level drops below 2.2mg-dL, and four supplement will be needed. After the phosphate level has started to rise, an oral supplement of phosphate, usually lactose-free cows' milk works well. Expect your cat to be monitored in the hospital for the first three days following initiation of nutritional support, and possibly longer. Re-feeding injuries can be usually avoided by starting with half, or less, of the required amount of calories and gradually working up to the full nutritional requirement over a few days. Having a low blood potassium level at the time of lipidosis diagnosis is associated with an increased chance of death. Many people are reluctant to place or work with feeding tubes and want to try feeding their cats at home. There is no room for tentative treatment when it comes to this disease. Cats that show a 50% drop in total bilirubin level within 7-10 days are statistically likely to survive. Keep in mind that hepatic lipidosis rarely happens for no apparent reason. If there is an underlying cause, it must also be addressed.