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Background  Hepatic lipidosis is increasing in incidence in the Western world, with cats being particularly sensitive. When cats stop eating and start utilizing their fat reserves, free fatty acids (FFAs) increase in blood, causing an accumulation of triacylglycerol (TAG) in the liver.    Objective  Identifying potential new drugs that can be used to treat hepatic lipidosis in cats using a feline hepatic organoid system.    Animals  Liver organoids obtained from 6 cats.    Methods  Eight different drugs were tested, and the 2 most promising were further studied using a quantitative TAG assay, lipid droplet staining, and qPCR.    Results  Both T863 (a diacylglycerol O‐acyltransferase 1 [DGAT1] inhibitor) and 5‐aminoimidazole‐4‐carboxamide 1‐β‐D‐ribofuranoside (AICAR; an adenosine monophosphate kinase activator) decreased TAG accumulation by 55% ( P  < .0001) and 46% ( P  = .0003), respectively. Gene expression of perilipin 2 ( PLIN2 ) increased upon the addition of FFAs to the medium and decreased upon treatment with AICAR but not significantly after treatment with T863.    Conclusions and Clinical Importance  Two potential drugs useful in the treatment of hepatic lipidosis in cats were identified. The drug T863 inhibits DGAT1, indicating that DGAT1 is the primary enzyme responsible for TAG synthesis from external fatty acids in cat organoids. The drug AICAR may act as a lipid‐lowering compound via decreasing  PLIN2  mRNA. Liver organoids can be used as an in vitro tool for drug testing in a species‐specific system and provide the basis for further clinical testing of drugs to treat steatosis.

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