Hepatic lipidosis or fatty liver disease is a common and dangerous feline condition that occurs when cats stop eating for several days. Fortunately, rapid veterinary treatment can reverse this potentially fatal disorder. Use this guide compiled by the Providence Vet team to ensure you understand the risks and signs associated with hepatic lipidosis in cats.

What is feline hepatic lipidosis?

The normal liver is a large organ responsible for numerous responsibilities and vital functions that include:

  • Filtering the blood stores and releasing energy (i.e., glycogen)
  • Aiding in digestion
  • Storing bile (i.e., digestive enzymes) and vitamins
  • Producing hormones
  • Synthesizing proteins and carbohydrates

When cats stop eating (i.e., anorexia) for a prolonged period—usually more than three days—the body begins converting stored fat tissue to energy and nutrients. Unfortunately, the sudden influx of fat exceeds the liver’s processing ability, and the excess fat accumulates in and around the liver cells (i.e., hepatocytes), resulting in liver enlargement and dysfunction. 

What causes hepatic lipidosis in cats?

In 90% of affected cats, hepatic lipidosis is a secondary condition in response to an underlying disease or disorder. In some cases, hepatic lipidosis may be the first clue that your cat is suffering from a hidden illness. If your cat has been diagnosed with a chronic (i.e., long-term) illness, fatty liver disease may indicate that their treatment plan is no longer effective or requires modification. 

What are hepatic lipidosis risk factors for cats?

Hepatic lipidosis in cats does not discriminate for age, size, or health. Kittens, adults, and senior cats are equally at risk for hepatic lipidosis, which can arise in otherwise healthy or normal weight cats, as well as overweight and chronically ill felines.

However, some health and behavior conditions can increase your cat’s risk, including:

  • Obesity 
  • Liver problems
  • Diabetes
  • Hyperthyroidism
  • Pancreatitis
  • Inflammatory bowel disease (IBD)
  • Cancer
  • Respiratory disease
  • Kidney disease
  • Stress
  • Starvation or food deprivation (e.g., unable to access available food)

What are hepatic lipidosis warning signs in cats?

Prolonged food avoidance is typically the most common and noticeable sign that your cat is being more than a finicky eater. Some cats suffering from hepatic lipidosis may display food aversion and completely avoid their food dish, while others may appear fearful or repulsed, no matter what you place in their bowl.

Cats may also hide or distance themselves from normal household activities. You may note jaundice (i.e., yellowing of the skin and mucous membranes) on the skin, sclera (i.e., eye white), and inside the ears. Weight loss and lethargy are also common. If the cat is suffering from any of the primary health conditions above, they may also show these related signs.

How is hepatic lipidosis diagnosed in cats?

If your cat has stopped eating for more than one or two days, schedule an appointment at Providence Vet. Our veterinarian will perform a complete physical examination to assess your cat’s overall health and identify any hepatic lipidosis signs and primary causes. We will generally recommend blood work to evaluate your cat’s liver function and other critical internal processes. We will need a tissue or cell biopsy to confirm diagnosis, but not for treatment, which involves nutritional support and hydration. Therefore, most veterinarians are comfortable treating a cat for hepatic lipidosis based on clinical signs, exam findings, and blood work results.

Can cats survive hepatic lipidosis?

Hepatic lipidosis is reversible with early detection and aggressive veterinary intervention. Treatment generally includes determining and addressing the underlying cause or condition, correcting the cat’s nutritional deficiencies, and restoring appropriate hydration. Hospitalization and advanced therapies are necessary to achieve these goals. Treatment includes:

  • Feeding tube — Because affected cats refuse to eat, temporary feeding tubes are placed to ensure direct and appropriate nutrition. Critically ill cats may require intravenous (IV) nutrition before graduating to a feeding tube.
  • Nutritional therapy — Specialized nutrient-rich liquid diets provide high-calorie balanced nutrition to fuel the cat’s recovery and support normal liver function.
  • Intravenous fluids — Fluids are delivered through an IV catheter to correct dehydration.
  • Medications — Various injectable medications are used to correct vitamin deficiencies and electrolyte imbalances, and reduce clinical signs (e.g., nausea). Additional condition-specific medications or treatments based on the underlying cause are often necessary. 

Nutritional support helps restore natural liver metabolism and clear the harmful accumulated fat. Some cats regain their appetite after clinical signs diminish, while others may require supplemental or supported feeding for several weeks. Once stabilized, cats can be discharged for at-home care and feedings.

After discharge, your cat will need regular rechecks to ensure they are consuming sufficient calories and gaining weight. The feeding tube is removed only when the cat is consistently eating on their own and maintaining their body weight. 

How can I prevent hepatic lipidosis in my cat?

The best way to minimize your cat’s hepatic lipidosis risk is to keep them as healthy as possible. This includes:

  • Wellness visits — Annual or bi-annual exams allow our veterinarian to detect hidden disease in its earliest stages and to ensure prompt treatment.
  • Monitoring — Daily observation helps you spot subtle appetite or behavior changes. 
  • Weight management — Keeping your cat at a lean weight may minimize hepatic lipidosis risk or reduce severity.
  • Stress management — Avoid sudden changes in your cat’s routine. For example, switching foods may increase stress, and they may refuse the new food.

Feline hepatic lipidosis is an unusual condition that often catches unsuspecting cat owners off guard. Don’t let that be you. If you’re concerned that your cat may be suffering from hepatic lipidosis, contact Providence Vet promptly.