This disease primarily attacks older, overweight cats that quickly begin to lose weight. Often, owners are pleased when an overweight animal sheds pounds and are not aware that such weight loss is dangerous. According to Wendy C. Brooks, DVM and educational director of Veterinary Partner, by the time a cat actually stops eating and is sick, the disease is well underway and will require more aggressive support. With appropriate treatment that includes proper nutrition or medication however, the effects of this affliction can be reversed.
Cats exhibiting this disease are typically middle aged and overweight. At least 25 percent of body weight has been lost because the cat has eaten little or no food for a week or more. Other signs include vomiting, diarrhea, constipation, depression, listlessness, decreased muscle mass and yellow color in the eyes, ears, and mouth. The yellowishness usually indicates jaundice, which is a destruction of red blood cells.
Blood tests of cats with cellular liver failure often show elevated levels of the enzymes alkaline phosphatase (ALP) and aspirate aminotranferase (AST) Elevated levels of ALP definitely indicates liver disease, according to Dr. Brooks of Veterinary Partner, but elevated levels of AST are also cause for concern and warrant follow-up testing to determine liver function.ALT and AST are normally only found inside liver cells. Their presence in the bloodstream indicates liver cell death. A liver can have damage without decrease in function.
A veterinarian may order a GGT (gamma glutamyl transpeptidase) test to determine if there is underlying liver disease in addition to hepatic lipodosis. Other possible conditions include cholangiohepatitis, which is a bacterial infection, lymphoma, and feline infectious periotonitis. A bile acid blood panel may also be ordered to determine if the liver is still functioning properly.
The only way to positively identify hepatic lipidosis is to examine a sample of the liver. This may be done by sedating the cat and obtaining samples through a needle inserted into the liver. or through a liver biopsy. The latter has a greater potential for complications but is more accurate.
Causes of Fatty Liver Disease
Disease, as well as environmental stressors can lead to hepatic lipidosis. These include diabetes, hyperthyroidism, pancreatitis, cancer, inflammatory bowel disease, and kidney disease. Other reasons why cats stop eating include social problems such as introducing a new pet into a home or introducing the pet to a new environment.
When a cat stops eating, its liver begins to accumulate excessive amounts of fat, causing a disruption in normal function and ultimately leading to liver failure and even death. Thanks to its genetic makeup, a cat’s liver is not equipped to deal with huge amounts of mobilized fat that enter the liver when a cat does not eat. Malnutrition develops fast because of high feline protein requirements.
The most important and obvious treatment is to get an afflicted feline to eat. Several methods may be used at the outset, including force feeding the cat, nutrition through a nasogastric tube, a pharyngostomy, which is a feeding tube inserted via an incision into the neck, or a stomach tube. The latter two must be bandaged in place for approximately 4 to 6 weeks of treatment, as noted by Dr. Brooks. Force feeding is gradually reduced as a cat’s appetite returns.
Nutritional and therapeutic support is often needed to return a cat afflicted with hepatic lipidosis to full health. These include supplementing diet with ursodiol, which aids bile flow, SAMe, to support liver function, L-Carnitine to help transport fats, and Taurine to help removal of toxic biles. Antbiotics are sometimes prescribed to improve overall health.
As noted by Long Beach Animal Hospital, cure rates range from 65% to 75% when treatment is started early enough. Cats with conditions such as pancreatitis, have low potassium or whose elevated bilirubin levels do not improve within 10 days have a lesser chance of survival.