Changes

==Signalment==

==Signalment==

Indoor cat more prone to primary hepatic lipidosis

Indoor cats are more prone to primary hepatic lipidosis.  Middle-aged cats are more prone.

==Description==

==Description==

Hepatic lipidosis is the derangement of lipid and protein metabolism, which occurs cats and dogs, but more clinically significant in cats.  It is important to differentiate primary (idiopathic) hepatic lipidosis from secondary hepatic lipidosis.   

Hepatic lipidosis is the derangement of lipid and protein metabolism, which occurs cats and dogs, but more clinically significant in cats.  It is important to differentiate primary or idiopathic hepatic lipidosis from secondary hepatic lipidosis.   

'''Primary hepatic lipidosis''' is most recognised in obese indoor cats following anorexia in North America.  The mortality rate is high unless the disease is treated aggressively.  The pathogenesis includes a number of factors:

'''Primary or idiopathic hepatic lipidosis''' is most recognised in obese indoor cats following anorexia.  It is the most common hepatic disease in North America but it is also becoming more common in Europe.  It is an acute hepatopathy with a large accumulation of lipid in hepatocytes, causing the liver to lose its function.  The mortality rate is high unless the disease is treated aggressively.  The pathogenesis includes a number of factors:

*Excessive lipid mobilisation which is induced by anorexia, illness or stress.

*Excessive lipid mobilisation which is induced by anorexia, illness or stress.

*Deficiency of dietary proteins and other nutrients, which reduces the liver's capacity to produce transport proteins and to metabolise fat.  Recognised nutrient deficiencies include arginine, carnitine, taurine and methionine.

*Deficiency of dietary proteins and other nutrients, which reduces the liver's capacity to produce transport proteins and to metabolise fat.  Recognised nutrient deficiencies include arginine, carnitine, taurine and methionine.

*Disturbances in the neurohormonal control of appetite resulting in inappropriate anorexia.

*Disturbances in the neurohormonal control of appetite resulting in inappropriate anorexia.

'''Secondary hepatic lipidosis''' is a common response in dogs and cats to other diseases for example, pacreatitis, diabetes mellitus, inflammatory bowel disease and primary hyperlipidaemia.  The effect on dogs is less clinically significant.  Aggressive intervention of the hepatic lipidosis and the underlying cause is required.

'''Secondary hepatic lipidosis''' is a neuroendocrine response in dogs and cats to other diseases for example, pacreatitis, diabetes mellitus, inflammatory bowel disease and primary hyperlipidaemia.  Secondary hepatic lipidosis is therefore less closely correlated with obesity and be seen in normal or even thin cats.

 

Up to 50% of cats have an underlying disease which leads to anorexia.  If treated aggressively, it is often a reversible process.

Factors which contribute to hepatic lipidosis are:

Factors which contribute to hepatic lipidosis are:

*Markedly increased level in alanine  

*Markedly increased level in alanine  

*Low gamma-glutamyltransferase (GGT) concentration

*Low gamma-glutamyltransferase (GGT) concentration