Understanding fatty liver disease in cats

Cats are famous for being finicky, but if they stop eating altogether, they can develop fatty liver disease. Here’s what you need to know about this serious liver condition.

I had never heard of fatty liver disease before my cat, Cleo, got sick. She’d always had a healthy appetite and I never had cause to worry about her.

But when my new husband and his dog moved in, Cleo suddenly had canine competition. I knew she was having a hard time getting to her food, but I didn’t know the potential ramifications, so all I did was scold the dog. A month later, I realized Cleo had gone from over 12 pounds to under nine. She was always hiding, and wouldn’t eat even when placed out of the dog’s reach or offered her favorite foods. The veterinarian diagnosed her with feline hepatic lipidosis, also called fatty liver disease.

Fatty liver disease occurs when a cat (usually overweight) stops eating, either partially or entirely. As his body tries to process its fat stores for energy, the liver becomes congested with fat and stops functioning normally. Fatty liver disease is categorized into two types.

1. Secondary hepatic lipidosis results from another illness that causes the cat to stop eating, in which case the focus is on treating the underlying condition as much as the liver disease.

2. The primary form is when the cat stops eating for another reason, often related to stress – a stressful boarding situation, the addition of another animal to the household, etc.

Once the liver starts getting congested, the cat feels ill and no longer wants to eat. “Primary hepatic lipidosis should be treated aggressively,” says veterinarian Dr. Cindy Kneebone. “These cats are critically ill and can die.”

Food intake is crucial

Most cats can recover from fatty liver disease given the right treatment. “The most successful therapy involves getting food calories into the cat,” says Dr. Kneebone. Since hepatic lipidosis usually isn’t diagnosed until the cat has stopped eating almost entirely, this usually means force-feeding, with a syringe or through a tube. Many vets recommend a feeding tube, since a lot of cats will fight against syringe-feeding. A nasogastric tube goes in through the nose and down the throat, and can be used for the first day or two until the cat is stable enough to undergo surgery. During the operation, feeding tubes are placed in the esophagus or through the side of the stomach.

Only when the cat is getting enough calories, primarily from protein, will the liver clear the congestion and start functioning normally again. It can take anywhere from a few weeks to a few months before the cat starts eating on his own again, and feeding him enough calories in the meantime can be challenging. “The stomach shrinks to 10% of its normal size in hepatic lipidosis,” says Dr. Kneebone. She recommends feeding smaller amounts of food every two or three hours to help prevent vomiting.

A conventional vet may also recommend additional treatments, such as subcutaneous fluids or electrolytes, antibiotics, steroids, anti-nausea medicine and antacids. Appetite stimulants may or may not be beneficial.

Holistic therapies

The most important part of treatment is to get plenty of protein-based calories into your cat. But a variety of holistic therapies can help support his overall health during this crucial time. It’s vital to ensure he gets adequate nutrition, so supplements such as magnesium, amino acid powders, potassium and electrolytes can all be beneficial. Vitamin B12 is often given as an injection. Milk thistle and SAM-e help support and improve liver function, while Ipecac and China, given periodically throughout the day, can help ease vomiting and nausea.

A solid holistic approach should also encourage healthy bowel movements, as this allows the liver to gradually clear everything out. Probiotics can be given to replenish the beneficial bacteria in the intestines.

As for Cleo, I had to syringe-feed her several times a day. It was the longest month of my life, but it paid off. As I write this, she’s curled up next to me in her favorite spot on the couch. I can’t say that nearly dying did much for her personality – she’s still particular and crabby – but I’m grateful she’s still here to complain about it!


Katharine Swan has been a professional writer for more than seven years, but she has been an animal lover all her life. She lives in Colorado with two cats, two big dogs, two horses, and a very patient husband. When she is not writing or reading, you can generally find her riding, walking a dog, or enjoying a snuggle with a cat.