My cat won't eat grain-free food for allergy. Is fatty liver a risk?

Hello, thank you for your question about Sweetie. Fatty liver disease, or hepatic lipidosis, can become a serious life threatening condition. It occurs when cats suddenly stop eating, which leads to abnormal fat accumulation in the liver. The most important aspect of treatment is to ensure that the cat is eating, as this prevents further fat accumulation. Many cats with the severe form of this condition become very dehydrated and develops other symptoms such as vomiting, lethargy, etc. Many cats who are severely affected due require hospitalization and often placement of a feeding tube. If Sweetie has no sign of other symptoms and has already regained her appetite and is starting to feel better, I think it is ok to continue to monitor her at home. If you notice that she stops eating, develops any vomiting, or other symptoms I would recommend having her rechecked and consider in-patient therapy. Hope this helps!

Liver issues can be tricky to treat, and cats with liver issues may be more picky about what they eat. The first suggestion to try is if your cat had a dry (or wet) version of a prescription diet is to try the opposite dry or wet version. (IE if you try Hill's l/d dry, try a can of the l/d wet). Some cats may find the change in consistency and flavor more palatable and may begin to eat without having to completely change foods. If your cat was on a dry diet, a wet food may also be easier for your cat's liver to process. Another suggestion to try is to add a few kibbles of a food or a teaspoon of wet food your cat really likes to his prescription food. While some cats may figure out and pick out the good bits, many cats will begin to eat the whole meal and thus get the nutritional benefit from it. Your vet can let you know if it's safe to try this method depending on the severity of your cat's condition. For over the counter foods, a diet that has a similar nutrient makeup to prescription foods (you can check the nutrition label of l/d or NF if you have a bag handy) may help your cat with his liver issues while still being palatable. This is usually higher protein, contains L-carnitine to promote fat metabolism are low in sodium and have vitamins E and C to support the immune system and liver function. Your vet may also wish to recommend a supplement such as milk thistle which can also help promote liver function without a major change in food.

If she won’t eat the food that is being offered, keep trying alternative suitable diets until you find one that is palatable to her. There are many options for novel protein or hypoallergenic diets. You can also try a home Cooked diet as an alternative.

Most veterinary clinics will carry prescription liver diets such as Hill's l/d that are designed specifically to help cats with liver issues. Some vets may also recommend supplements to help support liver health, however it is best to check with your vet first to make sure they do not interact with any medications Dash is on. Cats tend to be enticed by warm or smelly food, so if he is having trouble eating, moistening dry food, or using wet food and then heating it up for 3-5 seconds to get it smelly may encourage him to eat. If he refuses to eat completely, it is best to seek veterinary care to help get him eating again and prevent further stress to his body.

Hepatic lipidosis in cats typically develops secondary to long-standing inappetance, liver disease, or neoplasia (cancer). These cats are generally very ill and require medications to treat the primary cause in addition to trying to get them to take in enough nutrition for their body. To start from home, you can try syringing a canned food to Gimli; if needed you can mix a little water in with it in a blender to get to a consistency that is easy to push through the syringe. Unfortunately, many of these patients do not do well with syringe feeding and a feeding tube (esophagostomy tube) is needed to get enough nutrients to them. The bright yellow urine could be due to increased bilirubin content, which is common in cats with hepatic lipidosis. I would strongly recommend getting him to a primary care veterinarian to determine what the primary cause is for the inappetance. Thorough bloodwork (complete blood count, serum chemistry, FeLV/FIV test) should be performed to begin to look for an underlying cause. Abdominal x-rays or additional bloodwork may be recommended based on these findings. The liver is very good at recovering from an injury if it is caught early and treated appropriately and aggressively. I hope Gimli feels better soon.

Unfortunately it can take a long time - weeks to months - to recovery from hepatic lipidosis. I typically recommend a feeding tube because feeding the appropriate number of calories is most important and it can be difficult to get enough calories in with syringe feeding alone. If you have other concerns for questions about her care you should check in with your vet and be sure to follow up for all recommended rechecks.

It’s a medical emergency when a cat won’t eat, and if they go longer than 72 hours without eating, they will develop a fatty liver. A fatty liver is fatal without treatment. Koko cannot wait until Monday to be seen, i strongly urge you to take him into an ER vet now.