Signalment: Nine-year-old, castrated male Maine Coon cat. Chief complaints: vomiting and lethargy. History: Referral for further work-up for elevated cholesterol and liver enzymes, icterus, and lethargy. The patient had a history of vomiting for 7-10 days and lethargy for 1-2 days. Over the past year he lost approximately nine pounds. Examination: On presentation, the patient was quiet but responsive, purring, euhydrated, and obese (BCS 9/9). He had a severely matted haircoat, severe bruising on limbs where blood had been drawn, mild waxy aural discharge and dilated pupils. His mucous membranes, sclera and skin were icteric. He was eupneic with normal cardiothoracic auscultation. He had a tense, painful abdomen. This case study will discuss the diagnosis, pathophysiology, and treatments of hepatic lipidosis, in addition to iatrogenic bile peritonitis, which was the reason for euthanasia in this case.