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12 Diagnosis Presumptive diagnosis of feline HL can be made on the basis of clinical history, physical examination, clinicopathologic features, ultrasound examination, and liver aspirates.1, 13, 14, 15 Ultrasound examination of the liver often reveals hepatic parenchyma that is hyperechoic to that of falciform fat, but a thorough ultrasound evaluation of the gallbladder, pancreas, intestines, kidneys, bladder, and other abdominal structures is essential to rule out other primary disorders, such as acute pancreatic necrosis, which may be the basis of the anorectic event precipitating an episode of HL