Syringe Feeding or E-Tube?

rubear

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My 9-yo Ruby has recently stopped eating. The problem has been going on for over a month at this point. We've tried steroids and anti-nausea medications as well as changing to a high fiber food (Royal Canin Fiber Response). All seemed to work for a few days and then she'd be off her food again. I've been desperate and she's been getting a lot of turkey lunch meat and lactose-free ice cream because that's all I can get her to eat. It's not substantial enough, but anything at this point.

Today we had an ultrasound to try to get to the bottom of it and the vet suspects pancreatitis and possibly cholangiohepatitis. I was suspect that hepatic lipidosis is beginning because two of her liver enzymes suddenly became greatly elevated but the vet wasn't so sure. To get her eating again she gave me some pain medication (bupenorphrine) and an appetite stimulant (mirtazapine). I administered both medications about 5 hours ago and she still has no desire to eat. I've gotten her to eat a little lunch meat and some treats, but mostly she just wants to be huddled up with big open eyes.

My concern is that it's been so long since she's eaten normally that there could be significant harm. I've tried every trick in the book for stimulating her appetite to no avail. She'll eat a tiny bit of dry kibble from my hand and that's about it. My primary vet discouraged me from syringe feeding because it could cause resentment and lead to further eating issues. He preferred they do it in office with a tube feeding, but that's not a practical solution if this goes on for several days. My specialty vet said an e-tube may be necessary but she wanted to try the drugs first because the tubes can be problematic and require lots of round-the-clock care at home—avoiding one would be best.

So I don't know what to do to make sure my baby is getting enough nutrition. Do I try a syringe? I did get a large feeding syringe and several cans of Hills A/D critical care. I know it's going to be an awful fight—but tough love is better than starvation, right? Should I risk it and give the meds a few days to work?
 

bellel

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Ok first of all, e-tubes do not require that much care if the doctor inserts them correctly. Tater Tot had one for 5 weeks, almost 6. It's easy to clean, it's easy to feed them (a vet visit is not necessary after they show you how to feed them and how much to give them at one time). If anyone was going to screw a feeding tube up, it would be me. And guess what? Tater did just fine with it. I fed him early in the morning, gave him a second feeding before work, another during lunch, and two more after I got home. As long as you keep an eye on the insertion site for blood or pus, keep his tube clean and open (using warming water), and use the proper food (A/D mixed with some water...no, it does not have to be food processed), you'll be fine. Your vet's are very concerning to me, especially the specialist. It sounds to me like he/she doesn't have enough experience with feeding tubes. If he/she considers them dangerous, he/she does not know what they're doing. It is the first protocol vets use when a cat has pancreatitis (go ahead and do the research...I did). You really need a second opinion from a vet who has done a lot of feeding tube insertions.
 

mrsgreenjeens

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I would go with an E-Tube if I thought I would need to be "assist feeding" for any length of time.  Is there any reason to believe she might be eating on her own any time soon?  It's already been a month.  And when I say eating on her own, I mean regular meals, not hit or miss now and again. 

If the  meds are not working and she is not eating regular size meals yet,then YES, risk it and feed her that A/D with the largish syringe.  She needs nourishment.  Here's a video that  might help you with how to do it:

http://www.thecatsite.com/t/227858/syringe-feeding-lucky-video-if-your-cat-is-not-eating
 
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rubear

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Fortunately the meds are starting to work and her appetite has returned. Fingers crossed that things stay this way. We aren't out of the woods yet but the ultrasound showed mild IBD in the duodenum with secondary inflammation in the pancreas and liver (triad disease). Her liver enzymes were almost back in the normal range and it appears we probably weren't in danger of fatty liver (which was my biggest fear!). She did have a B-12 deficiency and we're doing injections for that now. That seemed to perk her up immensely.

She's still very tired (probably from a combination of soreness and, as I understand, a possible side effect of the depo medrol shot) but her appetite seems to have returned. There's no better sound a worried cat parent can hear than crunching at the food bowl!

Of course now that I know she's an IBD kitty there will be diet changes. At least to a novel protein or grain free good. Not sure we'll get changed to wet food at this age, but we might try once I'm sure she's back eating normally.
 

mrsgreenjeens

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So glad she's eating on her own again.  And I agree this is NOT the time to be making any changes.  But if she IS indeed and IBD cat, then definitely if her current food is not apprepriate, then you should slowly turn her around to a more appropriate food.

Here's a thread on how to do that.  http://www.thecatsite.com/a/transit...-to-a-new-type-of-food-canned-raw-or-homemade     No matter the age, you should be able to do it.  I transitioned all four of my furbabies from being free fed kibble to scheduled meals of canned food, and two of the cats were over 10 years old at the time.  And two were extremely picky eaters.  But we did it!  So can you
 

bellel

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Thank goodness that things are looking up! I realize that raw food is very popular with the IBD World (it's a huge fad), but it is dangerous for cats especially if they are having an issue with their pancreas. I don't care what anyone says, I've talked to several vets who say it's dangerous because of the bacteria. Please consider when the time comes to change her diet to either home cooked or a commercial novel protein.
 
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rubear

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Yeah, I'm not going to do raw and I probably won't do home cooked for practical reasons. I plan to switch to novel protein as soon as I can get her regularly eating again. Probably to a commercial dry, since she's used to that, and then we'll see if we can switch to wet. But I have to wait for this flare up to subside.
 
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