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Case Notes: Bob: Obese Cat with Hepatic Lipidosis
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Bob, affectionately known as “Blob”, is a very fat cat. Not to mince words, she is obese and despite years of dieting she remains obstinately obese and utterly oblivious to the danger this poses.

One morning Bob's food was put down for her and she turned away and left it uneaten. This was unprecedented but did not immediately alarm her owner, after all Bob was not going to waste away for want of a meal or two was she? Bob didn't eat her tea that night and she didn't even appear for breakfast the following morning. She was found collapsed on the upstairs landing, panting and staggering when she tried to get up.

On examination at the surgery her gums were terribly pale, her heart was racing and, even through all the abdomenal fat, we could feel that her liver was enlarged and tender. A blood sample was taken and tested immediately in our in-house laboratory. These tests confirmed that she was severely anaemic and had suffered extensive liver damage.

There are, however, many possible causes of both liver damage and of anaemia which cannot necessarily be distinguished by blood testing alone. These include bacterial, viral and parasitic infections, poisons, cancers of various sorts and disorders of the immune system. We sent off further blood samples to an outside laboratory to check for, or rule out, some of these causes. Meanwhile we homed in on what had to be the most likely diagnosis in this particular cat. That is hepatic lipidosis or “fatty liver disease”.

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Cats are more prone to this condition than many other species because their livers are particularly slow to break down fat to provide energy. Fat cats are particularly prone. If they stop eating or are deprived of food, for even a few days sometimes, they will start mobilising their plentiful store of body fat more rapidly than the liver can process it. The liver cells become choked with fat and unable to perform any of their many essential functions. The cat then feels very unwell and can't face food at all and so the problem quickly escalates.

More detailed questioning of Bob's family, shed some light on a possible initiating cause. It emerged that they had recently taken on a second cat, a hansome and dominant Tabby named “Obviously”. They had taken some care with the feeding arrangements. To ensure that Bob could not gain yet more weight by stealing Obviously's food, they employed the simple expedient of feeding Obviously at height that was beyond Bob's limited jumping ability. They had not considered the reverse scenario. The children, however, observed that Obviously had been scoffing his own food and then bullying Bob off hers using only an icy stare and no physical violence. This had apparently been going on for a couple of weeks but no-one had worried much. This could easily have caused Bob's life-threateneing illness.

The treatment for fatty liver disease is very simple – it involves getting enough calories into the patient to avoid any further need for breakdown of body fat thus allowing the liver to catch up with the backlog and recover. Sometimes this involves nasogastric or oesophageal tube feeding and nutrition and hydration via intravenous drip too. Sometimes the liver is damaged beyond the point of recovey.

Bob was extremely lucky. We started by just syringe feeding a liquidised convalescent diet of high nutritional density. She was utterly compliant and willingly swallowed 40ml of the stuff every two hours for the rest of that day without regurgitation or vomitting. We rechecked her red blood cell count the next day and it had improved significantly. We continued to feed in this way and she continued to take everything we syringed into her.She even started to purr every time we approached with the syringe. I think she thought she was in fatcat heaven! On day three she began to eat on her own and we were simply topping up the nutrition with periodic syringe feeds for the next couple of days. By day five she was up and about, no longer breathless on exertion or wobbly on her legs. We rechecked her red blood cell count which had recovered completely (ie she was no longer anaemic) and her liver enzymes whose levels had come down by half (ie her liver was well on the mend).

To Bob's great disgust we declared her fit to go home. To Obviously's great disgust a regime of supervised feeding was introduced. Both cats would have preferred her stay in hospital to have been permanent!

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Henley Vets and Twyford Vets
The Veterinary Centre: 271 Reading Road, Henley-on-Thames, RG9 1EL - Phone 01491 574490
Also at Twycombe Lodge, Loddon Hall Road, Twyford, RG10 9JA - Phone 0118 934 0259