Periactin and feline hepatic lipidosis

Someone brought this up to me recently when I was discussing Kippy's health. For the longest time, Kip was eating pretty consistently, about 8-9 ounces of canned food a day. Only recently has he started going off his food. He's been doing this delightful thing where he begs and whines for food, and when I give it to him, he'll eat maybe three bites and leave the rest behind and do that thing where he tries to bury it. Then 15 minutes later, he's whining again for food, but he won't want the food he left behind. Today, all he ate was a jar of baby food, and later on I let him pick at some meat loaf (which he proceeded to throw up several hours later). He also just ate some Meow Mix, but I don't know if it'll stay down. I was giving him milk thistle for a bit - something like 2-3 drops per meal (so 6 drops a day) and he was throwing up constantly. Normally I'd just clean it up, but my mother was having tantrums about his constant vomiting on her carpets (which she mistook for pooping because the stains were brown...from cat food). So no more milk thistle - he still vomits, but not like he was.

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Anyway, I'm starting to worry he's going to go on another little hunger strike. Despite his consistent eating for at least a month, he has not gained any weight and I have not noticed a change in his behavior. I'm wondering if he would benefit from an appetite stimulant, assuming I can get his vet to prescribe it (since they're bent on getting his teeth pulled as a cure). I've been told about something called Periactin, which is a gel that is administered in the ear canal and absorbed through the skin? That would be ideal for him since he gets depressed when I put anything in his mouth, and I really can't have him stressing out and going off his food even more. But I also am concerned with how an appetite stimulant would affect him in other ways. I understand it's not a cure for HL, but he does still show interest in food. In fact, the only time he's happy is when he's eating or wanting to be fed.

Cat parents who are familiar with Periactin - especially when used for a fatty liver kitty - what are your experiences? Pros and cons of using it? I'm just wondering if it would benefit my Kip at all and maybe get him eating kibbles again or eating more canned food.

Fatty liver isn't really a chronic disease in and of itself but the liver reacting to not eating.  The fact that he didn't gain any weight while he was eating could mean he has something chronic going on with his digestive system, something along the lines of IBD.  Was he eating a normal amount the month that he was eating or was he still eating less than normal?

What is going on with his teeth?  A sore mouth would explain him not eating but I don't know that it could explain the vomiting.  The only way it could explain the vomiting is if there is excess acid from not eating.  When he was vomiting something that was brown was it liquid?  Brown looking liquid could be blood.

An appetite stimulant might make him eat but it isn't getting at the root of the problem it would just be treating a symptom.  I know they are used extensively but my IBD cat as never had one.   I don't know if it's a regional thing but I had my IBD cat to several vets here before I found one that diagnosed him properly and he never had an appetite stimulant.  Most of the vets here were trained at the vet school at OSU maybe it's something that is taught and/or advocated at OSU.

Has he been checked out by a vet?  Had any bloodwork done?  I would find out why he is vomiting.  Periactin can help with appetite stimulant but it's like putting a bandaid on a wound that needs stitches.  My cat DeeJay is currently on it for an appetite stimulant.  We have done extensive testing on her and figured out she has some underlying conditions.  We are hoping once we get those resolved that she will be able to come off the appetite stimulant.

Hi there.  Complicated issues with various questions....

First, i would want to find out the cause of his loss of appetite before i just started treating him with an appetite stimulant.  And while Periactin isnt a cure for H. Lipidosis, there is no reason to assume he has HL, because if he did, he would likely be at the vets with a feeding tube while being VERY sick.

So back to the appetite.  It may be as simple as a change in his appreciation of what you're currently feeding.  When he refuses food but meows suggests he just doesn't like what's being offered, so you could try a variety of new foods (maybe a little bit at first next to the baby food so as not to upset his stomach).  But if this doesn't work, and work soon, then i think its time to see a vet.  9 oz's is a fair amount of food, and loss of appetite, if it isn't just being suddenly finicky over flavors, can indicate the presence of an illness.  Routinely throwing up isn't a good sign either, so i would really suggest a vet visit unless you can quickly find out if he just wants a new flavor of food.

Periactin in my experience is usually given when we know why a cat isn't eating, and know that it isn't connected to the flavor of food.  As an example, a cat with a bad URI who isnt eating because he's all clogged up may be given periactin to push him through his loss of appetite, but absent a diagnosis it might just mask the real problem.

Oops, my bad. Should have explained a bit more. Kip has had blood work and testing and all that done and it was determined that he does have fatty liver disease - this isn't just me making an assumption. I found this out in the summer, and I'm fairly certain the cause of the HL was Kip being unable to adjust to my other two cats being gone after they were all roomies for nine years. Unfortunately, I didn't notice his weight loss for a while because I was either grieving over one cat or trying to care for the other. The vet actually did not once suggest a feeding tube for him - instead, she was insistent on getting his remaining teeth pulled out (his teeth are not in great shape, but they never slowed him down, so I don't think they're the problem), saying that it "might" cure him.

And no, I don't think the brown liquid was blood. It's the same exact color as the food he eats. I also already am at a point where I've tried many kinds of food and have managed to find something he will eat consistently. I can't even begin to count how many cans of food I've thrown away because he was being a snot and wouldn't eat a particular flavor. I've found that he will only eat Fancy Feast pate Chicken & Liver and Turkey & Giblets. He also showed interest in Friskies, but I haven't been giving him that for a few days because he hasn't even been finishing off FF entirely lately and I know he won't finish off a 5.5 ounce can. The throwing up he's been doing for months and I know it's one of many HL symptoms. Sometimes he throws up what he ate, sometimes it's just a little liquid (might be clear, might be brown, depending on how long it's been since he ate last).

Today he did better. I think he's already had three cans of Fancy Feast (the usual flavors he likes) and he ate most of each...he left maybe a spoonful behind each time. Not quite where he was when he was eating better, but better than he has been lately. Who knows, maybe he's still recovering from the milk thistle. I have heard that while Periactin isn't a cure for fatty liver disease, it can show promising results in cats who aren't in horrible shape and that still show an interest in food on their own. It's also very hard to know what's a "normal" amount of food for him. When he was healthy, he ate nothing but kibbles and he didn't eat a whole lot, yet he was about 14 or so pounds for the longest time. Now he's on a strictly canned food diet and I just feed him as often as he wants to eat. At this point, he's probably half the weight he was at this time a year ago, so there's no way he can possibly overeat.

As well as he ate today and having eaten well for a month I don't think fatty liver is still a problem.  I am thinking that there is something chronic going on with his digestive system.  I take it he is around 7 pounds now, ate well for a month without gaining weight, and went through a period of low appetite and vomiting.  This really sounds like some form of IBD.  Cat's can quit eating when they lose a cat buddy.  It could also have been a coincidence or the stress could have brought out the symptoms of a chronic problem.

Has he had a recent liver test to see how his liver is?  With Fatty Liver disease often times the cat has a feeding tube for 1-3 months placed while they recover from the disease.  Normally the cat is tube fed until the liver parameters on the bloodwork are back to normal.  With his symptoms of Fatty Liver lasting this long there has to be something underlying that is causing his issues.  Has he been tested for a gastric ulcer?  That can cause brown liquid vomiting.

No, he hasn't had a recent liver test. I have been going by how orange/yellow his eye whites, gums and inner ears look, and he hasn't been orange for a while. He's off-white right now. Unfortunately, I have no job right now and I cannot afford the battery of tests that would normally be used to diagnose a bowel issue, and Kip reacts so horribly to stress that I don't even know if it would be worth it just to wind up making him sicker. I don't suppose a vet would be willing to put him on steroids for a short while to see what happens? Or an appetite stimulant? Would a steroid harm him if he didn't actually need it?

And I would love to feed him something a little better quality since, like humans with IBS, I imagine a cat with IBD needs some diet changes. However, I'm kinda broke. I'm reluctant to try raw food because Kip does not eat anything refrigerated or frozen/thawed (which, obviously, raw meat would have to be), and I don't want to blow money on all kinds of vitamins and meat just to have him walk away from it like he's been doing. The local Tractor Supply Company carries higher quality foods like Wellness and Hill's and the like, but Kip only liked Wellness on one occasion. He never liked Hill's either. He's been liking baby food lately, and with the holidays having just passed, he's getting leftover turkey breast too. He was all over the place today while the bird was cooking, I think from the smells in the kitchen. He was constantly whining for food, but didn't eat cat food. He was holding out for actual meat.

Ugh, I just don't know what to do with him. I love him, but it's extraordinarily difficult to feed him. Then he'll pester my mother for food and proceed to not eat it, and then she yells at him when he continues meowing after turning his nose up at canned food. She has a very short temper when it comes to whiny begging cats - my Caspurr did that all the time too, but she would usually knock it off once she had food. Kip doesn't do that - he's been refusing his favorite flavors lately and goes right back to whining. I'm also scared to give him vitamins of any kind because when I shove anything in his throat like a pill, he gets so stressed out that he'll make himself vomit (or he'll foam at the mouth to the point where none of the vitamin actually stays in his system), and he generally notices when I drug his food. He is the most impossible cat to feed.

I think you need to get blood work done, at least a liver panel done.  My kitty had fatty liver 3 years ago and he gets a liver panel done every six months and it isn't terribly expensive.  The office call, exam, liver panel and refill on his steroid always comes to less than $200.  As far as the tests for IBD it's kind of how far you want to go with it.  Most of us, myself included, actually have a diagnosis of probable IBD.  Every blood test done comes back normal.  The only possible way to get a definitive diagnoses, and that isn't 100 percent is a biopsy and most of us haven't had one done.  

Side effects from a steroid normally only happen with long term use.  The most common side effect is diabetes which usually resolves when the steroid is stopped.  Many vets use a trial with a steroid like a diagnostic for IBD.  The steroid of choice is Prednisolone but there have been supply issues with it for quite some time now.  My kitty has been switched to Dexamethasone.  Prednisone is thought to be a substitute for prednisolone but it usually should be avoided when there is liver damage.  The liver converts prednisone to prednisolone, the vet assumes that my kitty has liver damage because of having had fatty liver.