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Hepatic Lipidosis - Tube Feeding without Meds

post #1 of 7
Thread Starter 

I've been treating my cat Munchkin for the last few weeks. After a series of tests and vet visits, he was diagnosed with Hepatic Lipidosis. He's very jaundiced, vomits on occasion, and generally acts sick. He had a feeding tube inserted, and I've been syringe feeding him prescription canned food as well as attempting to administer subcutaneous fluids via IV.

Here are the following medications he is on: Flagyl, Clavomox, Mirtazipine, Denamarin, Reglan.

He also has B-Complex injected into his fluid packs.


Here is my situation:

-I have already spent more money than I can afford on treatment. I read the sticky on Vet Care being part of the responsibility, and I have done the best I can to finance his care. In Orange County, vet practices are fairly predatory...and the abundance of wealth here creates an environment of "Money isn't an obstacle" when it comes to pet care. I finally found a compassionate vet that I like, and she still would like to charge me thousands of dollars in medications, visits, continual tests, etc.

The thing is...we already know what he has, and what the treatment is. His liver is messed up, he needs tube feeding, and I'm doing the best I can. I have completely altered my life to account for this, I am overdrawn financially and cannot afford continual "check ups" at $100 for 5 minutes every other day. The economy in CA is failing, and I may not have a job in the future.

I have a game plan, and I'm doing the best I can to follow it.

Here is the problem:

-Everything I'm told and everything I've read tells me that he needs FOOD and FLUIDS above all else. Munchkin takes both without issue. However, his medications are making him miserable, causing him to vomit, and do not seem to be improving his condition.

In addition, my vet seems obsessed with medicating this guy to within an inch of his life...even though medication is making him vomit (which is making him lose food and fluids). Every concern I bring up is answered with more medication...and each additional medication makes him sicker. His condition seems best when I held off on medication for a day due to repeated vomiting. Of course, I'm sure the $50 per medication price tag doesn't encourage this behavior at all.

This is where my brain is at:
I haven't slept more than three hours in two weeks, so I'm a little loopy.

Food + Fluid = Healthy Munchkin
Medication = Vomiting Munchkin
Vomiting = Negative Food + Negative Fluid
Vomiting = Unhealthy Munchkin
Medication = Unhealthy Munchkin

This is my question:

Do any of you have experience with a cat that recovered from Hepatic Lipidosis (at the jaundice point) without the influx of half a dozen medications?

If I routinely feed him prescription "recovery" food via syringe, inject him subcutaneously with fluids via IV, and MAYBE keep the REGLAN for nausea...

...is this enough to make him recover?


I have asked the vets, and they answer with prescribing more medication. I informed them that he's vomiting with medication, and they've prescribed more medication. I've asked them the same question (is food + fluid enough), and they answer with yet more medication.

Enough. I've had it.

I understand that no one here can give me a definitive answer, so I'm asking for personal opinions and experiences.

Have you recovered a cat with Hepatic Lipidosis using JUST IV fluid and prescription food?

Have you heard of an aunt/neighbor/cousin who did so?

Are there alternatives to medication that won't make him vomit IN YOUR EXPERIENCE?

Thanks for your patience.

~Munchkin's Dad


post #2 of 7
Hi there... first of all many vibes for your kitty


Above isthe link for the Merk Veterinarian manual - the treatment described in there is more supportive - feeding high caloric foods, lots of liquids, controlling his potassium levels if he is throwing up, etc...
Based on what you are saying, instead of going back there, I would take the $$ for the next check up and go to another vet for a second opinion.
It sounds to me, that if he is doing well without all those meds, he should be without them - unless there is an underlying condition (which is often the case) that they are treating him for with these meds.
I am not a vet, and I can't recommend you to do anything, BUT I would highly recommend going to another vet and discussing this issue in depth.
Good Luck!!
post #3 of 7
Hi, I wish I had some advice but I don't have experience with this and I'm not familiar with all of those medications. It does seem like he is on an excessive amount and I'm not sure why he would be on Flagyl AND Clavamox. I do know that when my cat stopped eating last year, he was given flagyl to treat his bowel inflammation. I also know that many on here have had cats that vomit due to Flagyl and/or Clavamox so its possible one or both of those are upsetting his stomach worse.

I am not familiar with the other medications so don't know what they are supposed to be treating.

Hopefully someone with more knowledge and experience will come along to help you. I agree that I would try to at least talk to a different vet and explain that the medications are making things much worse. I found a site (not free) where you can ask a vet a question and they will reply by email. I don't know anything about it and can't verify their qualifications but I know you're desperate for some different solutions so it might be worth a try.

post #4 of 7
I nursed my cat back to health after hepatic lipidosis just using force feeding (with an oral syringe) and didn't need any meds or IV fluids (except when he was a little anemic and needed prednisilone to boost his red blood cell production.)

What are all those meds for? That seems concerning to me. When I asked my vet about cyproheptadine, something that's supposed to act as an appetite stimulant, that other TCS'ers had used, she said that while the liver is recovering, it's dangerous to give too many meds because it's too much for the damaged liver to process.

I think in the entire process (and it took about 10 weeks to recover, and yes, he was jaundiced when I brought him home), I think he threw up once, and from what I recall, it seemed to be when I gave him too much food too fast.

You can see some of my posts about everything I did in these threads:



Other than the physical rehabilitation you go through, one thing that really stuck with me through the whole process was something the shelter director told me, and it sounds cheesy, but it's true- this is basically feline depression and you have to convince the cat that you love them and you want them to live, and that they want to live. I really think that having that outlook and using that as my motivation to be persistent about getting the food into him was what really made the difference, and why I really bonded with him and vice versa.

Here's some info I sent to someone else who was going through HL; not sure how much is applicable to you since your cat has the feeding tube (the shelter I was fostering my, now adopted, cat through advised against the feeding tube because it can create more stress and lead to a permanent aversion to food):

Try feeding [their cat's name] anything- we tried fresh chicken livers (you can buy them at the grocery store and they're pretty cheap- less than $2.00 for a container of them.), canned tuna, fresh salmon....at first he wasn't really interested in any of it, but when they don't feel like eating anything, they're not going to do it on their own.

Here's the mixture that I made up. I'd try to get through one batch of this every day (I'd usually use one half of a 5oz. can of wet food):
- good canned food, like the Hill's Prescription A/D
- when I didn't have the A/D, I mostly used Nutro. You want something with a high fat content, so go for the duck or venison flavors. The kitten ones also have more fat than the adult. Just don't get the senior formula- less fat.
- 1 or 2 chicken livers- they have a lot of fat and nutrients in them, so they're really good for them.
- KMR milk, the replacement kitten milk they sell in pet stores- get the powdered one. It's a little expensive, but cheaper than the liquid version and it will last longer. Mix it with the water separately before you mix it with the rest of the food. I'd usually do one scoop of powder and two scoops of water
- some water, to keep the cat hydrated (just a couple of tablespoons)
- a couple of tablespoons of vegetable oil, to add fat
- sometimes I'd squeeze a fish oil capsule, like the kind you buy in the vitamin section at the store, into his food.

Other foods I tried- canned pumpkin, baby food (get one of the chicken ones, but make sure there is NO ONION OR GARLIC in the ingredients- those will cause anemia), Royal Canin canned food, different store-bought cat treats, catnip

I don't know if you have an immersion blender, like this: http://www.amazon.com/Braun-MR5550CA.../dp/B00006I4YF

I put all the ingredients into the little mini food processor that comes with that immersion blender and blend it until it was smooth. You could also use a blender or a regular food processor. I just think that little one was easier because you were making such a small amount every time.

If you're not using the A/D food, all the other canned foods are going to have little pieces of bone in them from the meat that's in there. If you're feeding with a syringe, those bone fragments will clog up the syringe. So, after you blend it, you should put it through a fine strainer, like this one: http://www.chefsresource.com/cia-5-mesh-strainer.html That will get all the pieces of bone out, and your syringe won't get clogged.

A trick I learned was to get some of those cone-shaped paper cups that they have for water coolers and put the food in there while you're feeding. This way, you waste less food because it's easier to suck up in the syringe from the point at the bottom, than trying to do it in a round bowl or dish. I bought them at Office Depot, I think.

When I had to do this with my cat, it was easiest to find a comfortable, quiet place in the house for them. I put his "bed" in the corner of the room, a room with a closed door, that way it was harder for him to run away when I had to feed him. When I first started, I tried to hold him while feeding him, but that was too hard. Once I figured out that it was better in a corner, I would let him sit there and I would sit in front of him with the cup of food and the syringe. I'm right-handed, so I would put my left hand on the back of his head, and put my left thumb in the right corner of his mouth to open it enough, then stick the syringe into the right corner of his mouth and squeeze the plunger on the syringe. Just a couple of cc's at per squirt. Eventually, I got good at it, and I could do a whole syringe in about 10 minutes. You have to give them a little break in between doses. I would feed him one syringe in the morning before work and 2-3 more in the evening when I got home. It took about 9-10 weeks of this before one day, he was just eating on his own.

Good luck! Don't give up!

P.S. Here's a before picture, taken around January 2008, when we'd had him about 2 weeks:

You can see that his ears were flopped (not sure if this was from dehydration or malnutrition or what) and his neck is all scrawny. He had pretty much no muscle tone in his back legs; he couldn't even jump up on our couch for the first 6 weeks or so.

And here's an after picture:

That was taken about a year ago. He's probably even put on a little weight since then. When he was at the vet in May, he weighed a little over 14 pounds (the "healthy end of heavy" from what the vet said).
post #5 of 7
My cat had hepatic lipidosis as well. She was at the point she was jaundiced and 5lbs (she is now her normal weight at 12 lbs). She was on NO meds, like your cat they made her sick. I force fed her and administered fluids for 2 months, I did have her injected with some sort of anti-nausea meds near the end of the sickness when she started eating again (this was to try to get her eating quicker.......it seemed to work) but this was the only meds she was on. That combo. of meds would make anyone sick!

I'm NOT a vet, but from my experience, the more you can do to take away the nausea, the better. Plesae keep us posted and thank you for taking such good care of your baby. I know how hard this illness is.

post #6 of 7
I don't have any experience with this illness but I have clashed with my vets on how my animals are treated...All I wanted to say after reading your story is....we can only do so much...not everyone has a endless supply of money....and in the end its your cat...Nothing wrong with trying what others have done on here to treat the illness....I hope whatever you decide works out...
post #7 of 7

I was just wondering how Munchkin was doing. My little man was just diagnosed with hepatic lipidosis and hepatic encephalopathy a week ago today. There was no way I could possibly afford the $3000 dollar treatment plan and my vet told me it was all or nothing. I took him home AMA with some medications and have been taking care of him since. Even though we couldn't afford full treatment we took all the medications the vet suggested. They were lactulose (which is for the hepatic encphalopathy), Clavamox and Metronidazole. As far as the Clavamox goes, my little man has been thowing up as well, but I'm not sure if that's the Clavamox or the feeding. We are calling the vet today to see if she has any opinions or advice on that matter. But my vet said that the Clavamox was only needed for 10 days. 10 days is the standard course I guess, and if you are going to stop it (you have probably already made a decision either way) it's would probably be best to finish the course, if it's anything like antibiotics in humans quitting in the middle could cause drug resistant bacteria. But once he's had a full treatment, the antibiotic has really done all it can possibly do and there is no point in continuing it.

Anyway, that's my experience and my personal opinion. Like I said earlier, I was just wondering how your munchkin was doing.
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