Hepatic Lipidosis force feeding plan for Timmy

Hello! I am new to this site, but found you while doing research on treatment for my HL cat Timmy. I have to say reading the thread on tube feeding gave me a huge dose of peace of mind, though I am still worried.
The hospital put him on fluids, meds and a feeding tube, he stayed in the hospital for a week and a half. Upon his release the vet said I would need to tube feed him at home-- which of course I would do, she said she would give me a feeding plan, how to ease into his daily caloric intake, and DIDNT. Her verbal suggestion was 20-40 mL every 2-3 hrs, a combination of AD/Clinicare, plus meds and supplements. Tim did well, for the first day, but I couldnt get the # of mLs suggested by the vet in him. I was feeding him every  2 hrs, and the first day seemed to go fine, with some nausea in the afternoons. I thought maybe it was one of the meds...I continued on this schedule and still couldnt get the recommended mLs in my poor kitty, and when I tried increasing the # he vomited, which made me soo sad, and worried. I started doing some research and found this site, and that most folks are feeding anywhere between every 3-6 hrs, so this makes me think my poor Timmy was too full, so I eased up on the frequency of feedings and hes seems more comfortable and content. That being said, I am still terrified - 1. he's not getting the nutrition he needs/caloric intake to recover, 2. making him vomit by increasing his mLs. Would any of you experienced HL tube-feeders have a recommended feeding schedule and caloric increments? Thank you in advance from Timmy and me.

That does sound like a lot.  It is true you want to get as many calories as possible in but it doesn't do any good if you feed to the point of vomiting.  My vet had me mixing the A/D half and half with water and then feeding 60mls of the slurry 4 times a day.  That means he was getting 30mls of the food 4 times a day.

Denice~ Thank you for your reply-- Im feeling alone and overwhelmed. I was so happy that I got 17 very slow mLs of AD+CliniCare in Timmy this morning...an hour later it was on the dining room floor. Im sure I was over zealous in the # of mLs, but I am desperate to get some nutrition in him. Waiting an hour and a halft to try again. Meanwhile I got him some PedaLyte to be sure hes not getting dehydrated. Has anyone here added Nutrical to their tube feeding routine? I have a new tube.

Thank you again~

deb & Timmy

The formula the vet recommend, and Im trying to get into Timmy,  is 1 can AD + 100 mL CliniCare mixed together, along with some digestion-aide, amino acids, vitamin E...

DebMerchant said:

 
The formula the vet recommend, and Im trying to get into Timmy,  is 1 can AD + 100 mL CliniCare mixed together, along with some digestion-aide, amino acids, vitamin E...

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okay, i've requested that the moderators move your posts and denice's reply over to a thread of your own. you'll receive more advice and support that way. i'll wait and watch for your own thread, then reply there.

Thank you
Thank you
Thank YOU!

great! the mods here at TCS are wonderful.

okay, so i don't have experience or much knowledge about caring for a cat who has hepatic lipidosis and has a feeding tube. but there are other members who do have that knowledge and/or experience.

i'll see if i can attract the attention of a member who has a cat that had a feeding tube recently. @crimmie -- may i ask for your first hand experience with feeding tubes for the OP (original poster)?

i'm sure others will reply soon. in the meantime, as @Denice posted, it doesn't do any good to feed to the point of vomiting. i can certainly understand feeling pressed to feed as much as possible in order to help your timmy. but if i'm not mistaken, others have had to feed smaller portions to start off with and then slowly work their way up to the larger portions. it might help to focus on feeding the amount/portion that your timmy will be able to keep down, because that's the very important part -- that the food stays down, is digested by your timmy.

has your vet recommended giving your timmy sub-q fluids?

PS he vomited up the Pedialyte I gave him, slowly.
8mL before he started to lick his lips, over 40 minutes.
An hour later he vomited. I just gave him his ondansetron 1/2 tab with 3mL of Pedalyte-- fingers crossed. But, I dread the next feeding...

Your kitty may respond better to another anti nausea med.  If I am not mistaken your kitty is on an anti nausea med that goes by the brand name Zofran.  Sometimes a kitty, for whatever reason, will respond better to one medicine over the others.  The other two that are often used is Cerenia or Reglan.  The Reglan is more prone to side effects but some kitties respond to that one the best.

I did ask about fluids, when the vet sent him home the first time. She suggested that a cat that needed sub-q fluids should be in the hospital...
I will ask the vet tomorrow about the nausea meds-- I do believe he had Cerenia at the hopsital...been talking to a vet online about feeding and requirements and I have hope, but there is still a huge amount of fear and dread coming with the next feeding.
WAH, I just want him to feel better and make little kitten steps forward.

So sorry you have to go through this. I know how frustrating it is when you don't have all the answers.
I agree that he needs something for nausea.
Going slowly with pushing the feedings and temp of the food is important. If it's cold or not warm enough it will cause nausea. Be sure it isn't too warm also...think of it like you are warming a bottle for a baby...test it on your wrist.
How much does he weigh?
I take serious offense to your vet's comment regarding sub q fluids. Especially in regards to a cat that has HL. He is dehydrated, and that alone can make him nauseous. Sub q fluids at home is easy and very good for a sick kitty. I would push hard for them.
I copied my reply in a previous thread:
I spent A LOT of time and energy calculating KCal/ml of A/d mixed with whatever....so find out how many mls to give her every day, divided by how many feedings per day. At the end of the day, anything you can get into her is awesome.
A/D is about 1.3 kcal/ml
My vet told me to aim for 1-1 1/2 cans per day. But you have to start slowly.
Day 1= 1/3 of can
Day 2= 2/3 of can
Day 3= 1 can
Day 4= 1 1/3 can....
Remember that mixing with water will change the calories per ml, since water has no caloric value. I mixed mine with KMR (the liquid, not the powder), and Nutri Cal

Read here: http://www.thecatsite.com/t/301163/added-calories-to-hills-a-d

Let me know his weight, and I can help you come up with some numbers, and a better idea of goals for feedings.
You should start slowly and work your way to a whole can over a few days.
I'm sorry your vet didn't give you a better plan...but honestly, any amount you can give him without it coming back up, is golden

I agree that the temperature of the food going into the tube has a lot to do with it.  Plus the position of Timmy while he's getting his food.  Make sure he seems comfortable.  And do check into which anti-emetic he got while in the hospital...if it worked there, he should be getting the same one at home. 

There is absolutely no reason why sub-q fluids cannot be given at home.  Many of us do them on a near daily basis (I do for my kidney cat).  IV fluids, on the other hand, are done in the hospital.  Are you in Europe?  I know they frown more on doing them at home in some countries over there. 

Hang in there.  Do you know what caused his H/L in the first place?  Has that been taken care of?  (infection, pancreatitis, etc.)

Also...You said he was in the hospital for a week and a half. Did he have the feeding tube that whole time? How long were they feeding him with the tube in the hospital, and what were the volumes he was getting while there? I ask because it may very well be all nausea and position related. Is he laying down, sitting up, front half elevated when you feed him?
I'm curious as to the cause of his HL as well...That can play into it.

The sad reality is that the ultrasound I had wanted performed when Timmy was first seen by the vet,  would have told us weeks ago he was riddled with CANCER! Yes, the cancer in his abdomen affected several organs, including the pancreas-- and pancreatitis was what the vet assumed was the diagnosis and treated my Timmy-friend as such, not knowing it would be a unnecessary and futile battle. In reality the tube feeding was not Timmy's problem but the cancer, nausea and resulting fluids, etc,  making him unable to take in much nutrition. The tips and support I received here on the CatSite gave me hope, and they were taken to heart, I wanted Timmy better. My disappointment in the lack of a  real feeding plan from the vet upon Timmy's release from the hospital, and her inability to really listen what I had to say and take my suggestion to get the ultrasound [she thought the ultrasound was "too expensive" and thats why she didnt go forward]  reiterated the lesson I need to speak up. Timmy's diagnosis would have been the same, but he would have not spent  the last few weeks of his life in a body that was declining rapidly and uncomfortagble...not to mention the bill that always accompanies hospitalization.
Thank you again for all of you who reached out and shared tip and storys to help Timmy and I, your kindness is appreciated more that words can say.
[sorry if this is a little babble-y, I keep crying and losing my train of thought]
With love

deb & Timmy

I am so sorry.  You did everything you could for Timmy.

I'm so sorry. Sending love and strength

i'm so sorry. sending you and your timmy many gentle  .

This is devastating news.  I'm so sorry.  My heart is aching for you right now.