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ASG Specialties:

  • Hip Dysplasia
  • Patella Luxation
  • Medial Patella Luxation
  • Elbow Dysplasia
  • Fragmented Coronoid Process
  • OCD Osteochondritis Dissecans Fractures
  • Arthritis
  • Ruptured Cruciate Ligament
  • Ruptured Cranial Cruciate Ligament
  • Ruptured Anterior Cruciate Ligament


Feline Hepatic Lipidosis

Feline Hepatic Lipidosis

Hepatic Lipidosis (HL) is a syndrome resulting from excessive accumulation of lipid (fat) within the liver cells that can lead to severe liver dysfunction. HL is one of the most common liver disease diagnosed in cats in North America.

By Mickila Collins, DVM
Diplomate American College of Veterinary Internal Medicine

Clinical Signs

Most cats affected with HL are middle-aged, obese, or overweight adults. Anorexia is the most common and sometimes is the only presenting complaint, with the period of anorexia ranging from 2 days to several weeks. Weight loss is common and can be profound. Other common historical findings are lethargy, jaundice, vomiting, diarrhea or constipation, and an unkempt, poor quality haircoat.

Causes

HL may occur secondary to any disease process that results in protracted partial or complete anorexia. Decreased food intake may be for a period of time, as short as 2 days. Common concurrent disease associated with the development of HL include pancreatitis, other liver disease, small intestinal disease, cancer, kidney disease and/or diabetes mellitus.

Risk factors for the development of feline hepatic lipidosis:

  • Obesity
  • Diet or intake change
  • Environmental stress
  • Chronic disease
  • Female
  • Middle-aged or older
  • Drugs

Diagnosis

The diagnostic goal in cats with HL is twofold: establish a diagnosis of lipidosis, and a simultaneous workup for the presence of an underlying disease process. The diagnosis of HL is based on a compatible history, clinical signs and biochemical and US abnormalities with cytologic or histopathologic confirmation.

Treatment

While hospitalization to address any fluid and/or electrolyte imbalances are often required, the cornerstone of therapy for HL is enteral nutritional support with a focus on meeting protein and caloric needs via a feeding tube. Another important component of treatment is the diagnosis and concurrent management of any underlying disease process. Significant owner participation is necessary for a successful outcome of this reversible condition.

Common complications of hepatic lipidosis

  • Malnutrition
  • Hypokalemia
  • Hypoglycemia
  • Coagulopathy
  • Ascites
  • Hepatic encephalopathy (HE)

Nutritional Goals

The nutritional goals for managing cats with HL require we replete nutritional stores, avoid secondary complications, and support the cat for a time period sufficient to achieve lipid dispersal from the liver and regain appetite. Specifically goals include:

  • Correct and prevent malnutrition
  • Provide nutrients to optimize hepatic regeneration and repair
  • Minimize hepatic workload
  • Avoid the production of neurotoxic precursors
  • Minimize metabolic balance of fluid, electrolytes, nitrogen, and glucose

Prognosis

In the absence of a fatal concurrent disease, a recovery rate of 80% or higher can be expected if early enteral feeding is initiated and is sustained until voluntary food intake resumes. The two most important factors affecting the outcome in HL appear to be the presence of a serious and irreversible concurrent disease and how early enteral nutritional support is begun. Once a cat recovers from HL, recurrence is unlikely.


Animal Specialty Group

DVM, Diplomate American College of Veterinary Internal Medicine

Dr. Mickila Collins received her Doctor of Veterinary Medicine degree from Ross University in 2005, completing her clinical year at Louisiana State University. After graduation, she completed a one-year rotating internship, followed by an internal medicine internship, both at ASG.


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