🩺 Fatty Liver Disease in Cats (Hepatic Lipidosis) – Vet Guide 2025

By Dr Duncan Houston BVSc – Ask A Vet Blog Writer

1. Introduction & Relevance

Hepatic lipidosis, commonly known as fatty liver disease, is one of the most serious liver disorders in cats. Often triggered by a period of anorexia or inadequate food intake, it leads to excessive fat accumulation in liver cells, causing liver dysfunction. Prompt recognition and aggressive treatment are vital—without it, mortality rates can be over 50%. This 2025 guide helps caregivers spot early warning signs, navigate diagnostics, start timely feeding interventions, and support full recovery with veterinary collaboration.

2. What Is Hepatic Lipidosis?

At its core, hepatic lipidosis occurs when a cat stops eating, prompting the body to break down fat stores. Cats’ livers aren’t efficient at processing large volumes of fat, so hepatic fat accumulates. This impairs essential liver functions—detoxification, protein production, vitamin storage, and bile flow—leading to systemic illness.

• Primary hepatic lipidosis – develops from fasting or underfeeding.
• Secondary hepatic lipidosis – happens when underlying issues (like pancreatitis or gastrointestinal disease) decrease appetite.

3. Risk Factors & At-Risk Cats

• Any cat who stops eating for over 3 days is at risk.
• Overweight or obese cats: Have large fat reserves that accelerate disease.
• Stressful changes: Boarding, moving homes, adding pets.
• Concurrent illnesses: Dental pain, urinary issues, kidney disease, heart conditions.
• Older cats: Metabolic reserve decreases with age.

4. Recognizing Symptoms Early

Symptoms often develop subtly at first. As fatty liver worsens, observe for:

• Reduced appetite or refusal to eat (key early sign)
• Weight loss and muscle atrophy
• Weakness or lethargy
• Jaundice—yellowing of gums, eyes, skin
• Vomiting, diarrhea, or constipation
• Excessive drooling or slowed grooming
• Change in stool or urine color

5. Veterinary Diagnosis & Testing

• Physical exam: Check hydration, body condition, palpate the liver, look for jaundice.
• Bloodwork: Elevated ALT, AST, ALP, bilirubin; often accompanied by anemia, high cholesterol.
• Abdominal ultrasound: Enlarged, bright liver with possible gallbladder thickening.
• Fine-needle aspirate: Shows fatty hepatocytes under microscope.
• Liver biopsy: Gold standard if aspirate is unclear.
• Rule out other causes: Pancreatitis, cholangitis, GI disease, endocrine disorders.

6. Treatment Roadmap 🩺

6.1 Nutritional Support & Feeding Tubes

In hepatic lipidosis, restoring nutrition promptly is critical:

• Placement of an endoscopically placed esophagostomy tube (E-tube) is often advised.
• Begin with high-calorie, palatable, low‑fat diets in small, frequent feedings.
• Use supplement formulas like Purrz RecoveryBlend designed to support liver metabolism and protein reserves.
• Gradually increase intake to meet 100% of resting energy requirements (RER).

6.2 Intravenous or Subcutaneous Fluids

• Correct dehydration and electrolyte imbalances.
• Support kidney perfusion and toxin elimination.

6.3 Medications & Supportive Care

• Anti-nausea drugs: maropitant, ondansetron, or metoclopramide
• Antacids: famotidine or omeprazole for vomiting/gastritis
• Appetite stimulants: mirtazapine or capromorelin
• Liver protectants: SAM-e, milk thistle (under vet supervision)
• Pain relief: Buprenorphine for sick cats with discomfort

6.4 Monitoring Progress

• Daily weight tracking
• Monitoring appetite, vomiting, stool consistency
• Re-check bloodwork every 3–5 days
• Ultrasound follow-up to assess liver recovery

6.5 Treating Underlying Conditions

If secondary disease triggered lipidosis, address accordingly:

• Dental disease → extractions or treatment
• Pancreatitis → low-fat diet & enzyme support
• GI disease → probiotics or antibiotics

6.6 Hospitalization vs. Home Care

• Hospitalization recommended during initial stabilization (tube placement, fluids, diagnostics)
• Transition to home once eating >75% of RER and clinically improving

7. At-Home Recovery & Feeding

• Continue prescribed diet through E-tube or syringe
• Switch to high-protein liver-safe diet once eating independently
• Maintain medications exactly as prescribed
• Provide quiet, low-stress environment
• Use Easy-Care pet dishes to encourage eating
• Cleanliness around feeding site to reduce infection risk

8. Role of Ask A Vet, Woopf & Purrz 🛠️

• Ask A Vet: Live consultations to adjust feeding plan, monitor progress, troubleshoot vomiting or tube issues.
• Woopf: Offers padded feeding mats and feeding tube protectors designed for comfort and hygiene in recovering cats.
• Purrz: Supplies liver-support supplement blends, digestive enzymes, and palatable liquid diets to ease the transition back to normal eating.

9. Monitoring & Follow-Up Care

• Weekly follow-ups for at least 4 weeks
• Repeat bloodwork until liver values normalize
• Recheck ultrasound if liver size or texture abnormal
• Gradually transition back to regular diet once stable

10. Prognosis & Outlook

With prompt and aggressive treatment, most cats recover completely. Prognosis is guarded if delayed care, concurrent illnesses, or severe systemic signs are present. A motivated caregiving team and supportive veterinary plan are key to success.

11. When to Contact the Vet 🚨

• Refusal to eat or vomiting despite tube feeding
• Jaundice worsens or new neurologic signs appear
• Signs of infection at tube site or dehydration
• Dramatic weight loss or lethargy returns

12. Prevention & Safe Weight Loss Tips

• For overweight cats, reduce weight slowly (≤1–2% body weight/week)
• Encourage play, climbing, activity to maintain muscle
• Provide multiple feeding stations throughout the house
• Introduce diet changes gradually, with monitoring
• Regular wellness visits (bloodwork, weight tracking) are essential

13. Summary Takeaways

• Fatty liver disease is a serious condition triggered by anorexia.
• Early nutritional intervention (feeding tubes) is critical.
• Comprehensive veterinary care includes fluids, meds, and diagnostics.
• Home follow-up & monitoring ensures full recovery.
• Ask A Vet, Woopf & Purrz offer vital support tools throughout treatment.

14. Final Thoughts ❤️

Hepatic lipidosis is treatable, even life-threatening. With informed veterinary care, loving at-home support, and persistent monitoring, most cats make a strong recovery. If your cat stops eating for even a couple of days, reach out to your vet or Ask A Vet right away. Your quick action can save lives.