The treatment is involved, meaning it must first be accurately diagnosed. *IF* hepatic lipidosis is confirmed through bloodwork, then your vet needs to determine the extent of the condtion in order to provide the most effective treatment. The lab work should tell him how critical the condition is, how severe, as well as how dehydrated she might be, if she's jaundiced, how much weight has been lost and how drastic that weight loss would be concerning.
Nutritional support is given through either of two ways: 1) forced feeding at home...I do not recommend this if the condition is severe because owners often are not compliant with the feeding amounts and schedules and if not compliant or consistent, the treatment will fail and be disastrous for kitty. 2) a surgically placed enteral feeding tube (i.e., naso-esophageal, or directly through the abdomiinal wall into the stomach). The second option provides the best chance at recovery, providing kitty is in a stabilized condition to withstand anesthesia necessary to place the feeding tube. Then, food is passed through a syringe that attaches to the feeding tube. This is where the feeding amounts and feeding schedules are crucial to recovery. A veterinary prescribed diet, such as Hill's Rx A/D is mixed with water and given through the syringe based on a strict feeding schedule. Additional water for hydration can be given this way as well. Liquid medications can also be given by this method. This method bypasses the need for the cat to eat, chew, etc, and the nutritional support goes directly to the stomach, affording quicker and more effective recovery.
If the condition is NOT severe, but only requires additional nutritional support, an owner can do this at home, but the feeding amounts and schedules must still be consistent and the owner must not miss feeding a meal, giving water, meds, etc. This is achieved through forced-feeding with a syringe orally. It must be done slowly and carefully on a daily basis with frequent bloodwork monitoring to monitor the progress of treatment and recovery.
You should not add anything outside of the veterinary prescribed diet when forced feeding or using a surgically placed feeding tube. Nothing, other than what your vet may specifically prescribe. No treats, (definately no milk), no human foods, nothing.
If the condition is severe, and if kitty is presenting severe jaundice, vomiting, severe dehydration, then it is recommended to hospitalize with continuous IV fluid support as well as a feeding tube for continous nutritional support. Hepatic lipidosis can take up to 4 months to recover completely, so it is vital that treatment is consistent and met with the owner's compliance.
I would go into more detail, but you need to get your kitty diagnosed immediately. This may or may not be hepatic lipidosis at all, but it is a vital condition that needs to be ruled out ASAP, like immediately.
cat not eating...
Re: cat not eating...
..........Traci
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turleyhead
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- Joined: Mon Apr 25, 2005 1:47 am
Re: cat not eating...
Update: She's only licked/ingested the little bit of liquid from her canned food this morning. The vet had an extremely hard time getting her blood samples for the tests...the needle was in the vein, but no blood flowing. Had to tie a tourniquet to get enough blood in the vials. She's very dehydrated and the IV does not seem to be helping. If anything, she seems worse afterward. She received another IV of saline and another B Complex injection. Her blood glucose test came back at 257.9. I'm still awaiting her other test results. She is due to go back for another IV and injection this evening at 6:30.
In the meantime, once I got her home, she is not really able to walk or hold herself up. She takes a few steps then flops over on her side, eyes open, but miserable. There is no such thing as 24-hour care here. I tried giving her sugar water, but she has promptly vomited that up within 20 minutes. She won't even entertain the idea of food or broth at the moment. As weak as she is, she tries to get up and away from it as soon as I put it in front of her.
I'm really beside myself at this point and don't know what else I can do other than what I've been doing. I was hoping for some sign of improvement but I'm really fearing the worst right now. My vet in NY stressed the importance of the IV/treatment over worrying about the diagnosis, but I'm just afraid it's not working.For a cat who has always been really healthy and content, this is just a horrible way to go....and I feel really helpless.
In the meantime, once I got her home, she is not really able to walk or hold herself up. She takes a few steps then flops over on her side, eyes open, but miserable. There is no such thing as 24-hour care here. I tried giving her sugar water, but she has promptly vomited that up within 20 minutes. She won't even entertain the idea of food or broth at the moment. As weak as she is, she tries to get up and away from it as soon as I put it in front of her.
I'm really beside myself at this point and don't know what else I can do other than what I've been doing. I was hoping for some sign of improvement but I'm really fearing the worst right now. My vet in NY stressed the importance of the IV/treatment over worrying about the diagnosis, but I'm just afraid it's not working.For a cat who has always been really healthy and content, this is just a horrible way to go....and I feel really helpless.
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turleyhead
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- Joined: Mon Apr 25, 2005 1:47 am
Re: cat not eating...
Hi Traci, thanks for more details. I am still awaiting the test results, but as you can see from my last post, I think things are pretty severe. I am not sure what they have available here in terms of surgical facilities and the kind of food you are describing or if that prcedure can be done here. I basically am going to have to make do with whatever is available here. She's been receiving ampacillin 125 ml injection via the IV, one yesterday evening and one this morning. I'll post once I hear what the blood test results are.
I'm so sorry to hear this! But hang in there. The cat I talked about earlier, who had 'a virus in the liver' acc to my then vet, went on like yours for weeks, with antibiotic injections daily and us force feeding him, before he started to show improvement. If it's hep as Traci suggests, treatment will take time before it shows results and recovery will be slow. Did you ask your vet how to get her to keep at least some food down? Something that surpresses the nausea? Or intravenous nourishment along with the saline? Vets here are often slow to really start treatment, because the general attitude is "oh it will all work out, don't worry, no problem". The 'wait and see' approach is the rule here. I would call the vet again and ask him what can be done now so that she keeps food down. Don't accept 'nothing' as an answer.
I also thought it highly unlikely that in India cats could get a surgically placed enteral feeding tube. But maybe you can ask around, maybe there IS a vet somewhere who does that. I remember I was very surprised to hear there is actually a heart specialist for dogs in Mumbai (probably the only one in India). And my husband said that Bangalore is the most modern city in India, most advanced ... maybe call the university, or call other vets in the phone book. Good thing is you're American and able to pay them well. That helps here! (Sad thing to say, but true.)
Another thought: for a little extra fee vets usually come to your house. It would certainly be less stress for her to be given the IV and injections at home. Ask him.
My thoughts are with you and your cat. What's her name?
I also thought it highly unlikely that in India cats could get a surgically placed enteral feeding tube. But maybe you can ask around, maybe there IS a vet somewhere who does that. I remember I was very surprised to hear there is actually a heart specialist for dogs in Mumbai (probably the only one in India). And my husband said that Bangalore is the most modern city in India, most advanced ... maybe call the university, or call other vets in the phone book. Good thing is you're American and able to pay them well. That helps here! (Sad thing to say, but true.)
Another thought: for a little extra fee vets usually come to your house. It would certainly be less stress for her to be given the IV and injections at home. Ask him.
My thoughts are with you and your cat. What's her name?
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turleyhead
- Posts: 15
- Joined: Mon Apr 25, 2005 1:47 am
Re: cat not eating...
Ash, thanks for your words of encouragement...I dont' have a lot of it right now. I've found a vet clinic closer to my house, which hopefully will reduce the stress on both myself and my cat. The other vet is not very communicative and doesn't give full answers to questions (I also have a problem with his accent and how fast he talks). And I am not certain but I think he made some sarcastic comment comparing how hard it was to get the blood sample from my cat's veins to how hard it is to get dollars out of the US. I have no idea what that means, but assumed it was some kind of anti-American comment. Not that I care, but whatever. I think that he's now basically pawned me off on this other vet who is in my neighborhood, and didn't seem to want to talk to me or my partner on the phone (we've called him back several times already). I asked him to fax the test results so we could fax them to our vet at home, but he said his office is closed now and won't be open until the AM. I'm in emergency mode and all of these guys are just like, come at 8 PM or come at this time (hours away). I get the feeling that they see animals drop dead all the time and that they more or less do take the "*beep* happens" approach to it.
I did manage to get a number out of him from the blood test. I have no idea if he ran a full battery of tests, a full biochem scan or not, but all he would tell me was that she has some kind of "liver infection", indicated by a number: 225.7 from her blood test. He also said her glucose was high (when I called the Lab, they told me it was 257.9). I'm not sure what the number 225.7 for her liver represents. Maybe someone else here (Traci??) would know....
I will have to see how this other vet is tonight and then see what I can do from there. I will try to force feed myself if there is no sign of improvement or she gets worse because at a certain point I am not going to have anything to lose.
She's not able to walk (she can crawl unsteadily for a few paces) and has urinated at least 4 times just lying in place since I got home from giving her the IV. At one point the poor thing actually made it into her litter box where she promptly collapsed. She's just plain miserable.
And her name, which normally needs explaining, is Psycho. She is not a crazy cat at all...one of the most mellow most affectionate cats I've ever known, so the name doesn't really fit her personality at all. It's a long story, but basically it's just that she looked like a wreck when I found her on the street 6 years ago and the name stuck. But we tried to change it and we mostly just call her "Kitten" now, although she answers to both names.
I did manage to get a number out of him from the blood test. I have no idea if he ran a full battery of tests, a full biochem scan or not, but all he would tell me was that she has some kind of "liver infection", indicated by a number: 225.7 from her blood test. He also said her glucose was high (when I called the Lab, they told me it was 257.9). I'm not sure what the number 225.7 for her liver represents. Maybe someone else here (Traci??) would know....
I will have to see how this other vet is tonight and then see what I can do from there. I will try to force feed myself if there is no sign of improvement or she gets worse because at a certain point I am not going to have anything to lose.
She's not able to walk (she can crawl unsteadily for a few paces) and has urinated at least 4 times just lying in place since I got home from giving her the IV. At one point the poor thing actually made it into her litter box where she promptly collapsed. She's just plain miserable.
And her name, which normally needs explaining, is Psycho. She is not a crazy cat at all...one of the most mellow most affectionate cats I've ever known, so the name doesn't really fit her personality at all. It's a long story, but basically it's just that she looked like a wreck when I found her on the street 6 years ago and the name stuck. But we tried to change it and we mostly just call her "Kitten" now, although she answers to both names.
Re: cat not eating...
Oh, I so feel with you! I know how hard this attitude here is for us who feel that they are our babies, friends, family members ... and most Indians, vets included, just don't feel this way. Yes, they are very complacent and it can simply drive you mad. Good you changed the vet. Don't be shy to change again if necessary. Maybe look around in the neighbourhood for affluent homes with dogs and ask them for a good vet (make sure you speak to the owner, not one of the staff, as they may not know). It works a lot by word of mouth here.
Maybe drive to the lab and get the report yourself, no time to lose, it's imortant the new vet knows the situation. And Traci will surely be able to give you more info once she knows what the report says.
Yes, dollars are very important here, even vets and other doctors don't earn much here, and people can be quite sarcastic and jealous. But you can work it to your advantage. Don't feel shy to wave your money around. $50 or $100 can make them move much faster! Ask your new vet for a specialist for cats (if he isn't one himself), tell him you'll give him 1,000 Rupees if he finds you one, for example. Drive to the old vets home with a $100 bill in exchange for the lab report. He will go and get it for you, I promise!
Poor little Psycho! As it is now I would continue to force feed her, always hoping that at least a little gets absorbed before she spits it up again.
Better to demand from the new vet that he gives her intravenous nourishment.
All the best! Don't lose hope!
Maybe drive to the lab and get the report yourself, no time to lose, it's imortant the new vet knows the situation. And Traci will surely be able to give you more info once she knows what the report says.
Yes, dollars are very important here, even vets and other doctors don't earn much here, and people can be quite sarcastic and jealous. But you can work it to your advantage. Don't feel shy to wave your money around. $50 or $100 can make them move much faster! Ask your new vet for a specialist for cats (if he isn't one himself), tell him you'll give him 1,000 Rupees if he finds you one, for example. Drive to the old vets home with a $100 bill in exchange for the lab report. He will go and get it for you, I promise!
Poor little Psycho! As it is now I would continue to force feed her, always hoping that at least a little gets absorbed before she spits it up again.
Better to demand from the new vet that he gives her intravenous nourishment.
All the best! Don't lose hope!
When you refer to the IV's she's getting, do you mean intravenously or sub-cutaneous? Intravenous means the IV is actually going through the vein....sub-q means it is only going through the skin (such as near the base of the neck, shoulder area). If the vet only gave sub-q fluids, this is not enough, it needs to be continuous IV fluid therapy.
Try to get all of kitty's records from the other vet immediately, then have the new vet review them. Tell the new vet you are concerned about Hepatic Lipidosis, and it needs to be treated agressively (of course, this diagnosis depends on any bloodwork results). Without seeing the results, I don't know which liver enzyme was elevated, and cannot accurately say it is Hepatic Lipidosis....I am making an educated guess based on the signs and symptoms, circumstances leading to this. Also, I don't know what system of metrics the vet is using, so the glucose could also be concerning. A urinalysis and blood glucose done together should be done to rule out diabetes.
Ask the new vet if he/she has any outlet to refer to more advanced vet medicine, such as a veterinary teaching hospital in your area. He/she should be able to refer to someone for appropriate treatment for certain health conditions. If he/she has a network available to consult with a specialist (ideally from the states!), that would be ideal.
I'm not sure the ampicillin is appropriate, but rather oral amoxicillin would probably be better, but without knowing exactly what the vet thinks he's treating, I cannot say for certain. Do ask the new vet however, if amoxicllin would be more appropriate. Ask about any veterinary diet available that is high in calories and low in protein, canned or soft, it should be fed consistently.
Lastly, ask the new vet what they do for complicated cases, and for conditions they don't seem to know enough about...do they consult with a university? Do they have access to a US vet for consult? Do they have access to a specialist in small animal medicine elsewhere in your country or direct area? If so, demand they get on it immediately, because I suspect your kitty needs agressive care promptly. Call your vet in NY and ask if he can somehow get connected to this vet and offer guidance.
Try to get all of kitty's records from the other vet immediately, then have the new vet review them. Tell the new vet you are concerned about Hepatic Lipidosis, and it needs to be treated agressively (of course, this diagnosis depends on any bloodwork results). Without seeing the results, I don't know which liver enzyme was elevated, and cannot accurately say it is Hepatic Lipidosis....I am making an educated guess based on the signs and symptoms, circumstances leading to this. Also, I don't know what system of metrics the vet is using, so the glucose could also be concerning. A urinalysis and blood glucose done together should be done to rule out diabetes.
Ask the new vet if he/she has any outlet to refer to more advanced vet medicine, such as a veterinary teaching hospital in your area. He/she should be able to refer to someone for appropriate treatment for certain health conditions. If he/she has a network available to consult with a specialist (ideally from the states!), that would be ideal.
I'm not sure the ampicillin is appropriate, but rather oral amoxicillin would probably be better, but without knowing exactly what the vet thinks he's treating, I cannot say for certain. Do ask the new vet however, if amoxicllin would be more appropriate. Ask about any veterinary diet available that is high in calories and low in protein, canned or soft, it should be fed consistently.
Lastly, ask the new vet what they do for complicated cases, and for conditions they don't seem to know enough about...do they consult with a university? Do they have access to a US vet for consult? Do they have access to a specialist in small animal medicine elsewhere in your country or direct area? If so, demand they get on it immediately, because I suspect your kitty needs agressive care promptly. Call your vet in NY and ask if he can somehow get connected to this vet and offer guidance.
..........Traci
Re: cat not eating...
I was wondering .. would it in such a case not be advisable to put her on a glucose drip? To get some strength back into her? Surely that would be possible to do here in India.
Re: cat not eating...
Glucose isn't going to to do a thing in this situation. Honey or sugar water are only temporary measures that are probably not even appropriate. Sugar isn't going to last in the system and is not enough to sustain or treat the symptoms.
If diabetes is diagnosed, an entirely new treatment approach with insulin regulation and correct diet would be the first course of action.
It is the liver that may be the crucial concern here, treating liver disease involves a totally different treatment approach.
If diabetes is diagnosed, an entirely new treatment approach with insulin regulation and correct diet would be the first course of action.
It is the liver that may be the crucial concern here, treating liver disease involves a totally different treatment approach.
..........Traci
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turleyhead
- Posts: 15
- Joined: Mon Apr 25, 2005 1:47 am
Re: cat not eating...
Hello Ash and Traci,
Thanks again for all of your help and good words and thoughts. I wish I'd found this site BEFORE I came to India. I have a feeling I would have made different choices. As of this evening, she's passed away, at home, with us. She was really miserable and honestly, I don't think there was a thing they could do for her here. They were ill-equipped to handle anything more than a saline or glucose drip and antibiotics. There were no surgical options or other treatment options available. I am just relieved that she didn't go through too, too much before she passed and that it was really only the last 2 days where she was so bad off. We had decided to put her down tomorrow morning if she had made it through the night. We really couldn't stand to see her suffer anymore and she just had that look like she was ready to go.
Again, thank you for your support and insightful information. It was very helpful and more informative than what I was getting from the vets here and even from my vet at home in NY.
Best,
Laura (Turleyhead)
Thanks again for all of your help and good words and thoughts. I wish I'd found this site BEFORE I came to India. I have a feeling I would have made different choices. As of this evening, she's passed away, at home, with us. She was really miserable and honestly, I don't think there was a thing they could do for her here. They were ill-equipped to handle anything more than a saline or glucose drip and antibiotics. There were no surgical options or other treatment options available. I am just relieved that she didn't go through too, too much before she passed and that it was really only the last 2 days where she was so bad off. We had decided to put her down tomorrow morning if she had made it through the night. We really couldn't stand to see her suffer anymore and she just had that look like she was ready to go.
Again, thank you for your support and insightful information. It was very helpful and more informative than what I was getting from the vets here and even from my vet at home in NY.
Best,
Laura (Turleyhead)