Which test is most sensitive for detecting hepatic lipidosis in cats?

• A. Abdominal ultrasound features
• B. Serum biochemical profile showing elevated liver enzymes with hyperbilirubinemia and ultrasound features
• C. Liver biopsy
• D. Serum bile acids

Answer: (B)

Detecting hepatic lipidosis is most effective when you look for both functional disruption and structural changes in the liver. When liver cells are stressed or damaged, enzymes such as ALT and AST rise in the blood and bilirubin can accumulate if bile processing is affected. Ultrasound adds another layer by showing liver changes typical of lipidosis, such as an echogenic, enlarged liver. Each finding alone can be inconclusive, but together they create a more sensitive signal of hepatic lipidosis than imaging or chemistry alone. While liver biopsy can definitively confirm lipidosis by histology, it is invasive and not ideal for routine screening; serum bile acids alone may not reliably reflect lipid accumulation in the liver. Therefore, a serum biochemical profile with elevated liver enzymes and hyperbilirubinemia, combined with ultrasound features, provides the best sensitivity for detecting hepatic lipidosis.