CONDITION

Hepatic Lipidosis

Why this matters now

Hepatic lipidosis (fatty liver disease) is the most common form of severe liver disease in cats and can develop rapidly when a cat stops eating. Overweight or obese cats are particularly susceptible, though any cat can be affected. The condition often develops secondary to another illness that causes appetite loss, or following a stressful event.

When cats stop eating, their bodies mobilise fat reserves for energy. The feline liver handles this fat influx poorly, leading to fat accumulation within liver cells. This impairs liver function progressively. Without intervention, the condition typically worsens over days to weeks. Jaundice develops as liver function declines, and cats become increasingly ill. The condition can become life-threatening if not addressed.

Signals & patterns

Early signals

Sudden loss of appetite

Refusing food entirely or eating much less than normal is often the first change noticed.

Rapid weight loss

Cats may lose weight quickly, sometimes within one to two weeks of reduced eating.

Hiding or withdrawal

Affected cats often become reclusive, avoiding interaction and seeking secluded spots.

Decreased grooming

Cats may stop maintaining their coat, appearing unkempt or greasy.

Later signals

Jaundice (yellow colouration)

Yellow discolouration of the skin, gums, and whites of the eyes indicates liver dysfunction.

Vomiting

Nausea and vomiting often accompany advancing liver disease.

Drooling

Excessive salivation may occur due to nausea or hepatic encephalopathy.

Weakness or unsteady movement

Severe cases may show neurological changes related to toxin accumulation.

Click to read about the biological mechanisms

How this is usually investigated

Diagnosis combines clinical signs, blood tests indicating liver dysfunction, and often imaging or liver sampling to confirm fat accumulation.

Blood biochemistry

Purpose: To evaluate liver enzymes, bilirubin, and metabolic parameters
Considerations: Elevated liver enzymes (especially ALP and GGT) and high bilirubin levels suggest liver disease. Low protein and glucose may also occur.

Blood clotting tests

Purpose: To assess the liver's production of clotting factors
Considerations: Prolonged clotting times indicate significant liver dysfunction and influence treatment planning.

Abdominal ultrasound

Purpose: To visualise liver size, appearance, and assess for other conditions
Considerations: The liver often appears enlarged and may have a characteristic bright appearance. Ultrasound also helps identify underlying conditions.

Liver fine needle aspirate or biopsy

Purpose: To confirm fat accumulation within liver cells
Considerations: Cytology or histopathology demonstrates the fat-laden hepatocytes characteristic of hepatic lipidosis.

Investigation of underlying cause

Purpose: To identify what triggered the appetite loss
Considerations: Hepatic lipidosis often develops secondary to another condition. Identifying and addressing this is important for recovery.

Options & trade-offs

Treatment centres on nutritional support to stop fat mobilisation and allow liver recovery, alongside addressing any underlying cause.

Feeding tube placement

A tube placed through the nose, oesophagus, or directly into the stomach to deliver nutrition.

Trade-offs: Often essential as affected cats typically refuse food voluntarily. Oesophagostomy or gastrostomy tubes allow long-term feeding at home. Requires anaesthesia for surgical placement.

Nutritional support

Calculated caloric delivery of appropriate diet through the feeding tube.

Trade-offs: Recovery depends on adequate nutrition. Refeeding must be gradual initially to avoid complications. Tube feeding may be needed for weeks.

Anti-nausea medications

Medications to control nausea and stimulate appetite.

Trade-offs: Helps with comfort and may encourage voluntary eating as recovery progresses. Multiple medications may be used together.

Liver supportive supplements

Substances such as S-adenosylmethionine (SAMe) to support liver function.

Trade-offs: May support hepatocyte recovery. Often used alongside other treatments.

Treatment of underlying condition

Addressing whatever caused the initial appetite loss.

Trade-offs: Essential for preventing recurrence. May require additional diagnostics and treatments.

Common misconceptions

Misconception:

"Cats can safely go without food for a few days"

Reality:

Even a few days of not eating can trigger dangerous fat mobilisation in cats, particularly if overweight. Cats should not go more than 24-48 hours without eating.

Misconception:

"Hepatic lipidosis only affects fat cats"

Reality:

Whilst overweight cats are at higher risk, any cat that stops eating can develop hepatic lipidosis. The key factor is the period of food refusal.

Misconception:

"Once a cat has hepatic lipidosis, recovery is unlikely"

Reality:

With aggressive nutritional support, many cats recover fully from hepatic lipidosis. Treatment is intensive but often successful.

Monitoring appetite closely and noting any reduction in food intake helps with early recognition. Understanding what a cat normally eats each day provides a baseline. Any cat not eating for more than 24 hours, particularly an overweight cat, warrants attention. Tracking body condition and weight periodically can identify gradual changes.

Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS