Question by tirazline1_1: More Advice on Feline Hepatic Lipidosis?
My 5yr male cat was diagnosed about 3 weeks ago with hepatic lipidosis. He used to weigh 12 pounds now he is down to 10 lbs. I am currently syringe feeding him about 1/4 can of feline a/d daily. (He still vomits a little after feeding). I am trying to increase more food in him because he is only eating and drinking very little on his own. The vet has prescribed an antibiotic called Zithromax daily for 10 days. I am concerned that this particular antibiotic will further damage the liver because it states that it is not recommended for this disease and needs to be used with caution. Should I give this med to him? Or question the vet’s treatment plan? Also how much should I feed him daily to reverse the damage? I know it takes time but I would like to know how much he needs to maintain his caloric intake for his size. Thank you for any help
Answer by ..shy<3
I know this is long but it includes many details and is extremely informative. Hope it helps.
Hepatic lipidosis, or fatty liver, is a common syndrome characterized by excess fat accumulation in the liver of cats. It can occur in cats of any age or breed and may affect more females than males. Hepatic lipidosis classically occurs after a period of anorexia (loss of appetite) of at least 2 weeks duration. When an additional disease state is found to be the cause of the anorexia, the hepatic lipidosis is defined as “secondary.” The term “primary” or “idiopathic” hepatic lipidosis is used when an additional disease state cannot be identified. This is the case in approximately 50 per cent of cats diagnosed with the disorder. Obesity before the period of anorexia increases the chances of a cat developing clinical hepatic lipidosis. The decrease in appetite causing secondary hepatic lipidosis can occur for a variety of reasons. The more common of the predisposing disease states are diabetes mellitus, pancreatitis (inflammation of the pancreas), cancer, and other liver diseases. Behavioral or stress-related causes of anorexia are also common; they include the owners being away on vacation, family members leaving or new people or pets being introduced into the household, boarding, and dietary changes. Unfortunately, once this disease develops, cats feel ill and may not begin to eat again even if the, initial cause of their loss of appetite has been eliminated. Without aggressive medical intervention, this vicious circle can, lead to death in over 90 per cent of the cats.
Cats are unique in their tendency to develop this disorder. Excessive amounts of fat are broken down from the cat’s peripheral fat storage tissue during fasting. This fat is then transported to the liver. The liver should then process this fat and export it to the rest of the body in a new form. In cats that develop hepatic lipidosis this process is impaired and the rate of fat export from the liver is much slower than the rate of fat intake, resulting in liver fat accumulation. Damage to the liver is caused by swelling of liver cells filled with fatty deposits as well as additional processes.
Symptoms commonly seen with this syndrome are anorexia, weight loss, lethargy, vomiting, jaundice (yellow tinge to the skin, inside of the ears, and gums), and occasionally behavioral or neurologic signs such as excessive drooling, blindness, semicoma or coma, and seizures. The suspicion that a cat is suffering from liver disease is confirmed by physical examination and appropriate abnormalities in blood work. Imaging techniques such as x-rays or ultrasound examination of the abdomen are helpful in demonstrating the size and appearance of the liver, as well as ruling out other disease states. The definitive diagnosis of hepatic lipidosis requires visualization of fat globules in liver cells obtained via liver biopsy or needle aspiration.
The treatment of hepatic lipidosis varies depending on its severity and the existence of other diseases. Prevention is extremely important. Any anorexic cat, especially if obese, should be seen by a veterinarian. Thus, the development of hepatic lipidosis can be caught in its early stages or prevented entirely with appropriate therapy. Hospitalization, fluid therapy, and supportive care may be required initially when the disease develops. Additional therapy such as antibiotics, vitamin K, and the treatment of other diseases may also be necessary.
The cornerstone of therapy, the only way to reverse the process of fat accumulation in the liver, is aggressive feeding to supply your cat with his or her full caloric requirements. Offering different diets and appetite-stimulating medications may induce a cat to eat in the initial phases of anorexia but will most likely not be of benefit once clinical signs of hepatic lipidosis develop. Appetite stimulating drugs, such as benzodiazepines (diazepam [valium], oxazepam) and cyproheptadine (Periactin), are primarily effective for stimulating appetite in those cats that are only partly anorectic, that continue to show some interest in food (even if not eating), and that are not severely ill. There is no place for these appetite-stimulating drugs in the treatment of feline HL. Furthermore, benzodiazepines may trigger or worsen hepatic encephalopathy, they require hepatic metabolism for excretion, and they may produce excessive sedation in cats with HL. In addition, chronic administration (>7 days) of diazepam PO to cats has been associated with fulminant hepatic necrosis.
Force feeding is usually not a good idea. Most cats resent force feeding, are uncooperative, become stressed, and rarely eat sufficient amounts of food for effective treatment. Cats with HL are very ill and severely stressed; thus, additional stress should be avoided. Cats also seem to develop food aversions rapidly, and the association between food and the unpleasant experience of forcing may d
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