Feline hepatic lipidosis

Can a cat die of a broken heart? In a way, yes. Though what breaks is in fact the cat’s liver. Cats like a settled routine, and can get very attached to certain places or people. If these are suddenly taken away, the cat can suffer from what is known as ‘separation anxiety’. A troubled or unhappy cat might suddenly stop eating.

This is bad news, because the feline metabolism does not take well to a sudden cut-off of nutrients. Suddenly depriving a cat’s body of a regular supply of food can bring on a bout of feline hepatic lipidosis, or ‘fatty liver disease’ (which is what ‘hepatic lipidosis’ actually means in Greek).

If a cat suddenly stops eating for any reason, its body turns for nutrition to the fat already stored there. However, this fat is meant to help the cat through times when food is low, not to replace external food altogether. Body fat is processed through the cat’s liver, but if a cat is living on nothing but her body fat, this places an intolerable strain on the liver. Fatty granules known as lipids start to accumulate inside the liver cells (hepatocytes). If the load of lipids inside the cells gets too high, this starts interfering with the normal function of the cells. Further build-ups can permanently damage the liver.

Because of the risk of permanent damage, early treatment of feline hepatic lipidosis is essential. If treated early the condition is reversible and 80-90% of cats will make full recovery. But if left untreated the build-up of lipids means that the cats may well die through malnutrition or complications arising from liver failure.

The causes of feline hepatic lipidosis

Whatever the root cause, lipidosis issues starts when the cat stops eating. So severe anorexia usually precedes the onset of the disease, and should be a call to action by any concerned human. The starting point should be why the cat has stopped eating in the first place.

It is not unusual for cats which are treated for cancer, feline immunodeficiency virus, feline leukemia virus or other serious condition to develop hepatic lipidosis. This is likely because a very ill cat will not feel like eating.

If an otherwise healthy cat suddenly refuses food this is often the result of a traumatic change. It is not uncommon for highly anxious cats to stop eating. Abandonment, prolonged boarding or changes in the home environment are all very stressful to many cats. Some pragmatically adjust to change, but different cats, like different humans, have individual temperaments and some react by getting too tense to eat.

Cats which are obese are even more likely to develop hepatic lipidosis - probably because they have more body fat to clog up the liver cells, and a system accustomed to a rich supply of nutrient.

What are the symptoms of hepatic lipidosis?

The early symptoms are not unique to lipidosis. However, lack of appetite, weight loss, and perhaps vomiting should at least signal that something is wrong. If anorexia and severe weight loss follow, then lipidosis is not far behind. The liver has started to process more body fat than it can handle. This may be accompanied by visible yellowing of the skin or the whites of the eyes - the condition known as jaundice.

If the body fat runs out of fat to process, it moves to protein-rich muscle cells which are a good source of nutrients. If the body eventually runs out of nutrients necessary to keep the brain and the rest of the body functional, death follows.


In the early stages, the symptoms of hepatic lipidosis are similar to those of some other diseases including renal failure, some cancers and FIV or FeLV. Therefore if the vet suspects hepatic lipidosis, tests targeting liver function will be necessary. Blood tests and histopathology of liver biopsy may also be required. The information thus gained, combined with history and physical examination, should be sufficient for the correct diagnosis. Jaundice is often a good indicator of hepatic lipidosis.


Since lipidosis is caused by the failure to eat, the best cure is the resumption of normal nutrition. In early stages of the condition, all that may be required to stimulate the cat’s appetite is a favourite food or treat. If that does not work and the condition becomes life-threatening, force-feeding will be necessary.

It is absolutely essential that the cat gets enough nutrient to reverse the metabolic malfunction occurring within her body. A vet can insert a feeding tube into his patient’s esophagus or stomach. Some people prefer to use a syringe and feed their cat that way. If you choose to take this route, consult with the vet which food to use and make sure that it is in liquid form. When feeding with a syringe, feed slowly by putting the food into the side of the cat's mouth, making sure she does not choke. Gently stroke the throat to assist swallowing. Often the resumption of normal digestion causes a cat to regain her appetite and she will start eating by herself.

If the hepatic lipidosis becomes advanced, the cat will have jaundice and/or seizures and will need to be hospitalized. Treatment involves i.v. fluid to rehydrate the cat, and treatments to avert potential liver failure and other complications.

Some basic points to remember are that hepatic lipidosis works fast, so a cat that has eaten nothing for two or more days is a serious cause for concern. Most cats eat several times a day, so even 24 hours without food should merit a consultation with the vet.

A cat which has been eating a balanced diet and is neither too fat or too thin has the best chance of survival.

If lipidosis is caught early enough, aggressive feeding will reverse the illness. Untreated lipidosis is almost invariably fatal, so doing nothing is not an option.

Note: This information is for guidance only. It is not intended to replace consultation with a licensed practitioner.

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