Hepatic lipidosis, a.k.a. “fatty liver disease,” is a serious and debilitating condition in cats. It’s caused by an overabundance of fat being moved to and deposited within a cat’s liver, which will happen when their body is otherwise “starved” for energy.
Read on to learn more about what hepatic lipidosis is, the signs to watch for, and how you can prevent your cat from suffering from fatty liver disease.
It all starts with fat! Fat cells are stored packets of energy that the body can use when food supplies or intake are low, or when the body can’t use the energy coming in from food normally, which is a good (or even great) and natural thing! As such “energy starved” states can happen, and they can arise from a variety of reasons, namely:
- Reduced or lacking appetite from conditions such as pain, stress, a rapid diet change, or being trapped in a garage or closet without food
- Increased energy requirements from conditions such as hyperthyroidism or cancer
- Reduced ability to properly break down, absorb, or utilize the energy from food from conditions such as diabetes or pancreatitis
One of the body's defenses to survive during periods of "energy starvation" is to break down and use the stored energy within the body — the fat cells — to make the glucose the body needs to function properly. The way it does that, in a nutshell, is to bring the fat out of the fat cells, into the bloodstream, and to the liver, where the fat can be converted into glucose. (The body really is amazing!!)
Depending on the underlying reason for the "energy starved" state and how long it’s been going on — as well as the amount of fat stores within the cat’s body — the degree of fat brought to and deposited within the liver can be enough to actually interfere with the normal functions of the liver. (See inset box for some of the important things the liver does.) This dysfunction or failure of the liver due to the depositing of too much fat is hepatic lipidosis, or "fatty liver disease." It is debilitating and devastating because the liver is a critical part in many of a cat’s vital body functions that are necessary to stay alive. So anything that interferes with the normal functioning of the liver is a bad thing.
Some of What a Cat’s Liver Does:• Makes proteins required to help the blood clot normally
• Makes proteins required to help maintain fluid balance and blood pressure within the body
• Makes bile, which is important for overall fat metabolism within the body, as well as for removing certain metabolic byproducts and toxins from the body
• Detoxifies blood coming from the digestive tract
• Stores important vitamins and minerals
• Converts ammonia (a toxic byproduct of protein metabolism within the body) into urea (a less harmful compound which is more easily cleared from the body by the kidneys)
Signs of Liver Dysfunction or Failure in Cats
Because the liver is involved in so many body functions, the signs you might see when your cat is suffering from hepatic lipidosis, or any other condition that causes liver dysfunction, can vary widely. Below are some of the signs that could indicate a problem with your cat's liver:
- Yellowing of the ears, eyes (whites), gums, or skin
- Decreased energy
- Decreased appetite
- Increased thirst
- Increased urinations
- Increased salivation
- Small, pin-sized bruises on gums, ears, or elsewhere on body ("petechiae")
- Large bruises under skin
- Nose bleeds
- Blood in urine or stool
- Breathing difficulties
- Swollen abdomen
Yellowing of the "whites" of the eyes is one potential sign of hepatic lipidosis. This photo is of a dog's eye, but similar yellowing happens in cat's eyes.
Common Conditions That Cause or Increase a Cat's Risk of Hepatic Lipidosis
While a cat can get "primary hepatic lipidosis," or hepatic lipidosis that has no underlying cause, it's more often the case that cats devlop hepatic lipidosis "secondary" to some other underlying condition. And, in reality, it's quite likely that many of the "primary" cases actually have an underlying cause, but it's just not detected or diagnosed. Below are some of the more common conditions that can cause, or increase a cat's chances of, a case of hepatic lipidosis:
- Inflammatory bowel disease (IBD)
Another thing that's important to know about hepatic lipidosis in cats is that it predominately affects, or is at least typically significantly worse in, cats that are overweight or obese. Given this fact, along with the fact that there is typically a preventable or, at least, treatable condition underlying most cases of hepatic lipidosis in cats, it means that there are several things you can typically do to protect your cat and minimize their chances of suffering from a bout of hepatic lipidosis. These steps are outlined below.
How to Prevent Fatty Liver Disease in Your Cat
Maintain a Healthy Body Weight for Your Cat
Since overweight and obese cats have more fat “stores” within their body to mobilize and deposit in their liver, excessive weight can be one of the most significant risk factors for your cat to develop fatty liver disease.
If your cat has a little extra “fluff in their coat” you’re not alone. Pets in the United States are overweight and continuing to get more overweight. The Association for Pet Obesity Prevention found that 58% of cats in the U.S. are overweight or obese. This is probably because many cat owners like to spoil their cats, indoor cats don’t often get much exercise, and not everyone knows what their cat’s weight should be. (Here are some simple steps you can take to get your indoor cat moving.)
In between vet visits (when your vet will usually tell you if your cat is overweight or underweight), you can “feel out” whether your cat is the ideal body weight.
How to Tell if Your Cat is Overweight
- Your cat should have a discernible waist that, when viewed from the side, “tucks up” toward the back of the legs.
- You should be able to feel your cat’s ribs easily without having to press through a thick layer of fat.
- Your cat’s back should not be perfectly flat.
- Your cat should not have “love handles.”
Learn more about identifying and preventing obesity by reading, “Recognizing and Helping Overweight and Obese Cats.”
Keep an Eye on How Well Your Cat is Eating
To prevent fatty liver disease, you need to make sure your cat isn’t too fat, but also that they’re eating an appropriate amount. A decreased or sudden halt in eating is almost always seen in cats with this disease. You shouldn’t think that you can “out stubborn” your cat by waiting for them to get hungry and start eating again. They will always “win” this game, which actually means that you’ll both lose.
For this reason, you should keep an eye out and always make sure your cat is eating an appropriate amount for their body type and size. And if they need to go on a diet, do so gradually and consult with your vet before making any dietary changes.
If your cat suddenly seems less interested in their food…
- Talk to your vet early, as a lack of appetite is rarely a good sign
- Take steps to tempt their appetite
You can find excellent tips in “My Cat Won’t Eat! How to Stimulate Your Cat’s Appetite.”
Introduce Diet Changes Gradually to Your Cat
Drastic or sudden changes to diet can upset your cat’s digestive system or even cause them to lose interest in eating, both of which can then lead to fatty liver disease.
If you need to transition your cat to a new food, do so slowly and start them on a mixture of the new and old food. Over the course of 1–2 weeks, gradually blend in more of the new food with the old food so your cat can adjust (both their taste buds and in their gut). With a little patience, you can make the transition without turning your cat off their new food. Some cats can make the transition over a week, while others might require a little more time to switch foods (hence the longer timeframes in the parenthesis below).
How to Properly Change Your Cat’s Food
- Days 1–2 (or days 1–4): Mix 25% new food with 75% old food
- Days 3–5 (or days 5–10): Mix 50% new food with 50% old food
- Days 6–7 (or days 11–14): Mix 75% new food with 25% old food
Don’t Leave Your Cat Home Alone
Though they generally have a reputation as “loners” and “low maintenance” pets, cats are typically neither. Most cats really do like to be around people… often times even more than they like to eat food, play with toys, or have catnip! If your cat is one of the social ones — and odds are good that they are — even leaving them alone without any human interaction or supervision for a “quick weekend” away can cause them stress and lead to problems like decreased food access and eating, urinary obstruction, and a host of others. Even if you’re only leaving for a couple of nights, it’s important to get a pet-sitter or at least someone who will reliably stop by once to twice a day to scoop litter boxes, check in, feed, and play with your cat.
Download This Pet Sitter Treatment Authorization Form
Stay on Top of Your Cat’s Health & Conditions
Since hepatic lipidosis is typically the result of an underlying medical condition — as mentioned above — it’s important for your cat to have their regular wellness check-up each year, as well as for you to have any concerning signs and changes evaluated and “worked up” by your veterinarian. If any medical conditions are diagnosed, it’s extremely beneficial to work with your veterinarian to treat and control those conditions as best you can.
Now that you have a firmer grasp of hepatic lipidosis itself, here again is the list of common medical conditions that cause or increase a cat's risk.
Limit Your Cat’s Stress
Stress can be a big contributing factor to fatty liver disease in cats, as stressed cats often don't eat as well (and sometimes not at all!). So it’s always a good idea to take the steps to have a calmer, more contented kitty. Some of the most common sources of kitty stress include:
- A new environment they don’t understand
- A small space where they have to compete for use of a litter box or food dish
- Bullying between cats within the home
- A home full of overnight visitors
- Construction, or other noise and commotion, within the home
- A new baby in the home
- A new pet in the home
You can be pretty sure that your cat is stressed if they start hiding. While some cats may normally be more solitary than others, a sudden and persistent change in the way they’re interacting (or not) with you should be cause for concerning. Not only could an increase in hiding be a sign of stress in cats, but it can also be indicative of pain or problems as wide ranging as a urinary obstruction, kidney disease, a digestive obstruction, or much more. So just remember… “hide and seek” is a bad game for a cat.
For More Information on Hepatic Lipidosis
To learn more about this potentially deadly condition, read Dr. Christopher Byers’ great review of feline hepatic lipidosis. Hopefully the awareness and prevention tips provided throughout this article will help your cat avoid a brush with this condition. But should your cat’s ears, gums, or eyes ever turn yellow, please take them immediately for veterinary evaluation and attention.