Hepatic lipidosis--anyone have experience with tube feeding?

Good luck! Monkey is totally back to normal, but it wasn't easy. My parents were in town for Christmas and they secretly thought she wouldn't make it. We did have one traumatic instance with the tube feeding where Monkey suddenly felt nauseous at the end of one of her bigger feedings and threw up the bottom end of her tube. Definitely err on the side of slow and cautious, even when it's a month later, half an hour past your bed time and you have a full syringe left. Kitty will thank you later. My fiance didn't trust himself to help feed her, but he did help by running back and forth to warm food and water as needed. His support, and reading up on others going through the same thing, made a huge difference.

Thank you, everyone!  =)

As an update - the vet kept her hospitalized until Friday afternoon, and by then her levels were good enough that we were allowed to take her home for the weekend.  Yay!  We set up a little nest for her in the bathroom (we have another cat, Lana, and we wanted to keep Lia quiet and calm and unable to hide anywhere), and the tube feeding actually went much more smoothly than I thought it would.  My husband was a huge help - he visited Lia every day in the hospital, and helped with her feedings too.  It helps that we are on different schedules, he works third shift and is able to be home during the day while I'm at work. 

However, we noticed that she was smacking her lips more often, and even started drooling.  She only vomited once, but was clearly nauseated.  We had a follow-up visit yesterday and her levels had gone the other way (potassium was VERY low and Bilirubin was higher), so we decided to put her back into the hospital so that she could get some IV fluids.  She had been on a potassium supplement in tablet form, but the vet said that sometimes that method doesn't work as well as adding potassium to the IV fluids and the low potassium levels could be what was making her even more nauseated.  I visited her today, and she seemed much happier than yesterday - was very lovey and rubbing on me, and even dozed off a little bit while purring.  =)

My gut is telling me that if we can get her nausea under control, she'll want to start eating again.  So, I feel pretty good about her progress so far, and am glad that she's getting what she needs at the hospital.  My little girl has charmed the entire staff, and they all comment on what a good girl she's been.  I've attached a few pictures - these were taken on Wednesday, before she went back into the hospital. 

I was able to get syringes from our local pharmacy. I didn't use a tube though, I fed her orally. It was hard for me too, but worth the effort. I hope for the very best for you and especially for Callie!
 

Here's another update on Lia...

Saturday the vet called and was concerned about fluid building up in her abdominal cavity.  Apparently common causes of this can be cancer or pancreatitis, so we freaked out a little.  (Okay, a lot)  Our vet referred us to another clinic for an ultrasound on Monday.  The doctor didn't find anything related to cancer or pancreatitis (yay!) but didn't really give me any answers regarding the fluid either (boo).  He did take some samples of the fluid that I will hopefully get the results of tomorrow.

So, unfortunately, the clinic that did the ultrasound is an hour away...so I had a grumpy kitty as a co-pilot.  =(  She hadn't eaten all day, and of course they gave her a small amount of sedative for the ultrasound, so when I finally got home I tried to feed her...and completely blocked up her tube.  Ugh, I felt like such a jerk.  I worked with it for an hour, panicked, and called our normal vet off-hours.  She met me up at the clinic and after another hour, we got it unstuck.  I was so relieved I hugged her.  Poor Lia...she was so tired and was just DONE with being poked and prodded that day.  I felt horrible. 

Her bloodwork from yesterday is still promising - her potassium levels are normal now (4.0), and her bilirubin levels are going down but are still high (they were at 11, now they are at 9).  She's had 5 feedings at home now, and has only thrown up once.  I'm concerned because she seems a little clumsy - but that could be because of the extra fluid, or because she's just weak, or maybe because she hasn't done a lot of activity in the past few weeks.  We have a follow-up appointment on Thursday to re-check her blood work, so I'll be mentioning it then.  Has anyone else experienced this with HL?
 

We didn't have any fluid build-up, but she was more clumsy -- partly from weakness I'm sure, and partly from not liking the feeling of the bandage and tube obstructing her neck area. She would guide herself along the walls to feel safe and supported walking around, and she'd wobble up and down the stairs slowly. I didn't have to take her for an ultrasound or to get the tube unstuck, but I was obsessive about flushing with warm water and letting it drain down a tiny bit before stopping up the tube. I only had one scare with the crushed up medicine powder getting stuck, I felt like I was accidentally going to splash a wave of warm water straight into her esophagus once the pressure broke (I could see most of the blockage so I wiggled a toothpick around to break it up and then added more warm water).

I don't have much expertise outside of this hepatic lipidosis experience, and some time as a vet tech when I was younger, but after a quick google check I see that fluid build-up is one of the top few side effects of liver disease. Hopefully it is just a side effect of the problem you're already aware of, and not an additional problem to worry about.

Hey jenfrog, I'm sorry to hear about Lia but glad to see that they seem to have ruled out cancer and pancreatitis. My cat Supra was recently diagnosed with HL (cause remains unknown) and has had her e-tube in for a little over a week. She has been home now for 1 week after 8 days in the hospital (4 days in, 2 days home, then right back in again for 4 days). I didn't realize how hard this would be, and I'm right there with you. The actual feedings and subcu fluids aren't the hard part - using the tube is practically second nature by now and I've had previous experience administering fluids to my Gypsy a couple years ago before she passed.

It's the emotional part that's wearing on me - I know it's a situation that needs to be taken one day at a time... more like one hour at a time... but it's so hard to be patient. I just want her to be better now. I wouldn't care if I had to deal with the tube for the rest of her life, so long as I knew she was feeling good. It's obvious she is miserable. Every feeding makes her incredibly nauseous and she vomits at least a little after almost every feeding, no matter how slow I go. She's supposed to be up to 30ml 4 times a day by now, but she can't handle more than 25ml at a time so I haven't increased past that. Originally, she was having 5ml Felovite and 90mg Denamarin crushed and mixed into her slurry of 1:1 Hill's a/d and water, but the Denamarin seemed to make the nausea and vomiting much worse, so I stopped it until I can discuss it with the vet.

She starts whining as soon as she sees the syringe and although she sits still through the feeding, she runs away and hides as soon as it's over. I try to spend as much lovey time with her as possible between feedings so that she doesn't come to associate me strictly with lousy feeding time, but she doesn't really want to be bothered... so I don't push her. My biggest fear is that her personality is going to permanently change because of this. Supra was a cat who, before she got sick would follow my every step, most times tripping me until I sat down so she could lay in my lap. All she wanted all day long was your company, as long as my boyfriend and I were lavishing her with attention, she'd be perfectly content.

I know it's only been a week, and we are in for a long, slow road to recovery, but I have seen it happen too many times before. Even after a pet makes a full (medical) recovery... they just aren't ever the same again. It's like they lose their spark. I've almost come to expect that of older pets, but Supra is only 4. I would hate to see her lose her spark so early on. I know I'm not doing myself or Supra any favors by being pessimistic, I guess I just need some support and somewhere to vent.

Supra has her 1 week checkup tomorrow, so hopefully the doctor can provide some insight.

jenfrog, if you need a buddy through this, I'm here

Sweet blasphemy, I know all cats are different but the bond Joey and I developed over this period was astonishing! He's more joyful and loving than ever before. I didn't know it was possible as he's the sweetest kitty ever. There will come a day when our kitty will feel better.

How big is she? Joey was over 13 lbs when he was ill and could never take in the amount of food the ER expected. We capped out at 60 mm the remainder of his treatment. Also, how much warm water are you flushing with before and after each feeding and medication? Joey's slurry consisted of wet food (I think a/d) and a milk like formula. It was rich and packed a punch. I think it got his levels back where needed. Within 5 weeks I could tell we were good! Maybe talk to the vet about the milk formula? Feeding should be slow and encourage drinking water. Food luck! You can do this!!!!

Thanks Dana I definitely believe when you say you and Joey bonded over the experience. If we could just get to the point where she understood that i'm only doing what i have to to help her and that i'm not just trying to torture her for my own amusement...

well, she's been hovering around 9lbs. Her healthy weight is between 11-12lbs as she's on the large side for a female. The doctor instructed us to flush with 3mls before and 3mls after. This whole week, there were 3 instances where she didn't vomit. Every other time she brought up anywhere between 1/4 and the entire feeding. This morning I barely got 5mls in before she started heaving. I'm beginning to wonder if she's allergic to something in the a/d. I k new to expect some vomiting but this just seems excessive. Well, we are about to take her in for her checkup in a few mins, so hopefully I will have some good news a little later on. Thanks for the kind words and encouragement

Well, we at least found out the cause for her excessive nausea and vomiting. The tube slipped down into her stomach, causing constant acid reflux. I've suffered from chronic AR since I was a kid, no wonder she felt so lousy! The doctor adjusted the tube and drew a mark on the outside where it should be so we can keep an eye on it. As soon as they brought her back into the room she perked right up and you could tell she was much more comfortable. They also sent us home with an anti-nausea and antacid. She's kept down ALL of both feedings she's had since we've been home and I even bumped them up to 30ml, which she couldn't even handle before. Of course, we still have a long road ahead of us, but it's a huge relief to know that, 1) she's feeling a lot better now and 2) it wasn't necessarily something I was doing wrong. I hated the idea of "making" her sick 4 times a day and she was starting to resent me for it we are headed in the right direction now...

How long was the feeding tube in place? We are heading unto week three with no interest whatsoever in food. However, we take our cats into our back yard for supervised "outings," and she nibbles on Bermuda grass (both have always eaten a little Bermuda most days of their lives, and we are careful to ensure no contaminants ever touch our patch - never use fertilizer or such). She's on ID because she was allergic to AD and the Denamarin. So far she is tolerating that and the Clavamox.

Hi there, Joey was on the tube for 6 weeks. I found that he broke into a bag of meow mix that I feed strays so I started to offer meow mix and his favorite treats. I believe I also cut back a bit on his tube feeds since I knew he was eating alone at night. Joey was on a very aggressive feeding. Milk thistle and high caloric wet food. I later discovered that some vets don't add the milk. I believe this feeding got him healthy quicker.

I wouldn't offer the same food she ate before falling ill as she will associate with what make her sick. My local pet stores let me buy food and return it if he refused it.

Today, Joey is happy and healthy. You would never know he was clinging to life just over 2 years ago. You can do this!

Dana

My Phradie got some kind of virus that made her vomit (not a lot) for two days and then would not eat much. After five days, she stooped eating altogether. Her resumption of a different food could be an issue because she was already on Hills ID prescription due to food allergies discovered four years ago (she's 10). She was also on Denamarin (which is a milk thistle pill) when she got home from her four-day hospital stay, but she had a severe allergy to that as well. Right now we tube-feed her 50 ml every five hours. She has very infrequent bowel movements, but urinates well (went from daily BMs to every three days). Is there another kind of liver therapy?

Great news today. Phradie ate 6 cat treats. Still not interested in her food, but we'll take anything. First food by her mouth in a month. Pray for more hunger!

It is so good that she ate a little.  It takes time and I know it is frustrating but you just have to be patient.

Tube feeding is the most aggressive feeding for healing an ailing liver. It will get the needed protein levels up and decrease the toxicity in her body. Be patient. She needs all the calories she can get. I hope the food situation is worked out now? Need her to keep down those calories! Joey is down here eating his wet food now. It has been over 2 years and you'd never now. Your little one can make it. Stay strong and loving. The bond becomes even more amazing!

Phradie continues to eat a little. Seems more active as well. It's a process!

Phradie acts like she will eat on her own now; however, she was never a big eater. Instead she would graze all day, eating smaller amounts. The amount of food the vet has us pushing down the tube is enormous for her, but I know it's important to keep up the calories to heal the liver. I did change the food from her old dry (never has liked wet food) to Royal Canin Special 33 because she had no interest in her old Hill's ID dry food - she only wanted to eat Greenies, but 6-8 at a time. She is back up to about 7 1/2 lbs. her normal weight has never exceeded 8 lbs. anyone with experience as to what constitutes a return to normal eating because we certainly do not want the tube out too soon. Since we have figured out a lot of this ourselves since she got home from the hospital (we determined she had allergies to Denamarin and the AD food which made her worse), I thought I would draw on pet owner's experiences as well.

The rule of thumb is 20 calories per pound of ideal weight.  If 8 lbs is her ideal weight then it would be 160 calories a day.  You can try delaying a tube feeding, not skipping it but delaying it, to see if she will eat.  It's kind of a balancing because the tube feedings are giving her what she needs and filling her up.  Acting like they want to eat and then not eating is a pretty classic sign of nausea and nausea goes along with fatty liver disease.

Joey did the same with the treats. I encouraged him to eat anything he wanted. I began delaying feedings and I also feed him a bit less when I thought he might want to eat. He's a big eater though so I knew he'd want food if he felt better. His chemistries were near normal when he showed signs of wanting to feed himself. I kept the tube in a week longer to ensure we wouldn't have a setback. He knew the day that we went in that he was good to go. We got his blood drawn and we waited. He heard the excitement from the vet staff from the back room (we had an amazing team) and hopped back in his carrier ready to go home! Vet came in and snipped the stitches and slipped the tube out all while he sat in his carrier

Phradie had started eating (almost normally for her) and really going after the Greenies. The vet told us to cut the feeding amounts in half. I would offer her food and treats before the tube and she ate. The last two days she will smell the food but not eat (unless she is eating at night because her dish is empty-a have another cat who may be eating her food). She still acts likes she feels better and the yellow is gone for the most part - hard to tell because she has a bit of a natural golden hue. She's not gaining nor losing weight. Did anyone have a reversal after your cat began eating?