Mèo Suffering from Fatty Liver: Caused by Prolonged Fasting and Multiple Antibiotic Injections

A. Feline Liver Disease

1. The Function of the Liver

Understanding the role of the liver is crucial in comprehending its impact on overall health and the consequences that arise when it fails to function optimally. The liver serves numerous functions, including:

  • Absorption of nutrients (via digestion and transport of fats)
  • Elimination of byproducts from the digestion process, such as toxins like ammonia
  • Production of proteins:
    • Blood clotting factors
    • Albumin: responsible for maintaining fluid balance and transporting substances throughout the circulatory system
    • Hormones
  • Maintenance of normal blood glucose levels

2. What Happens When a Cat’s Liver is Affected

When a cat suffers from liver disease (such as cirrhosis, liver failure, fatty liver disease, hepatic encephalopathy, or hepatitis), various liver disorders can damage the organ and impair its functionality. These disorders include:

  • Infections: bacteria, viruses, fungi, parasites
  • Toxicity
  • Inflammatory processes: originating from other parts of the body, trauma, chemicals, or autoimmune diseases
  • Reduced blood flow to the liver: due to heart failure or congenital abnormalities
  • Hepatorenal syndrome

These liver disorders often progress in a deteriorating trajectory. Impaired liver function and eventual liver failure lead to toxin buildup (resulting in abnormalities in the nervous and digestive systems), decreased protein synthesis (causing leaky blood vessels, fluid accumulation, and coagulation problems), low blood sugar levels, and even heart failure and death.

3. Treatment for Feline Liver Disease

When a cat is suffering from hepatic insufficiency, nutritional therapy can help optimize liver function and minimize further damage. The nutritional intervention goals include:

  • Supplying adequate energy in the form of high-quality protein
  • Reducing sodium intake to manage fluid retention
  • Increasing antioxidant content to protect cells from further damage
  • Alleviating symptoms of hepatic encephalopathy, if present (caused by ammonia buildup and toxic effects on the brain)

Making food for a kitten

Initially, adjusting the cat’s diet to include food that meets these criteria is necessary. You can cook meals for your cat using a formula recommended by a veterinary nutritionist or veterinarian. Generally, a cat with hepatic disease requires:

  • High-quality protein to reduce the workload on the liver
  • High-quality fats
  • Antioxidant supplements like vitamin E, vitamin C, and selenium to combat oxidative stress
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Most commercially available cat foods cannot meet these requirements. It is essential to understand your cat’s nutritional needs. We encourage you to read more about “Proper Feeding Guidelines for Cats” to understand their dietary needs better.

It is crucial to gradually change the cat’s diet to increase acceptance of the new food. If the cat refuses to eat, you can use a feeding tube or provide nutritional gel to prevent negative energy balance and the progression or aggravation of fatty liver disease. You can provide your cat with various nutritional gels, such as:

Virbac nutritional gel

GimCat nutritional gel

Nuvita nutritional gel

If your cat has hepatic encephalopathy, a low-protein diet can help limit ammonia (a byproduct of protein digestion) accumulation. Additionally, if your cat is retaining water, reducing sodium intake can help prevent further complications.

Close cooperation with your veterinarian is crucial to monitor the progression of the disease, implement necessary treatments, and ensure your cat has the best possible long-term health.

B. Feline Fatty Liver Disease

1. What is Fatty Liver Disease in Cats?

Feline fatty liver disease (also known as hepatic lipidosis) is one of the most common severe liver diseases in cats. The liver plays a significant role in the body, carrying out various complex functions. It is impossible to compensate for the loss of liver mass once damage has occurred.

Feline fatty liver disease

2. Symptoms of Fatty Liver Disease in Cats

Typical symptoms of liver disease in cats include:

  • Prolonged anorexia (usually lasting for several weeks)
  • Rapid weight loss
  • Vomiting (although this symptom can be present in many other diseases as well; it is essential to understand the causes of vomiting in cats)
  • Diarrhea
  • Constipation
  • Muscle wasting
  • Lethargy
  • Lowered head and neck
  • Jaundice (e.g., yellowing of the eyes)
  • Drooling
  • Cats may experience periods of collapse

Other symptoms of fatty liver disease in cats are related to concurrent or pre-existing health conditions.

Fatty liver disease symptoms

3. Causes

In most cases, the exact causes of fatty liver disease in cats remain unknown. However, several factors can contribute to liver disease in cats, such as:

  • Liver and kidney diseases
  • Cancer
  • Diabetes
  • Pancreatitis
  • Other diseases
  • Prolonged fasting (over 48 hours)
  • Obesity due to overeating and lack of exercise: Contrary to popular belief, overweight cats are not adorable; excess weight shortens their lifespan. We encourage you to read “The Consequences of Overfeeding Cats” to understand the importance of maintaining a healthy weight for your cat.
  • Excessive and unjustified use of antibiotics can also cause kidney and liver damage in cats. Anything unnatural needs to be processed by the liver, causing it to work more than it should.
  • Ingestion of harmful chemicals by cats, which can lead to liver inflammation.
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Preventing cat leukopenia

Critical risk factors include obesity, stress, lifestyle changes, getting lost, loss of appetite, and general illnesses.

4. Diagnosing Fatty Liver Disease in Cats

You will need to provide a detailed medical history, including the cat’s symptoms, onset, and any possible events leading up to the illness. The medical records you provide will offer clues to the organs causing the symptoms and the underlying conditions that could lead to liver damage.

  • Blood tests and urine analysis can indicate whether the cat has liver disease. A cat is at risk of liver disease if:
    • Red blood cells are abnormally sized (indicating increased white blood cells)
    • Blood cell breakdown (hemolysis)
    • Increased alkaline phosphatase (ALP) levels, which may indicate liver failure
    • Abnormal levels of liver enzymes and bilirubin
    • Liver plays a crucial role in the clotting process, and abnormalities related to blood clotting can also be observed in affected cats.
  • X-rays and ultrasounds of the abdomen can reveal liver enlargement and assess liver structure and abnormalities, such as the presence of bright spots (indicating fat) within the liver.

Image of a cat with fatty liver disease

  • Veterinarians may take liver biopsies (via biopsy or needle aspiration) to evaluate liver cell condition and related abnormalities, including fat accumulation within the cells, to confirm fatty liver disease.

5. Treating Fatty Liver Disease in Cats

  • The primary treatment for feline fatty liver disease involves dietary adjustments. You need to ensure that your cat’s protein requirements are promptly met to reverse their state of starvation.
  • If the cat refuses to eat, you may need to hand-feed them by placing food directly into their mouth, which they are obliged to swallow. If the cat still refuses to eat, your veterinarian will place a feeding tube. Various methods exist for tube feeding: some may pass through the nostril into the esophagus or stomach, while others may go directly through the skin of the neck into the esophagus.
  • Tube feeding is performed four to six times daily. Tube feeding starts gradually, and the amount of food is increased over a few days to allow the stomach to accommodate the food and prevent metabolic disturbances. This process may take several weeks until the cat can eat willingly and fully independently.
  • In extreme cases, your cat may need to be hospitalized for intensive care and treatment. Fluid therapy will be administered to restore fluid and electrolyte balance lost through vomiting or diarrhea. Anti-nausea medications might be required if the cat continues to vomit.
  • Your veterinarian may administer liver-supportive and detoxifying medications and supplement with vitamins, including vitamin B-complex, cobalamin, and thiamine. Your cat will be discharged once its condition has stabilized.
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6. Considerations when Treating Cat Liver Disease

  • Early diagnosis and treatment are key to successful recovery from fatty liver disease in cats. If your cat holds out for several days, the prognosis for complete recovery is high. You must comply with all veterinary instructions regarding treatment, feeding, and care.
  • Obesity is a significant contributing factor to fatty liver disease in cats. Hence, adhering to dietary guidelines to minimize this risk is crucial. Increase your cat’s physical activity to help reduce adiposity.
  • If you are feeding your cat through a feeding tube or any other force-feeding method, ensure that you follow your veterinarian’s guidelines for feeding techniques and schedule. You may encounter difficulties during feeding time, so it is helpful to have a second person to assist.
  • Minimize stressors for your cat as much as possible. Identify stress factors for your cat to limit their exposure to them. Allocate a quiet space in your home where your cat can rest, away from household traffic, energetic children, and other pets.

Resting cat with fatty liver disease

  • Follow-up visits with your veterinarian are necessary to evaluate your cat’s progress during treatment and recovery. Monitor weight, water intake, and overall health indicators. Consult your veterinarian if you notice any concerning symptoms in your cat.
  • Most cats with fatty liver disease can recover within three to six weeks.


The liver is an indispensable organ with irreplaceable functions. Unfortunately, many cats today are prone to liver disease due to their lifestyle and diet. Typically, fatty liver disease is identifiable by the characteristic jaundice. Causes of fatty liver disease include:

  • Obesity
  • Excessive antibiotic administration
  • Pre-existing liver, kidney, diabetes, or pancreatic diseases
  • Ingestion of toxic chemicals
  • Prolonged fasting (over 48 hours)

The primary treatment for this condition is through dietary adjustments.

  • You must provide your cat with a nutritionally balanced diet containing high-quality protein. If the cat refuses to eat, you need to force-feed or use a feeding tube.
  • Supplement with liver-enhancing vitamins.
  • In severe cases or advanced stages, your cat may need to be hospitalized for treatment.
  • Your veterinarian may prescribe liver supplements, detoxifying medication, and vitamin supplementation including vitamin B.

The best treatment remains prevention: maintaining a healthy weight for your cat, ensuring they exercise regularly, not allowing them to fast for over 48 hours, and scheduling annual veterinary check-ups for your cat’s well-being.

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