Many modern cats—even skinny ones—can suffer from a fatty liver. Holistic vet Rohini Sathish offers abundant ways to slim them down
Our fat cat, Frodo, has been diagnosed with fatty liver disease. He is losing weight and turns his nose up at all his favorite foods. Our vet says his condition is serious and he may need to be hospitalized. Please advise.
Fatty liver syndrome is the layman’s term for feline hepatic lipidosis (HL) and is characterized by excess accumulation of lipids in the liver cells, or hepatocytes. It is the most common and potentially fatal feline liver disease and is referred to as a multifactorial syndrome that should not be taken lightly.
Causes: HL can be primary with no obvious causation, or it can be secondary to underlying diseases like diabetes, renal failure, pancreatitis, cholangiohepatitis or any other chronic disease that makes a cat anorexic. HL is most commonly associated with a period of starvation, which is the main trigger for infiltration of free fatty acids into the liver and for increased triglyceride production.
Obesity, stress, sudden changes in food or environment, a new home, new pets, being accidentally locked outside, being locked in a room by accident and other distressing events are predisposing factors contributing to starvation and consequent HL. This is why vets keep stressing to cat owners that while it’s okay for dogs to go without food for 48 hours, cats must not starve for more than 24 hours as HL could set in.
Symptoms: Appetite loss/poor appetite, anorexia, vomiting, sudden weight loss (more than 25 percent of body weight), lethargy, diarrhea and jaundice
Diagnosis: An enlarged liver (hepatomegaly) is usually visible on a radiograph/ultrasound. Blood tests are necessary and usually show raised liver enzymes. Apart from alanine aminotransferase (ALT) and alkaline phosphatase (ALKP), if there is also raised gamma-glutamyl transpeptidase (GGT), it has more clinical significance. In jaundiced cats, raised bilirubin may also be observed. A complete abdominal ultrasound scan will help rule out other causes of HL.
Treatment: The aim in HL cases is to correct the fluid and electrolyte imbalances and metabolic deficits and to initiate food intake as these cats stop drinking and eating. Conventional vets will therefore hospitalize these cats and start fluid therapy and force-feeding. Antiemetics may be necessary if the cats are nauseated or vomiting. Appetite stimulants may also be given although they may not work in HL as there is metabolic liver failure. They can help in early stages to stimulate feeding, though, so they’re worth trying. A mirtizapine transdermal, applied on the ear, is commonly prescribed.
Traditional Chinese Veterinary Medicine (TCVM): In cats, HL is considered a result of damp phlegm with qi deficiency. As the disease progresses, there may also be heat and yin deficiency with or without blood stagnation. A good TCVM-trained holistic vet will be able to perform a proper pattern diagnosis. Once the correct pattern is identified, treatment is initiated.
Diet (food therapy): In the initial stages, if the HL is not too advanced, a high-protein diet that is palatable should be force-fed by syringe. Hospitals use Hills AD or Royal Canin recovery formula. At home, you might feed rabbit, duck, liver, cod, kidney beans and seaweed. Foods that are too hot, like chicken and lamb, should be initially avoided. Hard-boiled eggs are a good choice.
Milk thistle: It clears dampness and promotes bile flow. It is useful for jaundice and helps protect the cell walls of the liver and prevent the deposition of toxins.
It can be obtained as a tincture. Dilute 20 drops in 1 oz of distilled water. Boil off any excess alcohol by heating the dilution uncovered for 2–3 minutes. Give 1 dropperful twice daily.
Oregon grape root: It helps to detoxify the liver and clear heat and dampness. Dilute the tincture using 15 drops in 1 oz distilled water, then give 1 dropperful one to two times daily.
According to Dr Francis Hunter, veterinary homeopath, Chelidonium 30C should be dosed three times daily for 3–7 days, or longer (10–14 days) if improving slowly.
Liver Tonic from Adored Beast (AdoredBeast.com) has a proprietary blend of dandelion root, Chelidonium, milk thistle and Berberis, all of which can support the liver and help it recover.
Feline Hepatic Support from Standard Process (StandardProcess.com) has several glandular extracts including Bovine liver PMG. It is a very useful supplement in any liver disease.
ST36 (located in a depression on the outer aspect of the hind limbs just below the knees) and BL20 (located on either sides of the spine in the depression between the last two ribs) are two important acupoints that help stimulate the appetite. Applying light finger pressure on these points for 30–60 seconds once daily can correct any energy imbalances that have affected the appetite of your pet.
LIV 13: Known as “Gate of Symbol,” this is the alarm point for the spleen. It is useful in jaundice and liver enlargement, hence its use in hepatic lipidosis. It is found at the end of the 12th (next-to-last) rib in the last enclosed rib space. Holding the point or just stroking along the entire rib space with light pressure once daily can help.
Aqua acupuncture: This should be performed by your holistic vet trained in acupuncture. She will inject vitamin B12 in critical acupoints to balance the liver, clear jaundice and stimulate the appetite. Weekly or biweekly sessions may be needed.
Massage: Tui-na practitioners advise pushing and pinching gently at BL20 and just in front of it (BL18–19) for three to five repetitions daily for 3 days, and then every 3 days afterward.
Vitamin C: 200 mg Ester-C a day for average-sized cats, 125 mg for small cats. It is helpful in restoring cellular liver function and as an effective antioxidant. Use less if it gives your cat diarrhea, a common side effect.
Vitamin E: 50 mg (pierce a capsule with a pin and squeeze onto your cat’s food).
Vitamin B12: Injections once a week.
Flower essences: Bach’s flower remedy Crab Apple (BachRemedies.com) is helpful for cats with appetite issues or for any pet with eating disorders. You can add 3 drops to drinking water or directly into the mouth.
Enlist the services of an energy healer or pet Reiki master to provide healing. Positive and soft, gentle communication is also vital for keeping stress levels down.
Hepatic lipidosis is a serious disease and needs aggressive therapy based on an integrated approach combining the best of conventional medicine and holistic therapies, especially TCVM. Cats should be observed regularly to ensure that they are eating and not losing weight due to starvation. Special attention should be paid to obese and shy cats that hide for days at a time.