Feline Hepatic Lipidosis: The Cat Who Stopped Eating

Dr. Rosemary Stolzer, DVMFelinePre-RACE approval · credit hours set at approval

Feline hepatic lipidosis carries a 50-60% mortality rate without treatment — and an 80-90% survival rate with early, aggressive nutritional intervention. The difference is almost entirely in the clinician's willingness to place a feeding tube without delay. Follow Butterscotch, an obese 8-year-old DSH with three days of complete anorexia and overt jaundice, from the metabolic cascade that makes cats uniquely vulnerable, through esophagostomy tube placement, graded refeeding, refeeding syndrome prevention, and evidence-based hepatoprotective support.

Learning Objectives

  • 1Explain the obligate carnivore metabolic cascade that makes obese cats uniquely vulnerable to hepatic lipidosis within 48-72 hours of anorexia, including the role of VLDL export limitation and carnitine depletion
  • 2Recognize the classic FHL bloodwork pattern — disproportionate ALP elevation relative to ALT, severe hyperbilirubinemia, hypoalbuminemia, and Heinz body formation — and distinguish it from primary biliary or hepatocellular disease
  • 3Apply the esophagostomy tube placement technique, calculate RER at ideal body weight, and implement a graded refeeding protocol to prevent refeeding syndrome
  • 4Identify and manage refeeding syndrome through pre-emptive electrolyte monitoring, potassium and phosphorus supplementation, and appropriate escalation of caloric delivery
  • 5Describe the mechanism, dosing, and evidence level for each hepatoprotective agent — SAMe, silymarin, L-carnitine, ursodiol, vitamin E, and cobalamin — and establish appropriate criteria for feeding tube removal

Course Syllabus

  1. 1
    Meet Butterscotch — The Cat Who Stopped EatingPreview

    module-1-meet-butterscotch

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    7 min
  2. 2
    The Metabolic Trap — Why Cats Are Uniquely Vulnerable

    module-2-pathophysiology

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    9 min
  3. 3
    Diagnosis — Confirming FHL and Ruling Out the Trigger

    module-3-diagnosis

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    9 min
  4. 4
    Conventional Treatment — The Feeding Tube and Beyond

    module-4-conventional-treatment

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    10 min
  5. 5
    Integrative Hepatoprotection — Supporting Liver Recovery

    module-5-integrative-hepatoprotection

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    8 min
  6. 6
    Case Resolution — Recovery, Tube Removal, and Prevention

    module-6-case-resolution

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    8 min

Final Assessment

10 questions · Passing score: 70%

Complete all course modules to unlock the assessment. Upon passing, your certificate of completion will be generated automatically.