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Hepatic Lipidosis occurs in Felix as the usage of peripheral fat  is highr than the liver ability to either redistribute or use the fat for beta oxidation.This condition results in the  hepatocyte cytosolic expansion with storage of triglyceride molecules.It is clearly seen and proved in the blood biochemisty records where the components of glycerides, leptin and glucose is about 60-80% which is abnormal.

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I would like to add on.Yes, i tend to agree with all of you that this cat Felix must be suffering from Hepatic Lipidosis (HL) a potentially Lethal Feline Liver Disease based on the clinical signs of having inappetance for the past two weeks (trigger 1) and prominent symptom of jaundice.

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Thank you everyone :)
Good job!

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Great! That concluded well :)

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I agree with Syahida too

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I agree with you.

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Yes, I agree with Syahida.

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From my reading, Small Animal Internal Medicine (2015), Feline Hepatic Lipidosis can be primary or secondary to another diseases. For the primary, the pathogenesis is not clear but seems to involve a combination of excessive peripheral lipid mobilization to the liver, deficiency of dietary proteins and other nutrients that would usually allow fat metabolism and transport out of the liver, and concurrent primary disturbances in appetite. The secondary is may occur in association with any disease causing anorexia, but has been most commonly recognized in cats with pancreatitis, diabetes mellitus (DM), other hepatic disorders, IBD, and neoplasia.

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One of the differential diagnosis of the death could be Hepatic lipidosis as we know that there is hepatic vacuolization in the histology slides.
But what is the cause of hepatic lipidosis? I think it could be diabetic mellitus and actually hepatic lipidosis is related to diabetis mellitus. Both will shows clinical signs of jaundice.

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Yes. Other than Diabetes Mellitus, hormonal disturbance also will affect the fat metabolism and cause fat mobilization from other part of the body to the liver. This will increase the workload of the liver. How can we know the cat is having hormonal disturbance? From trigger 1, it was stated that Felix was loosing appetite for the past few week. This can be a sign for hormonal disturbance.

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From my reading in merckmanual.com , HL is a most common and potential lethal feline liver disease. Peripheral fat mobilization occur inside the body. However, the process exceed the hepatic capacity to either redistribute the fat or use it for beta-oxidation for producing energy. This will leads to profound hepatocyte cytosolic expansion with triglyceride(fat) store.

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I agree with Shila. Feline Hepatic Lipidosis (FHL) share the same symptoms with FeLV, FIP liver diseases and renal failures and other cancers. However, from Felix case, the initial symptom form trigger 1 is jaundice which is quite severe. Jaundice is a main indication of FHL so we can narrow down the disease.

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- From what I understand, I'd probably think that Felix was diabetic (most probably diabetes mellitus? If so, which type of DM is he suffering from?) prior to all the clinical signs that Felix had exhibited.

- And the diabetic state according to the blood biochemistry in Felix led to the accumulation of fats in his liver because the body tissues are unable to utilize glucose as a source of energy.
- And maybe the case of jaundice was shown in trigger 1 was due to this liver dysfunction.

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Another possibilities that could cause hepatic lipidosis is the prolonged starvation of Felix.
From what I read from an article in PetMd website, in normal condition when an animal is starved or undernourished, the body automatically moves fat from its reserves to the liver to be converted into lipoproteins for energy. However, cat's bodies are not designed to convert large stores of fat.
So when Felix is in starvation mode, the fat that is released to the liver is not processed efficiently, resulting in a fatty and low functioning liver (hepatic lipidosis)

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This is something I learn before, anyone know more about this? Please correct me if I'm wrong :)

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Besides, Hepatic Lipidosis also a clinical sign of Diabetes Mellitus. This is because the owner maybe reducing the glucose in the feed in order to lower the blood glucose level, but this will lead to accelerating of fat metabolism of the cat. In short, the liver undergo fatty necrosis and Hepatic Lipidosis occur

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First of all, I agreed with Kian Siang and Kah Ying. In my opinion, Felix might be suffering from Diabetes Mellitus as well. The reason I saying this is because the high glucose level in the blood chemistry test that indicate hyperglycemia in Felix.

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So everyone, I would like to make a conclusion of the discussion for trigger 2. From most of our comment, we agreed that Felix are suffering from Hepatic Lipidosis due to lipid vacoulation finding in the post mortem histology of the liver hepatocyte. However, there are a few differential diagnosis that may lead to Hepatic Lipidosis:
1. Diabetes Mellitus
2. Prolong starvation
3. Hormonal Disturbance

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Feline Esophagostomy Feeding Tube Placement

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http://healthypets.mercola.com/sites/healthypets/archive/2011/12/13/feline-hepatic-lipidosis.aspx Mercola.com veterinarian Dr. Karen Becker, explains the Feline hepatic lipidosis, also known as feline fatty liver syndrome, is one of the most common forms of liver disease of cats.

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Base on the previos trigger Felix has loss it appetite for about a week right? So classically hepatic lipidosis occur after a period of anorexia of at least about 1-2 weeks

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Just an extra information, Feline Hepatic Lipidosis (FHL) do have similar symptoms with other diseases such as FeLV, FIP, liver diseases, renal failures as well as various cancers. Though still, FHL's main indication is jaundice🐱

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Basically the liver responsibility is to synthesize the lipoprotein to be used by other body tissues. Lipid and fatty acids are converted to lipoprotein by the hepatocytes. So, the result of accumulation of triglycerides might occur because of the interruption of this conversion.

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From the biochemistry report, we can notice that leptin , glucose and triglycerides were higher in comparison to a healthy cat. I agree with you Amir. Anyone have other idea or can clarify more about hepatic lipidosis?

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The fact we obtain from the trigger 2 are
- Felix died over the weekend after being admitted for two days- blood analysis and biopsy was done
- Histology of the liver show that there is a vacuolation containing liver in the hepatocye

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So base on my reading, this might be a fatty liver disease or hepatic lipidosis.
Hepatic lipidosis is a disease characterized by excess fat accumulation in the liver

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Any possible disease you guys think it is from the fact given?

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Hi guys, feel free to drop any comment here :)