ISSN 2398-2950      

Liver: lipidosis


Synonym(s): Hepatic lipidosis, HL


  • Accumulation of fat in >50% of hepatocytes.
  • Cause: idiopathic, secondary to systemic illness.
  • Signs: anorexia, jaundice, vomiting, diarrhea, constipation, weight loss.
  • Diagnosis: liver biopsy including fine needle aspiration (FNA).
  • Prognosis: fair-good, reversible if underlying disease controlled.
Print off the owner factsheet Fatty liver disease (hepatic lipidosis) in cats to give to your client.



  • Idiopathic - between 1-50% of reported cases.
  • 50-98% of cases reported secondary to systemic disease, eg neoplasia, diabetes mellitus  Diabetes mellitus, hyperthyroidism Hyperthyroidism, hyperadrenocorticism   Hyperadrenocorticism.
  • Syndrome characterized by hepatocellular lipid accumulation, intrahepatic cholestasis and abnormal hepatic function.
  • Pathophysiology incompletely understood and is likely due to multiple mechanisms including:
    • Chronic overnutrition and excess caloric intake leading to increased hepatic triglyceride content.
    • Increased mobilization of fat from peripheral stores Hyperlipidemia overwhelms hepatic fat utilization and/or mobilization capacity.
      • Increased hormone sensitive lipase activity (via increased levels of noradrenaline, adrenaline, cortisol, growth hormone, glucagon and thyroxine) promotes lipolysis.
      • Decreased rate of fatty acid oxidation.
      • Increased hepatic fat synthesis.
      • Decreased mobilization of fat from liver as lipoproteins.
    • Relative carnitine deficiency - carnitine is required for fatty acid transport into and out of hepatocytes.
    • Resistance to insulin activity (hence reduced lipoprotein lipase activity, which cause lipid uptake and reduced inhibition of hormone sensitive lipase).
    • Protein-calorie malnutrition.
    • Nutrient deficiencies (taurine, arginine, methionine, cysteine, vitamin K1 and B-vitamins).

Predisposing factors


  • Caused by illness, change in diet, environmental factors and stress (eg boarding cattery stay, introduction of new cats to household).


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Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Armstrong P J, Blanchard G (2009) Hepatic lipidosis in cats. Vet Clin North Am Sm Anim 39 (3), 599-616 PubMed.
  • Centre S A (2005) Feline hepatic lipidosis. Vet Clin North Am Sm Anim 35 (1), 225-269 PubMed.
  • Chastain C B, Panciera D, Waters C (2000) Metabolic and hormonal alterations in cats with hepatic lipidosis. Sm Anim Clin Endocrinol Sept-Dec 10 (3), 10.
  • Griffin B (2000) Feline hepatic lipidosis: pathophysiology, clinical signs and diagnosis. Compend Contin Educ Pract Vet 22 (9), 847-858 VetMedResource.
  • Griffin B (2000) Feline hepatic lipidosis: treatment recommendations. Compend Contin Educ Pract Vet 22 (10), 910-922 VetMedResource.
  • Center S A (1999) Chronic liver disease - current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.
  • Willard M D, Weeks B R, Johnson M (1999) Fine needle aspirate cytology suggesting hepatic lipidosis in four cats with infiltrative hepatic disease. J Fel Med Surg (4), 215-220 PubMed.
  • Dimski D S (1997) Feline hepatic lipidosis. Semin Vet Med Surg (Small Anim) 12 (1), 28-33 PubMed.
  • Akol K G, Washabau R J, Saunders H M et al (1993) Acute pancreatitis in cats with hepatic lipidosis. JVIM (4), 205-9 PubMed.
  • Center S, Crawford M, Guida J et al (1993) A retrospective study of 77 cats with severe hepatic lipidosis: 1975-1990​. JVIM (6), 349-59 PubMed.

Other sources of information

  • Holan K M (2008) Feline hepatic lipidosis. In: Kirks's Current Veterinary Therapy XIV Small Animal Practice, Ed Bonagura J, Twedt D, Missouri, Elsevier Saunders. pp 570-575.

Related Images




Anemia: immune-mediated hemolytic

Bile duct: disease

Biopsy: hepatic

Blood biochemistry: alanine aminotransferase (SGPT, ALT)

Blood biochemistry: albumin

Blood biochemistry: alkaline phosphatase

Blood biochemistry: ammonia

Blood biochemistry: aspartate aminotransferase

Blood biochemistry: bile acid stimulation test

Blood biochemistry: chloride

Blood biochemistry: cholesterol

Blood biochemistry: creatinine

Blood biochemistry: gamma glutamyl transferase

Blood biochemistry: glucose

Blood biochemistry: magnesium

Blood biochemistry: phosphate

Blood biochemistry: potassium

Blood biochemistry: total bilirubin

Blood biochemistry: total globulin

Blood biochemistry: total protein

Blood biochemistry: urea

Blood biochemistry: vitamin B12

Computed tomography: abdomen


Diabetes mellitus

Diabetes mellitus: other considerations

Diabetic ketoacidosis


Esophagostomy feeding tube placement


Feline infectious peritonitis

Feline pancreatic lipase immunoreactivity (fPLI) test

Fluid therapy: for electrolyte abnormality

Gastrostomy: percutaneous tube (endoscopic)

Hematology: activated partial thromboplastin time (APTT)

Hematology: leucogram

Hematology: packed cell volume

Hematology: prothrombin time

Hepatic encephalopathy








Inflammatory bowel disease: overview



Liver function assessment

Liver: cholangitis / cholangiohepatitis

Liver: chronic disease

Liver: primary hepatic neoplasia

Liver: toxic hepatitis

Maropitant citrate


Nasoesophageal intubation


Nutrition: disease modulation




Potassium chloride / gluconate

Radiography: abdomen



Ultrasonography: liver

Urinalysis: ketone

Urinalysis: specific gravity

Vitamin E


WSAVA Liver Diseases Guidelines

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