NG tube for hepatic lipidosis?

Hi all...

  Do any of you have experience or thoughts about having a NG tube placed for hepatic lipidosis?  My normal vet doesn't place feeding tubes, period...they recommended a couple of places 2 hours away from me (which I think is insane...how can you not place feeding tubes???).  So I called another local vet that comes highly recommended from my Sister.  I talked to him briefly on the phone...gave him the short history and asked if he places "feeding tubes".  He said his first recommendation would be an NG tube as it is much less invasive.  I just haven't read much about an NG tube for hepatic lipidosis...All I can find is information about an esophageal feeding tube. 

Until someone with more experience comes on to post advice, yes, I and my cat baby, unfortunately, have a little experience with a nasal feeding tube. It is the cheapest option. Some vets do not place feeding tube and others...I'm not sure if some vets are doing it when maybe they shouldn't be? I'll try to sum up quickly what happened with my cat and only focus on the feeding tube part. My cat baby was vomiting a lot one morning. Really a couple vomits and then lots of hacking up foam. She went into shock quickly and had low temp and low pulse, so I'm very glad I brought her in for a Banfield check-up. They said she really needed to go in for emergency tests, so I took her to one emergency hospital to get her hospitalized. They gave her IV and oxygen and medications. I took her home the next day, but she wasn't eating and after several days of my cat not eating and losing lots of weight, I took her back in. Over the phone, the vet said nasal feeding tube, but in person, he kept pushing an esophageal feeding tube that is much more expensive and said cats with hepatic lipidosis can need a feeding tube for up to a month, so esophageal tubes are best in that situation. 

After a disagreement, treatment was refused, so I had to take her to a different vet who said they do not place feeding tubes and are surprised that the emergency vet said he could place them. That vet said she thought only vet specialists could place them. Was an older woman. Makes me wonder if the emergency hospital vet should not be placing them? Took my cat baby to the recommended vet specialist where they agreed to place a nasal feeding tube, do tests, etc. I saw my cat baby after the tube was placed and she had a soft cone around her neck. This vet specialist prescribed pills instead of horrible liquid meds that made my cat foam at the mouth and drool. My cat reacted a lot better with the new pill medications. One was Mirtazapine. Surprisingly, the vet specialist said she was taking out the nasal feeding tube the next day already because my cat seemed interested in food. 

For cats that are not eating, kitten food is recommended. Also, stinky foods apparently that entice the cat. I can't remember what else. But I accidentally gave my cat Mirtazapine too soon. It's supposed to be given 3 days apart or something as an appetite stimulant. I wouldn't recommend anyone else trying this as Mirtazapine is supposed to be bad for cats from what I read briefly; however, not eating and hepatic lipidosis is also very bad for cats. That early dosage really kickstarted my cat's appetite again along with Hill's Prescription A/D wet cat food & Hill's Science Diet kitten kibble. (No, I would never ordinarily feed Hill's Science Diet, which is supposed to be terrible cat food, but the vet specialist gave it to my cat and it got her to eat combined with the Mirtazapine and the Prescription A/D.) Hopefully, some of what I posted in here is helpful.

Oh, if you do the nasal feeding tube, your cat will need to wear a cone or a soft cone around his neck because your cat will try to dislodge it as it is uncomfortable. That's why my cat had a soft cone around her neck. If you get an esophageal feeding tube, I believe your cat needs to go under anesthesia, which is always a risk. In that case, you really want someone good with cats and not necessarily the cheapest option. Also ask what type of anesthesia they will use. Someone might post the best ones to use. My cat recently went under for a dental cleaning. I'll try to find what info I found. 

EDIT: Someone had recommended Sevoflurane for anesthesia. That's what my Banfield vet used while my cat was under anesthesia during her dental cleaning. They gave her a sedative to calm her and then Sevoflurane.

Thank you for your reply...that was helpful!

Sorry for the multiple posts, but some people have had success syringe feeding their cats with the Hill's Prescription A/D or with blended wet cat food using a blender. This would never work with my cat as she fought me very much when I was just trying to syringe feed her medications to her and also syringe feed water to her and also senior cat supplement milk. 

The esophageal tube, though easy to place by someone with experience, can be difficult to place accurately.  When my kitty had one the vet actually used their in house ultrasound machine to make sure it was right.  I think an x-ray can also be used to check placement.  There can be some devastating outcomes if the tube isn't placed correctly.

My kitty only had the esophageal tube so I don't know about the one in the nose.  I would think the kitty would be much more likely to mess with one that is in the nose.

crimmie said:

 
Hi all...

  Do any of you have experience or thoughts about having a NG tube placed for hepatic lipidosis?  My normal vet doesn't place feeding tubes, period...they recommended a couple of places 2 hours away from me (which I think is insane...how can you not place feeding tubes???).  So I called another local vet that comes highly recommended from my Sister.  I talked to him briefly on the phone...gave him the short history and asked if he places "feeding tubes".  He said his first recommendation would be an NG tube as it is much less invasive.  I just haven't read much about an NG tube for hepatic lipidosis...All I can find is information about an esophageal feeding tube. 

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Personally, for HL,  I would NOT go with the NG tube, mainly for the fact that it could very well be in her for a month, maybe even longer, and that is a very long time for an NG tube. Honestly, I've never, EVER, heard of someone offering to put one in for HL. 

When MY cat had HL, he got his tube inserted directly into his tummy, but nowadays most Vets do the esophagial tube. 

Yes, the nasal feeding tube could be easy for a cat to dislodge without a cone around his head. My cat looked very disgruntled with her nasal feeding tube. Poor kitty. If you decide to try feeding your cat Prescription A/D, you can ask your vet for a prescription. Apparently it works well in getting cats that aren't eating to get interested in food again. If your cat won't eat the Prescription A/D on his own, you can then try watering it down, mixing it up, and putting it in a syringe to feed your cat. You can buy a feeding syringe at a pet store. Some cats apparently will docilely take the syringe feeding while others will fight it and can be syringe fed if wrapped tightly in a towel. Others, like my cat baby, cannot be fed this way at all as they will struggle mightily and let the liquid dribble down their chins. Best of luck to you in such a trying time!

Bonitababy said:

 
Sorry for the multiple posts, but some people have had success syringe feeding their cats with the Hill's Prescription A/D or with blended wet cat food using a blender. This would never work with my cat as she fought me very much when I was just trying to syringe feed her medications to her and also syringe feed water to her and also senior cat supplement milk. 

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This is what I have been doing for the past week, and she fights it so much.  I can't get more than 5cc in her at a time

crimmie said:

This is what I have been doing for the past week, and she fights it so much.  I can't get more than 5cc in her at a time

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Oh, that's a bummer. I'm very sorry. I know how hard it is for you and your cat if your cat fights it. It made me an emotional wreck. Also, how skin and bones my cat became. I think my expensive vet specialist was fine with putting a nasal feeding tube in first because she wanted to try the Mirtazipine appetite stimulant to see if that worked. If it hadn't, I'm sure she would have wanted to put in an esophageal tube. If Mirtazapine and kitten food and Prescription A/D was already tried or you're fine with the cost of the esophageal tube, it sounds like the best option.