Hepatic lipidosis in a 3 year old domestic shorthair

Abstract

This is the case of an approximately 3 year old male castrated feline Domestic Shorthair that was diagnosed with hepatic lipidosis. Multiple environmental stress factors had occurred prior to disease onset including a move across the country and introduction into a multi-cat household. Inappetance, vomiting, and weight loss were reported following these events. General physical examination revealed icterus, mild dehydration, muscle atrophy of the head and neck, and obesity. Biochemistry panel on presentation disclosed hyperbilirubinemia and increased ALP activity in the presence of normal GGT activity. Abdominal ultrasound revealed a diffuse hyperechoic hepatic parenchyma consistent with hepatic infiltration of fibrosis or lipid. Ultrasound-guided fine needle aspiration confirmed severe hepatic lipidosis. An underlying disease process was not identified. Aggressive supportive medical therapy was instituted including placement of an esophageal feeding tube and feeding of a quality high protein diet, fluid therapy, l-carnitine supplementation, antioxidant therapy, empirical antibiotic therapy, and appropriate vitamin and electrolyte supplementation. Follow up examinations and blood work disclosed resolution of hyperbilirubinemia and abnormal hepatic enzyme activity.