Prognostic markers in feline hepatic lipidosis: a retrospective study of 71 cats

Abstract

Feline hepatic lipidosis (HL) is a common, potentially life-threatening disease resulting from prolonged anorexia and increased catabolism. This retrospective study included cats diagnosed with HL based on liver cytology or histopathology (years 2004-2015), and aimed to identify clinical and laboratory parameters associated with mortality. The study included 71 cats (47 females and 24 males) and 85 control cats with non-HL diseases. Most HL cats (90 per cent) were mixed breed, neutered (70; 99 per cent), female (47; 66 per cent), indoor cats (56; 79 per cent), fed dry commercial diets (44 cats; 62 per cent), and with a median age of 7.5 years (range 1.5-16.0). Common primary conditions included gastrointestinal diseases, pancreatitis and cholangiohepatitis (31 cats; 44 per cent) and stressful events (14; 20 per cent). HL was idiopathic in 20 cats (28 per cent). The overall mortality was 38 per cent (27/71 cats). Older age, as well as dullness, weakness, ptyalism, hypoproteinaemia, hypoalbuminaemia, increased serum creatine kinase activity, hypocholesterolaemia and hepatic failure at presentation were significantly (P≤0.033) associated with mortality. The primary disease was unassociated with mortality. Worsening hypoalbuminaemia, hyperammonaemia, hyperbilirubinaemia, electrolyte disorders, and occurrence of cavitary effusions or hypotension during hospitalisation were significantly (P≤0.045) associated with mortality. A decrease of serum β-hydroxybutyrate during hospitalisation was significantly (P=0.01) associated with survival, likely reflecting improvement in the catabolic state. The identified risk factors may be therapeutic targets.

A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome

“…Increased CK activity, albeit unassociated with survival, was noted frequently in our study. A marker of muscle injury, CK activity was associated with longer hospitalization time and death in a large heterogeneous cohort of ill cats, where pancreatitis constituted 8.5% of the cases, of which 45% had increased CK activity, and recently was associated with death in a study of 71 cats with hepatic lipidosis (HL), of which 24% had concurrent pancreatitis . In another study, CK activity was significantly higher in anorectic cats, and was deemed a useful nutritional status marker, as in humans .…”

Hypocholesterolemia in cats: a multicenter retrospective study of 106 cats

“…Indeed, hypoalbu minemia has been identified as a negative prognostic factor in cats with other critical illnesses, including acute kidney injury and hepatic lipidosis. 23,24 Albumin has diverse and vital roles in maintaining vascular integ rity and oncotic pressure, and it would appear logical that decreased concentrations would be associated with more severe illness. Given that gastrointestinal and hepatobil iary diseases were the most encountered categories in our study, it is likely that cats with concurrent hypocholester olemia and hypoalbuminemia had more severely com promised gastrointestinal integrity or hepatic function.…”

Identification of potential drugs for treatment of hepatic lipidosis in cats using an in vitro feline liver organoid system

“…Cats with hepatic lipidosis accumulate approximately 34% more TAG in their livers compared to healthy cats . They are often clinically presented with icterus, dehydration, lethargy, and ptyalism, with a history of anorexia and weight loss . Treatment is mainly supportive and consists of correcting hypoperfusion using fluid therapy and reversing the negative energy balance by feeding the patient by means of force feeding or tube feeding .…”

“…Treatment is mainly supportive and consists of correcting hypoperfusion using fluid therapy and reversing the negative energy balance by feeding the patient by means of force feeding or tube feeding . A mortality rate of 38% has been reported, and drugs to directly target lipidosis are not available yet. An in vitro model for hepatic lipidosis in cats has been described in which feline hepatic organoids were loaded with TAG .…”