Q: Phoebe is my 8-year old, spayed, Siamese mix. Two weeks ago, she was overweight. Recently, she quit eating and drinking. My vet could not detect anything wrong during her exam. Her blood tests were negative except for slightly elevated liver enzymes. He gave her an antibiotic shot and then prescribed oral antibiotics. We gave two pills and quit. She weights about 11 pounds; she used to weigh 13 pounds. She still drinks water. She gets interested when offered food, but then she gags and walks away. She barely eats her dry food now. Any ideas what’s wrong?
A: It’s difficult to say what is going on with your cat without examining her or interpreting the blood work myself. The facts that she was overweight, has stopped eating and has elevated liver enzymes make this sound suspicious for a condition called hepatic lipidosis, or fatty liver disease.
Hepatic lipidosis is a condition that often occurs when a healthy, overweight cat suddenly stops eating. A classic scenario is a healthy overweight cat stops eating because of a sudden stress, such as the owner going away on a trip or a move to a new household. Body fat is broken down to be used for energy; however, the fat accumulates in the liver rather than being used for fuel. This accumulation of fat in the liver causes a bunch of clinical signs, including anorexia, vomiting, weight loss, lethargy and jaundice. Some of these cats feel nauseous, and the mere smell of food will make them gag. The diagnosis is made via liver aspirate or biopsy. Your veterinarian should perform an ultrasound on Phoebe and obtain an ultrasound-guided liver biopsy or a fine-needle aspirate.
The cornerstone of treatment for hepatic lipidosis is aggressive nutritional support. Hepatic lipidosis can be fatal; however, recent medical advances have allowed for better treatment. Today, most cats with hepatic lipidosis survive and do well.
Arnold Plotnick, DVM