Feline hepatic lipidosis (FHL), also known as "feline fatty liver syndrome," is the most common form of liver disease in cats in North America. The disease is unique to cats; it is not found in other companion animals.
The condition is triggered when a cat stops eating due to stress, another disease or for any other reason. After a few days without food, the cat’s body will begin to use fat for energy. Cats do not metabolize fat well; therefore the fat cells build up in the liver and eventually prevent it from functioning normally. FHL is very dangerous for cats and can be life threatening if left untreated.
"I strongly urge pet owners to contact their veterinarian if their cat has not eaten in one or two days," says AAHA member Dr. Ted Cohn of the University Hills Animal Hospital in Denver, Colo. "Feline hepatic lipidosis can progress rapidly and become life-threatening in a few days to a week after onset."
While cats of all breeds and any age are at risk, middle-aged, obese cats are most susceptible to the disease. The most common form of the disease is idiopathic (of unknown origin), however the disease can also occur in conjunction with other diseases of the liver.
Lack of appetite causes the disease and is also the most obvious symptom. A cat in the early stages of FHL will show some weight loss and may experience dehydration, excessive salivation and vomiting. In later stages of the disease, the cat will have lost a severe amount of weight, have a yellow tint in his gums and eyes, and may experience seizures. If you notice any of these symptoms in your cat, take him to your veterinarian immediately.
The history of an overweight cat losing his appetite will cause a veterinarian to suspect that the symptoms may be indicative of hepatic lipidosis. A physical exam of the cat will reveal a loss of muscle mass and possibly jaundice, which is highly suggestive of liver disease.
Your veterinarian will draw blood to test for decreased liver function. Elevated levels of several liver enzymes as well as high cholesterol and ammonia levels may appear in laboratory findings. A liver biopsy revealing a large amount of fat in and among the liver cells would indicate FHL.
Hepatic lipidosis is very treatable, especially if caught in the early stages of the disease. If aggressively treated, 70 to 80 percent of cats will recover from the disease. When left untreated, FHL advances rapidly and is always fatal. Successful treatment requires intensive nutritional support until the cat’s appetite returns. An ideal diet for a cat with FHL fulfills her basic nutrition requirements, promotes liver regeneration, and facilitates recovery from metabolic imbalances associated with the syndrome.
In almost all cases, a feeding tube needs to be placed into the cat’s stomach, either directly through the side of his body or through his nose or esophagus down into the stomach. Your veterinarian will prescribe a special food mixture to be syringed through the feeding tube three to five times per day. "The average time from diagnosis to recovery with intense treatment is four to six weeks, and some cases may require up to 18 weeks of nutritional support," explains Dr. Cohn.
During treatment, try offering your cat a small amount of his favorite food about once a week so that you will know when his appetite returns. After the cat has been eating on his own for three to four days, take him to the veterinarian for removal of the feeding tube. Do not attempt to remove the tube yourself.
Cats with advanced symptoms such as jaundice or seizures require hospitalization. They need intravenous fluids to reverse dehydration and liver failure.
The disease is more common in obese cats because they tend to metabolize fat more readily than thinner cats. The best way to prevent your cat from developing FHL is to keep him in a healthy body condition. Your veterinarian can recommend an effective weight control plan for your cat.
You can ensure that your cat enjoys a long, healthy life and is at a reduced risk for health problems such as hepatic lipidosis by providing him with an active lifestyle that includes the appropriate diet and plenty of exercise and water.
Copyright © 2009, American Animal Hospital Association
Reprinted with permission from the American Animal Hospital Association.