Relapse? Fighting against fatty liver disease.

I didn't notice the breathing but I did notice louder purring.  Patches has never been very loud with purring but I could easily hear him with the feeding tube in.

She may be drawn to wet food now because it is easier to digest.  I know many of us that have kitties with chronic digestive issues have commented that their kitties were picky eaters before they got sick.  I think what happens is they eat something that doesn't agree with them so they shy away from it and become what we think of as picky eaters.

Denice said:

 
I didn't notice the breathing but I did notice louder purring.  Patches has never been very loud with purring but I could easily hear him with the feeding tube in.

She may be drawn to wet food now because it is easier to digest.  I know many of us that have kitties with chronic digestive issues have commented that their kitties were picky eaters before they got sick.  I think what happens is they eat something that doesn't agree with them so they shy away from it and become what we think of as picky eaters.

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You could very well be right!! 

Atleast right now the kibble we have out is Blue Buffalo Basics. It's for cats with sensitive stomachs and is grain free and all that good stuff. I went with the simpliest I could find when she stopped eating originally. Because at first I thought maybe the food was not agreeing with her. Before they were on the Hills Science Diet for Mature Cats. The Indoor Hairball Formula. I thought the throwing up was due to hair balls

Does anyone know if it is safe to continue tube feeding your cat if they attempt to eat by mouth during the feeding? 

Sabbath has done this to me 2 times now. One time she tried to eat some dry food while I was tube feeding her. So I stopped the tube feeding until she finished and then I started it up again. The second time was last night. I was tube feeding her and she decided she wanted to lap up some wet food that was near. She ate a decent amount of it too. Definitely not complaining but want to be sure I should stop pushing food into the tube when she does this or is this her way of associating the tube feeding with the food and I shouldn't stop?

I am just so nervous when she does that as I don't want her to throw anything up. Once she is sitting still I like to get the whole feeding done and don't want to stop.

Also if she does do this then should I not give her the full dose she would get in the tube because she ate as well? Again don't want her to get too full and get sick.

We see the vet tonight but wanted to see what people noticed through experience with their own cats and what your vets may have said. Curious. 

She doesn't do this with every feeding but she has done it to me twice now and I see it as a good sign. I just was not sure what to do when she does it as I don't want her to have any discomfort.

You can overfill a small stomach, so yes speak to the vet about this.  He can best help you with the amounts she ingests on her own vs feedings.

Great question!

peaches08 said:

 
You can overfill a small stomach, so yes speak to the vet about this.  He can best help you with the amounts she ingests on her own vs feedings.

Great question!

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Thank you. Glad I didn't give her the full amount of food through the tube then. 

Naturally I just thought not to because it makes the most sense. If she is eating bits on her own I am sure that amounts to something as far as what she is digesting and how much I am suppose to pump into her.

Once I have a definite answer from the vet I think I might start offering food to her before each tube feeding and see if she attempts to eat it before we start pumping. 

The food she has ate on her own has all been her going to the plate or bowl that I had already set out before. Which is what we want to see and makes me super happy. I just wonder if I offered her something before the tubing if she would attempt to eat it if she has done this to me 2 times now.  

Oh and actually another time.. I had fallen asleep on the couch. The alarm on my phone woke me for her tube feeding. I woke up and she was in the kitchen eating the dry food out of the bowl ha ha. She apparently knew before I woke up what time it was. That evening I did giver her less in the tube because of it. So really this has happened 3 times ha ha.

nicolefrank117 said:

 
Thank you. Glad I didn't give her the full amount of food through the tube then. 

Naturally I just thought not to because it makes the most sense. If she is eating bits on her own I am sure that amounts to something as far as what she is digesting and how much I am suppose to pump into her.

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I'll be interested to hear what the vet says.  How's the litter box?  Is she pooping OK?

You kind of have to play it by ear when they start eating on their own.  It's kind of a balancing act, you want them to eat on their own but they also have to continue getting enough calories to recover.

Denice said:

 
You kind of have to play it by ear when they start eating on their own.  It's kind of a balancing act, you want them to eat on their own but they also have to continue getting enough calories to recover.

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Yah it's like how do you know how much a tablespoon or a few nibbles is worth calorie wise vs how many ccs/ml you have to get into them.

Took Sabbath in for her 1 week checkup, bandage change and blood work.

She gained a 1/2 a lb in a week.

She said she definitely could tell she was less jaundiced just by looking at how much yellow was no longer in her skin.

Blood work shows progress. One of her levels went down to "normal" range. The others are still in the higher range but they all dropped. For instance one was 795 last time when she was admitted and is now at 313. 

She was impressed to hear she has been eating on her own. She told me to go ahead and reduce her tube feedings from 73 cc back down to 55 cc. Give her some room to be hungry to want to eat even more on her own. She also told me that if she eats say a tablespoon of food on her own (which = to 20 cc since there is water mixed in with the a/d)  that it was ok to deduct that from her tube feedings so she is not over eating. 

Went home insanely excited.. not about the bill but about the progress ha ha. 

I did also pick up some Feliway spray at the vet as Ichabod hissed at her when we were bringing her down stairs yesterday before taking her to the vet. I sprayed the house with it when we got home and Ichabod seems to be calmer. The only thing is Sabbath doesn't seem to attempt to leave our bedroom anymore even with the door open. There are times she sortof attempts to and then scrurries back into the room eventually. So I ended up putting another litter box in our bedroom so she doesn't hold anything in if she doesn't leave our room. I hope this changes. I hope it isn't because she is scared of Ichabod now. 

Anyways.. so after all this progress some things happened after the vet that concern me. Sabbath has been holding down all of her tube feedings from the minute we brought her home after her surgery. Well yesterday I bring her home from the vet and since she had not eaten or got in her 2nd dose of meds I gave her a little time to relax and get comfortable and then I did it all in the tube. I subtracted the fact that she ate some during the day and everything. She was doing fantastic and we all her meds in and when I got to about 20 cc into food she stood up and look anxious. Usually she does this if she has to use the litter box so I closed off her tube and let her go. She got into the litter box had a small bm. Then she got out of the litter box and vomited 3 times. I looked at the puke when I was cleaning it up and it was a mixture of wet, dry etc. I am sure her meds were in that mix too since she just took them in. So anything she ate during the day and anything I just had given her now on my carpet instead of in her. I was devastated. I thought well maybe she is still shook up from the vet. So then I am cleaning things up and she goes over to her food dish and proceeds to eat on her own. She ate a little of the dry and then ate all that was there of her wet food. I was shocked. I mean she just threw up and then she ate. I didn't tube feed her the rest of the night and just left out food for her. 

When I got up this morning it appeared she had eaten so once again I deducted what I thought and gave her a tube feeding of 35 ccs and her morning meds. She sat perfectly for me. As a matter of fact she purred and laid on her side all sprawled out and happy. That was at 5am. I went back to bed to be awoken by my husband who had gotten up to use the washroom around 9am (so you figure 4 hours had passed). She was throwing up again. Once again the puke was everything she had eaten. I am praying that the 4 hours gave her body time to absorb her meds this time. Then again while I cleaned it up she went over to her bowl and ate on her own.??????

This freaked me out so I called the vet and of course my vet has left for vacation and will be out all next week as well. I talked to another vet on duty and she told me that she might be eating more on her own then I realize. Which is true because she had dry food in the vomit as well and I didn't know if she was eating alot of that or not. When I remeasured it there was not all that missing. The wet food was obvious. She said that the tube feedings might be too much. She told me to stop the tube feedings altogether today and see if she continues to vomit. If she does bring her in for fluids. 

Since then she has ate some wet food on her own 2 times.I am just nervous of her relapsing now if she does not get enough calories into her. 

Any advice or input would be appreciated!!

I wonder if maybe the A/D isn't agreeing with her.  I know it's a mild easily digested food but maybe she is having issues with the pork now.

Denice said:

 
I wonder if maybe the A/D isn't agreeing with her.  I know it's a mild easily digested food but maybe she is having issues with the pork now.

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My husband did mention that. He said wasn't she only suppose to eat this for so long. Here she has been eating it for a month since this all started. Between the food offered, the syringe feedings and now the tube feedings. 

The food she has been eating on her own is the Grain Free Natural Choice Chunky Chicken Pate which seems to be the only wet food she will eat.  I have offered her different flavors and brands and she snubs her nose at them so I have been sticking with this one. She has been keeping this down since she came home with the tube and has been attempting to eat on her own. The same with the dry. It's Blue Buffalo Basics Limited Ingredient For Cats with Sensitive stomachs. She's been nibbling on that since the tube was put in as well. 

I am so concerned now that she won't get in enough calories to continue fighting this. But maybe this is a sign she doesn't need the tube as long as we thought she would. Not getting my hopes up though. Last time I did that was when she was eating more and then she relapsed. 

Her next feeding would be at 5:30 pm. So I am going to do the tube meds and water and see if she keeps that all down. Then offer her some food to eat on her own. I have been leaving the dry out all day so she can just go to it when she wants to. So far she has not attempted to eat any of it as she has been sleeping and being her lazy kitty self ha ha. She did eat a little wet food I offered her around 2:00pm.

So far today minus what she threw up she has gotten in about a 1/2 of a 3 oz can of Natural Choice Chunky Chicken Pate.

I hope the Feliway spray didn't make her feel sick. That is really the only new thing in the equation of things. I am going to stop spraying it to be sure. She did not throw up when I sprayed the Sentry Calming Spray the other day. And the Feliway diffuser is still plugged in as it has always been. 

So good thing I didn't get my hopes up.

So Sabbath ate some on her own since I last posted.

It was time for her 5:30 meds and food. So I prepared fresh wet food on a plate and put her meds in the tube with water and got the clearing water tubes ready. 

She sat perfectly as I gave her the meds and water etc. When I was all done clearing the tube with water she started to lick her lips really quickly. Never seen her do that before. Then she got up and started to gag and threw up again.This time she did not throw up as much because there was not a bunch of tube fed food in her. So now everything she has eaten today on her own has been for nothing. Not to mention I now have no clue what amount of meds she actually has gotten into her.

I did notice that when I was pushing the water through that it was dripping where the connector meets the syringe. It had done this to me from time to time before. I took it off and readjusted it a couple of times and it still did it. I looked though and the water was pushing through. She has the type that screws together. It did not leak with her food earlier in the day or when I gave her the meds mixed with water. It's seems to only happen when it only has water in it. Is that a sign that something is wrong?

I called the vet and she said to stop giving her anything through the tube. She is thinking it could have shifted or it could be kinked. I told her the last time we were there for bandage change she started breathing heavier. Then this time we bring her in for a bandage change and now she is vomiting. Each person who did her bandage changes said the site and things looked good. She hadn't pulled anything etc. 

They want to do an xray on her to see if the tube is still in the correct place first thing when they open tomorrow morning. UGH! Why is this happening when everything was looking up again. once again I am in tears. I am almost to the end of my credit limit with Care Credit too. I have no idea how I am even going to pay them back.

What medications is she on?  If there is nothing wrong with the tube I am thinking this is part of the same up and down stuff that is part of whatever it is that is at the root of this.  She had an ultrasound and nothing remarkable showed up so this is very likely inflammatory in nature.

So if it is IBD would that make her throw up just her meds if she was not given any food? 

Also what confuses me is if I was overfeeding her with the tube then that would explain her throwing up right after I tubed her the food last night. But why would it take 4 hours for her to throw up everything this morning? And here this was the meds alone with no food and she threw up right away again. 

Do you think her meds could suddenly not be agreeing with her. She has been doing fine with them but was also getting a ton of food forced into her. Maybe with less food in her belly the meds are upsetting her stomach??? 

She is on way too many meds for me to force feed them. I have to have the tube for that. If they take it out tomorrow I will be lost. 

Before she threw up last night she was given...

1 cc Clavamox

1 cc Metronidazole

1/2 tab Prednisolone

1/4 tab Famotidine

Before she threw up this morning (4 hours after) she was given..

1 cc Clavamox

1 cc Metronidazole

1/2 tab Prednisolone

1/4 tab Famotidine

0.5 cc Urisodiol

1/4 tab Vitamin K

1/2 tab Denamarin

Before she threw up just now she was given...

1 cc Clavamox

1 cc Metronidazole

1/2 tab Prednisolone

1/4 tab Famotidine

She is on the usual meds for IBD plus an extra antibiotic, the Clavamox, which makes 2 antibiotics.  The Metro is actually an antibiotic though it is often used for the anti-inflammatory affect.  

My kitty was never given the urisodiol.  It's used to dissolve gallstones and has nausea as a possible side effect.  It can also adversely affect liver function, I know people who take it have to have their liver function checked on a regular basis.

The pred, denamarin, and the famotidine are routine meds for IBD.  I'm not sure why the Vitamin K, I know it is need for blood to clot, but I don't think it would be causing issues.  Metro is also routinely given during a flare.  If there is no issue with the tube I would question the Clavamox and the urisodiol.  I am not saying there aren't good reasons for those medicines, that's for a vet to decide, but I would ask about them.

Denice said:

 
She is on the usual meds for IBD plus an extra antibiotic, the Clavamox, which makes 2 antibiotics.  The Metro is actually an antibiotic though it is often used for the anti-inflammatory affect.  

My kitty was never given the urisodiol.  It's used to dissolve gallstones and has nausea as a possible side effect.  It can also adversely affect liver function, I know people who take it have to have their liver function checked on a regular basis.

The pred, denamarin, and the famotidine are routine meds for IBD.  I'm not sure why the Vitamin K, I know it is need for blood to clot, but I don't think it would be causing issues.  Metro is also routinely given during a flare.  If there is no issue with the tube I would question the Clavamox and the urisodiol.  I am not saying there aren't good reasons for those medicines, that's for a vet to decide, but I would ask about them.

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This info is extremely helpful and I will definitely ask them tomorrow.

I do plan to ask about the Clavamox. Sabby finished her weeks worth she was originally prescribed yesterday morning. She would have been done with that. When we brought her in for her check up we mentioned that ever since her bandage changing on Tuesday she has been breathing a little funny. Noticed she was breathing a little harder. I was thinking maybe her bandage was done too tight. It was not done the same way because another vet did it. Our vet wanted to be sure she hadn't caught a cold or something being there so she decided to renew another week of the Clavamox incase that was causing the heavier breathing. Now that I think about it. Ever since her bandage was changed yesterday I don't notice the breathing. I bet it was done too tightly. I will be sure to bring that up tomorrow. Maybe she should be taken off of this. 

It's also funny that you mention the ursodiol as I decided to look up all her meds again. That one was given to her this morning 4 hours before her vomiting episode but it was not given to her before last nights or todays most recent one.  

The vitamin K she told us was for blood clotting. She said that liver disease and pancreatitis could cause a lack of vitamin k etc. 

I noticed she has eaten a decent amount of the tablespoon of wet food I left out for her. I just pray this is enough to keep her getting better. 

The other thing I failed to mention was the fact that I fed her 35 ccs by tube at 11pm last night and she kept it all down even after her vomiting episode yesterday at 8:30pm. The 11pm tubing was strictly just food and no meds. So you figure she kept that all down until I got up at 5am and fed her again.. which was the meds and then 35ccs of food. She then kept that all down for another 4 hours until 9:00am when she vomited out of nowhere. She then ate on her own. She then kept anything she ate on her own down until I gave her the meds in the tube at 5:30pm today. Since then she has not vomited and has eaten on her own.

If it was the tube you would have thought she would have thrown up the 35ccs I gave her last night at 11pm and why did she keep everything down for 4 hours after I fed her this morning? This is boggling me.

I know nothing about food tubing and am learning a great deal here.

I have a thought though. Do you give the meds and water first? and then the food? Giving food first and then the meds might be easier on the stomach. Giving water and meds first seems like giving it on an empty stomach. The food wouldn't stand a chance.

Well it's been quite a roller coaster of a weekend. 

Sabbath kept all the food she ate on her own down all night. Then this morning about 8:00am I refreshed her foods and she ate some. She did that thing again where she went to the litter box, had a BM and then got out and threw up. 

Needless to say it was only an hour until we had to return to the vet so I cleaned it up and took away the food. 

The vet we got was great. Thank god. Our vet is off on vacation and will be gone all this week. So we were hoping she would be in good hands with someone else. She examined her and noticed food on the inside of her bandage near the stoma. They say that often happens when food comes back up the esophagus and up the tube. 

They did an xray and it showed a lot of trapped gas in her stomach, intestines and colon. The tube is still in it's the right place. The vet immediately believed she had ileus/slow intestinal motility as a result of going from no food to alot of food all at once to beat the liver disease and pancreatitis.

She asked to keep Sabbath until they closed at 3pm. Her goal was to attempt to tube feed her and give her meds in the tube to see if something was going on with it since it is internally still in place. Also for my own piece of mind that I didn't do something wrong. Here I did fine for a week of feedings and meds and she improved and then this happened so I felt bad because I was not sure if I was to blame. I also told her how they bandaged her poorly last Tuesday to the point I felt her heavy breathing was due to it being too tight. I told her how the breathing like that has stopped since our vet did the bandaging on Friday.  I also told her that the tape job to hold the tube on was not done well either until our vet did it and that I was experiencing leakage whenever I put water in it to clear it.. I told her how the tube kept coming out of the tape and I would catch it hanging off her. Sometimes even whacking it on things.

Well.. she checked it out and the plastic adapter that connects to the syringe had a small crack in it which means I am not crazy (well atleast in regards to this ha ha) and was causing  the leak I was getting when I would put water through it. I think that most likely this happened when Sabby whacked it on something due to their poor tape job. She fixed it right away but said she did not feel it would have caused as much of the gas bubbles that showed up in the xray. She said a few but nothing like we were seeing. She attempted to tube feed her and she ended up throwing up like she has been. She gave her metoclopramide which is used in cats with ileus and it helps their intestine move things along. She gave her a break and then later feed her some tuna. She said Sabby lapped it all up. So she still continues to want to eat. She did another xray for comparison as Sabbath kept all the tuna down. The gas had pushed out of the stomach, out of the intestines and was now only sitting in the colon ready to be released. You could see the tuna in her belly. The medication seemed to have worked. 

Also no more Clavamox. She said it can definitely be contributing to her upset stomachs and since the breathing is no longer happening since her bandage change it's best to take her off of it. She was going to prescribe the metoclopramide but she is afraid she still might not keep it down just yet through the tube. We have to drop her off first thing in the morning before work. They are going to do the same thing they did today. Give her the meds and observe her. They will most likely do another xray to see how things are moving. 

She did tell me that this is not a disease and it's not what would have caused her to stop eating originally. This is caused by everything else that is going on in her system right now and the amount of food change she is experiencing. Thank god! 

I hope these meds continue to help her.

Sounds like things are still going well even with the ups and downs this weekend.  It also sounds like you are going to a good vet clinic, I take it this was a different vet at the same clinic.  I have found that generally speaking when a clinic is good all of the vets there tend to be good.  Of course being human we usually have a preference based on personality but the vets tend to all be good at what they do.

Glad you got a good vet who took the time to figure things out.