Garret E. Pachtinger, VMD, DACVECC, VETgirl; Veterinary Specialty and Emergency Center, Levittown, Pennsylvania
Feline hepatic lipidosis is a potentially fatal intrahepatic cholestatic syndrome that develops in cats in association with anorexia (of 2-7 days’ duration) and a catabolic state (ie, a state of negative energy balance). Most affected cats are obese or overweight, middle-aged (median age, 7 years), and/or domestic shorthair breed (see Suggested Reading).
Hepatic lipidosis can occur secondary to another disease process or be a primary, idiopathic disease; anorexia is usually the predisposing factor. Although a simple household stressor may lead to appetite loss, anorexia can result from heart disease, kidney disease, chronic feline lower urinary tract disease, upper respiratory disease, cancer, and pancreatitis.
Figure 1 Icterus of the hard and soft palate in a cat with hepatic lipidosis
Patients are typically presented with inappetence, lethargy, vomiting, diarrhea, and weight loss. Most cats are alert, but some may exhibit lethargy and depression caused by hepatic encephalopathy or weakness caused by electrolyte derangements (eg, hypokalemia).
Common examination findings include icterus (Figure 1), signs of dehydration (eg, skin tenting, dry mucous membranes, sunken eyes, dull corneas), an unkempt hair coat, a pendulous abdomen with cranial organomegaly (ie, hepatomegaly), and weight loss often exhibited by dorsal muscle wasting.
Specific examination findings may be associated with an inciting, underlying disease process (eg, abdominal pain accompanying pancreatitis, nasal discharge accompanying upper respiratory infection).