If your pets are like most pets in America, they could probably stand to lose a few pounds. The problem with this, if you are feline, is that rapid weight loss or anorexia can lead to a form of liver disease called Hepatic Lipidosis. If left untreated, this illness can be fatal due to liver dysfunction and failure.
Hepatic lipidosis, also known as “fatty liver disease”, often occurs in overweight cats who stop eating. Usually there is an underlying reason why kitty has stopped eating which may include illness such as cancer, renal disease, infectious disease, or gastrointestinal disease. It is also common to see cats stop eating secondary to stress; examples of stressful situations for cats include new pets in the house, new baby, moving, or if the owner is out of town for an extended period of time. Lipidosis can be prevented if the owner notices that their cat is not eating as much as normal, and takes steps to immediately correct the problem. Often enticing them with canned food will keep them eating, though sometimes appetite stimulants will be prescribed to boost the appetite temporarily in cats that appear to be stressed. If there is an underlying medical problem it is important to address the primary issue. The earlier you address your cat’s loss of appetite with your veterinarian, the more options you will have for management and the more successful you are likely to be.
Once triglycerides (fats) have been deposited in the liver cells, the cells are no longer able to function normally and symptoms of liver dysfunction, or failure, will become apparent. These symptoms may include weight loss, anorexia, vomiting, lethargy, and jaundice or yellow tinge to the skin and mucous membranes. Your veterinarian should examine your cat to determine the extent of the illness: is the cat dehydrated? Are vital signs normal? Bloodwork will be run to evaluate the liver enzymes as well as the electrolytes, protein levels, kidney values, blood cell counts, and other markers of internal disease. Your doctor may recommend hospitalization with intravenous fluids to correct dehydration and electrolyte abnormalities while waiting on blood test results. Abdominal ultrasound may also be recommended to look at the liver and other internal organs, and may be used to obtain a needle aspirate or biopsy sample of the liver if necessary.
Based on blood test results, your doctor will address any underlying causes of the anorexia and help you determine the best treatment plan. With hepatic lipidosis, a feeding tube is often recommended so that you are able to get an appropriate amount of calories into your cat in order to begin the recovery process. Lipidosis, if caught early enough, can be reversed with proper nutrient intake. In advanced stages of the illness, cats may die even if treatment is initiated. Also, there are some underlying disease processes which may not be treatable including cancer and certain viral infections. Your veterinarian will help you determine if any treatment options are available, and what to watch for at home to indicate that your cat is not responding to treatment.
A feeding tube can be placed quickly under sedation or general anesthesia. Feeding tubes can be easily managed at home with a little bit of education and practice. At first it can seem really intimidating, but if you spend time with your veterinarian practicing, and asking questions, you will become comfortable feeding your cat at home. Tube feeding is time consuming, but won’t last forever. Most cats have the tube in place for a minimum of 3-4 weeks, depending on how quickly the patient responds to treatment and if there are any complications (such as vomiting) which have to be managed. Cats are usually fed 2-4 times a day and medications can usually be given through the tube so you don’t have to try to force a pill down an unwilling participant’s throat.
My cat Brady, (pictured above on the right, snuggling with Gus), came to me after a bout of hepatic lipidosis. Brady’s owner had recently acquired a dog and Brady began to hide more and not eat as much. Soon he began to lose weight and vomit. His owner noticed the changes and brought him to me. Bloodwork confirmed that his liver was not functioning well, but no other illnesses were identified. Due to her lifestyle and her children’s preference, Brady’s owner elected to keep the new puppy, and relinquish Brady to a new home. Since his illness was treatable, she elected to have a feeding tube placed so that we could help rehabilitate him. Brady was started on medications to help control nausea and tube feedings commenced. Within a few weeks of tube feeding, Brady was gaining weight and beginning to get some energy back. I knew he was almost healed when he hopped up on the kitchen table to steal from a bowl of peas at dinner time (he’s a veggie lover!). I began to reintroduce dry cat food to him and he began eating on his own. After a week of no tube feedings, and maintaining his weight on kibble, Brady’s tube was removed. Tube removal is a simple procedure that doesn’t require any sedation.
By this time, I had fallen in love with Brady and he seemed happy at my home with my other cats so he became part of my family. Brady has gained all of his weight back and is a happy, well adjusted kitty. He “talks” to my husband when he comes home from work and waits to be picked up to hang over my husband’s shoulder. Brady’s (previous) owner has visited a couple of times and laughs at how heavy he is now and is pleased that he is happy in his new environment.
Brady’s story is unique, as are all versions of lipidosis. I would like to point out that relinquishment of a pet is not always necessary in a situation like Brady’s. A behaviorist may be able to help integrate both pets into the same household successfully. I would encourage you to discuss all options with your veterinarian before making a final decision. Most veterinarians are willing to discuss options for ill pets including what treatments are available, options for relinquishment or placement in a shelter or rescue organization, and when euthanasia is appropriate for a pet who is ill or suffering.
The most important thing to take away from this? If you notice that your cat has not been eating well, or has lost weight, have him evaluated by your veterinarian as soon as possible. Though it can be fatal, lipidosis is treatable and curable. Not every anorexic cat has lipidosis. It is important to take steps early to identify the problem and work toward making your cat better.