Feline hepatic lipidosis

Symptoms an owner can spot at home

• Not eating, or eating far less, for more than a day or two
• Rapid weight loss, often obvious over a week or two
• Yellowing of the gums, the whites of the eyes, or the skin inside the ear flaps
• Drooling, and vomiting or retching
• Hiding, weakness, and a hunched posture with the head held low
• Muscle wasting over the spine and hips despite remaining body fat

When to see a vet

• Any cat that has not eaten for 48 hours, and sooner for an overweight cat, this is the single number worth remembering
• Any yellow tinge to the gums, eyes or ear skin, which is jaundice and needs same-day assessment
• Repeated vomiting alongside not eating
• Sudden weakness, collapse, or a cat that will not lift its head
• A cat losing weight on a deliberate diet faster than roughly one to two percent of body weight per week

What it is

When a cat stops eating, the body breaks down fat reserves for energy and routes them through the liver. Cats are obligate carnivores with a limited capacity to process that volume of fat, so it accumulates inside liver cells instead of passing through. The engorged cells stop working, and liver function fails.

The disease then sustains itself. Liver failure causes nausea, nausea further suppresses appetite, and the cat eats even less. The more body fat present at the start, the more fuel there is for the process, which is why obesity is the principal risk factor and why the illness moves quickly in a heavy cat.

In the large majority of cases the loss of appetite is itself a symptom of something else: pancreatitis, inflammatory bowel disease, dental pain, another liver disease, cancer, diabetes, or stress from a house move or a new animal. Treating the lipidosis without identifying that underlying cause addresses only half the problem.

Why it hides in multi-cat homes

Where several cats share bowls, nobody notices which cat has stopped visiting them. Food disappears, so the household assumes everyone is eating. If one cat seems subdued, feeding separately for a day is the fastest way to find out who is actually eating and how much. Weighing the cat monthly on kitchen scales catches this earlier than watching bowls ever will.

Diagnosis and treatment

Diagnosis rests on blood tests showing impaired liver function, usually supported by ultrasound and by a fine needle aspirate or biopsy of the liver. The workup also looks for the underlying trigger, because that determines much of the longer-term plan.

Treatment is sustained nutritional support until the liver recovers, most often delivered through a feeding tube because the cat is far too nauseated to eat voluntarily. Owners frequently resist the tube; it is generally well tolerated, it lets medication and food be given without a fight, and it is the intervention that works. Recovery commonly takes six to seven weeks of consistent feeding.

With early and committed treatment the outlook is good. Untreated, it is frequently fatal. Nothing available at home substitutes for veterinary management, and appetite stimulants are not reliable enough to justify delaying assisted feeding once a cat is jaundiced.

Prevention

• Keep cats at a healthy body condition, since obesity is the main modifiable risk factor.
• Never crash-diet an overweight cat. Weight loss must be gradual and veterinary-supervised, because rapid fat mobilisation is precisely the mechanism of this disease.
• Treat any appetite loss as information rather than fussiness, especially in a heavy cat.
• Introduce diet changes slowly, and never leave a cat with only a new food it refuses to eat.
• Manage stress around moves, building work and new arrivals, and monitor intake closely through those periods.