Practitioner reality – How I deal with hepatic lipidosis (Proceedings)


Hepatic lipidosis accounts for approximately 50% of feline liver disease.

  • Hepatic lipidosis accounts for approximately 50% of feline liver disease

  • Excessive accumulation of fat in the liver

  • Can be primary or secondary

  • Early diagnosis makes for the best prognosis!!


  • Majority of cats have history of obesity, may still be obese at time of detection

  • Any age, no breed or sex predilection

  • Typically a history of some sort of stress to the cat

o Food change

o Housing change

o Infection/other disease

o Inappetance for days to weeks

Physical exam findings

  • Weight loss

  • Muscle wasting

  • Depression

  • +/- history of vomiting

  • Icterus occurs gradually

  • Dehydration

  • Mild hepatomegaly

  • With severe liver failure, signs of hepatic encephalopathy may be present, clotting disorders may be present


  • Elevated AlkPhos, NORMAL GGT

  • Alt and Ast typically not as significantly elevated

  • CBC – boring, possible stress leukogram

  • If lipidosis is secondary to other disease process, there may be evidence of primary disease on bloodwork results

  • Rads – mild hepatomegaly

  • Ultrasound – hyperechoic liver

  • Definitive diagnosis is made with biopsy

Differential diagnosis

  • Neoplasia

  • Chloangiohepatits

  • Hemolytic disease?

  • Any cholestatic disease process


  • Aggressive nutritional support

  • Manage concurrent disease if present


  • Greater success rate with earlier detection, can be over 80% if caught early and treated aggressively

  • If signs of more significant liver failure are present (hepatic encephalopathy, clotting disorders) prognosis for survival is <40%

  • Once recovered, there is no increased risk of further liver disease or recurrence of lipidosis

Practical management

  • Hospitalize the cat – manage fluid and electrolyte imbalances

  • Place a feeding tube – whichever kind you are comfortable with

  • Control vomiting

  • Feed the cat!

o 50% of nutritional needs (based on a healthy weight) divided among several feedings for the first 1-2 days

o If tolerating feedings well, increase to 100% of nutritional needs by day 4-5.

o Do not offer any food until after day 5-7. Ok to leave water available.

o Make sure hydration needs are being met as well.

  • Weigh the cat weekly

  • Change bandage weekly or as needed

  • Support the client!!

  • Manage concurrent diseases or issues

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