Hyperlipidemia, a complex term for the presence of too many fat molecules, or lipids, circulating in the blood, can impact our beloved cats as much as it does humans. The primary culprits in this condition are cholesterol and triglycerides. Unlike water-soluble substances, lipids don't easily dissolve in blood, so the body creates lipoprotein complexes to transport them. In a healthy animal, lipid levels typically rise temporarily after a meal (known as lipemia) and then return to normal. Hyperlipidemia occurs when certain conditions hinder the removal of excess fat from the bloodstream, causing lipid levels to remain high for longer than intended.
Hyperlipidemia can involve elevated levels of various fat components and lipoprotein complexes, such as hypertriglyceridemia (excessive triglycerides), hypercholesterolemia (elevated cholesterol), and heightened chylomicrons. Chylomicrons, the largest lipoproteins, consist of triglycerides enveloped by a protein coating and are formed in the intestines from dietary fats. They lend the blood a creamy, white appearance.
In cats, hyperlipidemia often arises as a consequence of other underlying disorders, including diabetes mellitus, hypothyroidism, Cushing's disease, certain liver diseases, and protein-losing nephropathy. It can also occur spontaneously after indulging in high-fat meals, especially table scraps.
Certain medications, such as progestogens and corticosteroids, can elevate lipid levels. Your veterinarian should be aware of any medications your cat is taking before investigating primary diseases causing hyperlipidemia.
While hyperlipidemia is less common in cats, it can be hereditary in rare cases, typically surfacing after the age of eight months.
Common Signs and Symptoms
Hyperlipidemia itself may not present significant clinical issues, but associated metabolic disorders, such as diabetes, can bring about common signs and symptoms. These may include:
- Loss of Appetite, Vomiting, Diarrhea, Abdominal Discomfort
- Acute Pancreatitis: Leading to the above signs along with severe abdominal pain
- Skin Problems: Such as hair loss or itching
- Central Nervous System Signs: Such as seizures
- Eye Inflammation: Resulting in a cloudy appearance
- Lipid Deposits: In tissues like the skin, eyes, and blood vessels
Diagnosis
Diagnosing hyperlipidemia typically involves various blood tests, many of which are cost-effective. Prior to blood testing, your cat should fast for 12 hours, ideally in the morning before breakfast.
A comprehensive assessment includes a complete blood count, biochemistry panel (including triglyceride and cholesterol measurements), urinalysis, and hormonal assays. These tests confirm hyperlipidemia and help identify its root cause. The blood sample may also be examined for chylomicrons. Specialized tests can determine which specific types of lipoproteins are present in the blood, such as low-density lipoprotein (LDL) and very-low density lipoprotein (VLDL).
Treatment
When hyperlipidemia arises secondary to another disease, addressing and controlling that underlying condition takes precedence. A low-fat, high-fiber diet is typically prescribed to reduce fat levels in the blood, accompanied by maintaining a healthy weight and ensuring adequate exercise. While commercial low-fat diets are available, some cats may resist due to their relatively bland taste. Homemade diets are discouraged unless formulated by a veterinary nutrition service to avoid potential nutrient imbalances and related health issues.
Cats with hyperlipidemia should be kept away from high-fat human food and table scraps to prevent episodes of acute pancreatitis, which can result from consuming excessive fat. Fish oil supplements may be considered based on the cause or source of hyperlipidemia, as they can partially reduce lipid levels.
While most lipid-lowering medications used in humans, such as statins, are not suitable for animals due to side effects like cataracts, other drugs and supplements, such as gemfibrozil and niacin, may be considered if dietary and other approaches are ineffective, but only under veterinary supervision.
Regular monitoring is essential to track lipid levels, with the timing and frequency of recheck exams and blood tests often determined by the needs of the underlying disease. If unexplained vomiting or diarrhea occurs, testing is usually performed promptly, even if ahead of the scheduled evaluation.
Prognosis
The prognosis depends on several factors. Mildly elevated lipids without other diseases can often be managed with dietary adjustments. However, when elevated lipids are linked to other metabolic disorders, the prognosis is primarily associated with that specific condition. For example, acute pancreatitis can be potentially fatal, but mild cases are typically not life-threatening. In cases of hereditary hyperlipidemia, treatment can be challenging, and affected animals should not be used for breeding.
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