🧬 Vet Guide to Feline Hepatic Lipidosis (Fatty Liver) in 2025 🐱🍽️

Feline hepatic lipidosis—also called fatty liver disease—is the most common liver condition seen in cats in North America. Though potentially life-threatening, this condition is highly treatable when caught early and managed properly with nutrition and supportive care. In this 2025 guide, Dr. Duncan Houston BVSc explains everything cat parents need to know about symptoms, causes, treatment, and prognosis. 🩺🐾

🧪 What Is Hepatic Lipidosis?

Hepatic lipidosis occurs when fat builds up inside liver cells (hepatocytes), disrupting normal liver function and potentially leading to liver failure. It’s most common in overweight or obese cats who suddenly stop eating. 🛑

Fat is mobilized from body stores to the liver, which becomes overwhelmed, swollen, and unable to process nutrients or bile efficiently—leading to cholestasis and liver dysfunction. ⚠️

🔍 What Causes Hepatic Lipidosis?

Anything that causes a cat to stop eating can lead to hepatic lipidosis within 2–7 days. Common triggers include:

• 🐱 Obesity and sudden fasting
• 🤮 GI disease (IBD, vomiting, diarrhea)
• 🔥 Pancreatitis or gallbladder inflammation (cholangitis)
• 🧬 Diabetes, cancer, liver toxicity
• 🧠 Stress or household changes

In ~30% of cases, no clear cause is found. This is referred to as idiopathic hepatic lipidosis. 🧩

⚠️ Symptoms to Watch For

Signs may appear suddenly and worsen quickly. These include:

• 📉 Rapid weight loss (sometimes half of body weight)
• 🥱 Lethargy and weakness
• 🤢 Vomiting or diarrhea
• 🚫 Poor or no appetite
• 🟡 Jaundice (yellow gums, eyes, or skin)
• 🚽 Constipation or loose stools

🧫 Diagnosis

Your vet will start with lab tests and imaging:

• 🧪 CBC and chemistry panel (check anemia, inflammation, liver enzymes, and electrolytes)
• 🩸 Elevated liver enzymes, especially ALP and bilirubin
• 🖥️ Abdominal ultrasound (fatty appearance of liver)
• 🔬 Biopsy or needle aspirate may be done if safe
• 🧪 Bile acids test may assess liver function

💉 Treatment: Act Fast

Hospitalization is usually required. Cats are often dehydrated and malnourished. Key steps include:

1. 🧴 IV Fluids & Electrolytes

• 💧 Rehydrate slowly over several days
• ⚠️ Monitor for potassium and phosphate deficiencies

2. 🍽️ Nutritional Support via Feeding Tube

Cats must be fed—even if they won’t eat voluntarily. Feeding tubes make this safe and effective:

• 🧪 Esophagostomy tube (through neck)
• 🧬 Gastrostomy tube (into stomach)

Feeding guidelines:

• Day 1: 33–50% of daily calories
• Day 2: ~66%
• Day 3+: 100% daily needs

High-protein, low-carb diets are preferred (e.g., diabetic or recovery diets). Avoid human liquid diets. ❌

3. 💊 Supportive Medications

• 🥩 Appetite stimulants (mirtazapine, cyproheptadine)
• 🤢 Anti-nausea (Cerenia®, metoclopramide)
• 🧬 Liver protectants (SAMe, Denamarin®, vitamin E)
• 💊 Probiotics or metronidazole for GI signs

⚠️ Refeeding Syndrome

When a starved cat begins to eat again, insulin release can deplete phosphate and potassium—leading to weakness or red cell rupture. Close monitoring is essential for the first 72 hours. 🩺

📈 Prognosis

With early treatment, 80–90% of cats recover. But success depends on:

• 📆 Early intervention
• 🧪 Whether the underlying disease is treatable
• 🐱 Patient response to tube feeding

📲 Ask A Vet for Support

Worried about your cat’s sudden weight loss or yellowing eyes? The Ask A Vet app offers immediate access to Dr. Duncan Houston and other licensed vets for nutritional advice, feeding support, and personalized liver care plans. 📱

Visit AskAVet.com or download the app for fast, expert help. 🐾

💬 Final Thoughts

Hepatic lipidosis is a serious condition—but it’s also highly treatable. Early diagnosis, aggressive nutrition, and vet-guided care offer the best path to recovery. Don’t wait—every hour counts. 🐱❤️

Dr. Duncan Houston and the Ask A Vet team are here to help your cat regain their health and thrive again. 🩺🍽️