Hepatic Lipidosis (Fatty Liver)

Hepatic Lipidosis (Fatty Liver)
This information was developed to assist cat owners whose pets have been diagnosed with fatty liver, or for whom fatty liver is being considered as a possible complication of another problem. Briefly, lipidosis is considered as a cause or contributing cause of liver failure when a cat that was once overweight loses weight too quickly. Often the owner is not aware that such a thing is dangerous and is pleased to see the obese cat trimming down. By the time the cat actually stops eating and is clearly sick, the disease is well underway and will require more aggressive support to reverse. The good news is that there is a good recovery rate for this condition provided it has not progressed too far.


The average cat with lipidosis is middle-aged, was at one time obese but has lost at least 25% of its original body weight, has a poor appetite, and may have an obvious upset stomach (38% will have vomiting, diarrhea or constipation). Cats that are especially weak may have concurrent electrolyte imbalances or vitamin deficiencies from their liver disease.

The Cat in Liver Failure
The cat in liver failure is jaundiced, frequently nauseated, will not eat and generally is an obviously ill animal. The jaundice (more clinically termed icterus) is often not noted by the pet owner but can be seen by carefully examining the whites of the eyes for yellow coloration. Sometimes the yellow color is not evident to the naked eye but is picked up as a blood test elevation in bilirubin, a yellow pigment normally kept in check by the liver.

If the blood test shows that the bilirubin is not elevated, liver disease may be picked up as an elevation in a blood test enzyme called alkaline phosphatase, abbreviated ALP. This enzyme should never be elevated in a cat under any normal circumstances although there are several forms of this enzyme and an elevation does not necessarily indicate liver disease. An ALP elevation is definitely suggestive of liver disease and requires follow up testing such as a bile acids liver function test. Other liver enzymes commonly monitored on routine blood panels are alanine aminotransferase (ALT) and aspartate aminotransferase (AST). These enzymes elevate relatively easily and are not as important in liver evaluation as ALP elevations but a substantial increase may also warrant follow up liver testing. In the event of hepatic lipidosis or fatty liver, the elevation in ALP is often dramatic.

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