Felis ISSN 2398-2950

Liver: lipidosis

Synonym(s): Hepatic lipidosis, HL

Contributor(s): Angie Hibbert, Philip K Nicholls, Penny Watson

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.

Pathogenesis

Etiology

  • 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

General

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

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

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.


ADDED