Q: My cat Cassandra is the fattest I've ever seen. I adopted her as a 20-pounder and never managed to get the weight off. I started feeding her only a small handful of kibble twice a day but she got sick and had to be hospitalized for fatty liver disease. The vet said it was my fault for feeding her so little, but I'm worried she's eventually going to die of diabetes or heart disease. If only she would exercise!

A: As you discovered, fat cats who lose weight precipitously have a way of mobilizing fats in their bloodstream and gumming up the workings of their livers. Fortunately, this potentially lethal side effect can be mitigated.

Most obese cats can achieve weight loss once a healthy plan is established. In fact, if your approach had been less aggressive at the outset, I do believe Cassandra would have lost weight. You had the right idea; you just needed guidance.

Here are three suggestions:

• Switch to wet food.

Many veterinary nutritionists recommend wet foods over dry for weight loss because the protein and fat percentages are higher, making it less likely protein malnutrition will lead to fatty livers.

• Make exercise fun.

Make a game of throwing peas (or another low-cal treat) across the room. Play with feather toys for a few minutes a couple of times a day.

• Get professional help.

If your veterinarian doesn't feel comfortable providing a detailed plan for Cassandra's much-needed weight loss, ask for a referral to a veterinary nutritionist or internal medicine specialist. Both training in calorie administration and potential side effects.

Dr. Patty Khuly has a veterinary practice in South Miami and blogs at www.dolittler.com. Send questions to khulyp@bellsouth.net, or Dr. Dolittler, Tropical Life, The Miami Herald, 1 Herald Plaza, Miami, FL 33132.