Introduction
- 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.
Diagnosis
Differential diagnosis
- Other causes of intra-hepatic cholestasis:
- Cholangitis
, acute neutrophilic, lymphocytic. - Hepatic neoplasia-lymphoma, mast cell neoplasia, hepatoma, hepatic carcinoma .
- Toxin-induced hepatopathy , eg diazepam, paracetamol.
- Cholangitis
- Causes of post-heptatic cholestasis, ie biliary obstruction .
- Cholelithiasis.
- Biliary tract neoplasia.
- Pancreatitis .
- Pancreatic neoplasia.
- Duodenal pathology causing obstruction of duodenal papilla.
- Causes of pre-hepatic jaundice:
- Hemolysis, eg immune-mediated, oxidant injury, inherited RBC membrane enzyme deficiency.
- See Liver: chronic disease .
Sequelae
Prognosis
- Good if idiopathic HL.
- Fair if secondary HL, depends on underlying disease.
- >60% cases improve if meticulous care and management.
- Recurrence rare once recovered if idiopathic HL.
- Positive prognostic factors:
- Younger age (more likely idiopathic HL).
- Higher initial serum potassium level.
- Higher initial hematocrit.
Expected response to treatment
- Recovery of voluntary food intake to sustain daily calories requirement may take several weeks - couple of months.
- Hepatic enzymes and biochemistry return over weeks-months if idioapthic.
Sources
Publications
Refereed papers
- Recent references fromPubMed.
- Armstrong P J, Blanchard G (2009)Hepatic lipidosis in cats.Vet Clin North Am Sm Anim39, 599-616.
- Centre S A (2005)Feline hepatic lipidosis.Vet Clin North Am Sm Anim35(1), 225-269.
- Chastain C B, Panciera D, Waters C (2000)Metabolic and hormonal alterations in cats with hepatic lipidosis.Sm Anim Clin EndocrinolSept-Dec10(3), 10.
- Griffin B (2000)Feline hepatic lipidosis: pathophysiology, clinical signs and diagnosis.Compend Contin Educ Pract Vet22(9), 847-854.
- Griffin B (2000)Feline hepatic lipidosis: treatment recommendations.Compend Contin Educ Pract Vet22(10), 910-920.
- Center S A (1999)Chronic liver disease - current concepts of disease mechanisms.JSAP40(3), 106-114PubMed.
- Willard M Det al(1999)Fine needle aspirate cytology suggesting hepatic lipidosis in four cats with infiltrative hepatic disease.J Fel Med Surg1(4), 215-220PubMed.
- Dimski D S (1997)Feline hepatic lipidosis.Semin Vet Med Surg (Small Anim)12(1), 28-33PubMed.
- Center S, Crawford M, Guida Jet al(1993)A retrospective study of 77 cats with severe hepatic lipidosis.JVIM7, 349PubMed.
- Akol K, Washabau R, Saunders Het al(1993)Acute pancreatitis in cats with hepatic lipidosis.JVIM7, 205.
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.
