My cat has Hepatic Lipidosis. We're treating it with 4 feedings a day through a feeding tube in her neck. She is 12 years old.
My question is. Does this work? It must, but it would be nice to hear success stories.
It's taking me about 1/2 hour per feeding, faster and she throws some of it up. I just watch TV and pump in 2-3 CC per push. She's not too happy about it but . . . . .
She was diagnosed 3 weeks ago and we trying the oral thing but were not getting enough food in her.
On AVERAGE - how long does this take. I'll do it as long as I have to but IS THERE A LIGHT AT THE END OF THIS TUNNELL?
Rod
Blake is wonder too, he's our Cardi Corgi and Gabbys best friend and will lay next to Gabby when we're feeding her (although he does like to clean up any messes).
Hepatic Lipidosis
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Tina B and crew
- Posts: 2536
- Joined: Fri Apr 25, 2003 9:48 am
- Location: Virginia
Re: Hepatic Lipidosis
Hi...Yes there are success stories out there. Our Gizmo is one of them. He developed HL in the fall of 2001...factors included him being overweight and stress. Before his bout with HL he weighed in at 18lbs. Vet put him on a diet and we started him losing weight slowly, very slowly. However with the adoption of a kitten and the stress of his new eating pattern, as well as the human stress over 9-11 he quit eating as much and after a few days of trying for assist feed him we opted for the esophogeal tube. In our case the esophogeal tube didn't work because Gizmo ripped it out after it became infected...so he had to go back into surgery and have the PEG tube put in. For a while it seemed like it would never end...we'd feed him and he'd throw up...he was on Reglan, Pepcid and Baytril...he'd hide from us, we had to block off access to under our bed or we couldn't reach him to feed him. He wouldn't leave our bedroom at all for about month. And he wouldn't touch food for about a month. But he did finally start eating, slowly picking up interest in food. His bloodwork eventually started improving.
Over all it took about three months, from October to December. He had his tube removed after Christmas. I will be honest and tell you that he isn't the same cat he was before. His personality changed, he's not longer the big sweet "galoot" he use to be. He's more territorial than ever, grumpier than before. He still can be amazingly lovable though, as long as other cats aren't around. But his eating habits are like old times! He is obsessed with food as usual. We now have him on a no free feeding diet of high quality canned food and he maintains his weight very well. His bloodwork is checked yearly and anytime he seems depressed.
Hang in there!! Feel free to ask any questions and hugs to your kitty, i know it is tough on them
Over all it took about three months, from October to December. He had his tube removed after Christmas. I will be honest and tell you that he isn't the same cat he was before. His personality changed, he's not longer the big sweet "galoot" he use to be. He's more territorial than ever, grumpier than before. He still can be amazingly lovable though, as long as other cats aren't around. But his eating habits are like old times! He is obsessed with food as usual. We now have him on a no free feeding diet of high quality canned food and he maintains his weight very well. His bloodwork is checked yearly and anytime he seems depressed.
Hang in there!! Feel free to ask any questions and hugs to your kitty, i know it is tough on them
Tina B and "what a crew!"
How we behave towards cats here below determines our status in heaven ~Robert A. Heinlein
How we behave towards cats here below determines our status in heaven ~Robert A. Heinlein
Re: Hepatic Lipidosis
Thanks - I'm no longer "Guest" LOL.
We went on vacation and Gabby was alone (but with good care) with 2 other cats, not friends but they were OK togather. However - her humans were gone along with her best friend Blake (dog).
So far it's been OK with the tube - she does not seem to mind it and sleeps in out closet in the dark. We cah get 40 CC of food into her 4 times a day with only a small vomit once and a while.
We have a hospital room set up for . . . .accidents and her own litter box upstairs although Blake (dog) does like to "clean up" here poop so we have to work on THAT problem. YUCH!
We went on vacation and Gabby was alone (but with good care) with 2 other cats, not friends but they were OK togather. However - her humans were gone along with her best friend Blake (dog).
So far it's been OK with the tube - she does not seem to mind it and sleeps in out closet in the dark. We cah get 40 CC of food into her 4 times a day with only a small vomit once and a while.
We have a hospital room set up for . . . .accidents and her own litter box upstairs although Blake (dog) does like to "clean up" here poop so we have to work on THAT problem. YUCH!
Re: Hepatic Lipidosis
Rod...some helpful tips and reminders...
1) As you've found, slow feeding is best, if you feed too much too fast, vomiting WILL occur, and this is not good. The more frequent the vomiting, the less likely the feedings are going to work. The goal is to reduce vomiting at all costs, so feeding slowly is ultimately the best. If it takes a half hour or an hour, so be it, she must be comfortable with it first and foremost.
Your vet should have given you a feeding amount schedule to base kitty's nutrition on, if he didn't, call him immediately and confirm that... this is based on kitty's weight, severity of disease, tube size used, and assuming vomiting is not a problem. It's so important that she receives her required amounts at each feeding session, and do not miss any, this will defeat the purpose of the schedule. You said you are feeding 40 cc 4xdaily (160 cc) so this might actually be too much for her, again, please confirm with your vet.
Assuming kitty has a nasoesophageal feeding tube placed, expect the feeding to go much slower than a gastro-parenteal tube, as they are somewhat smaller to accomodate the esophagus. Also, you need to be aware that if you force the syringe/food too hard, this can cause the tube to shift and can cause displacement, gagging or vomiting.
2) Frequent blood profiling is paramount to monitoring her success. I would recommend at least every two weeks checking her liver enzymes. The bloodwork will tell you how fast her liver is regenerating and/or if additional antibiotics, fluids, anti-emetics, etc may be necessary.
3) Expect anywhere from 4 weeks to 6 months for a full recovery. Recovery depends on her liver's ability to regenerate itself, depending on the severity when she was diagnosed. Other factors include proper and sufficient tube feeding amounts (no missed feedings), no additional stress and no secondary bacterial infections. Frequent blood monitoring will tell your vet and you how she is recovering and/or if additional measures must be implemented.
4) Don't expect her to eat on her own too soon. Again, depends on the severity of the liver failure, but she will let you know on her own when she develops interest in her own food again. Until then, continue with the feeding schedule as per your vet's instructions.
Once she does start eating her normal food on her own, you may still need to continue the tube feeding until she is completely eating on her own. Your vet will only remove the tube when he feels she is eating a sufficient amount of normal food over a period of a week or more.
5) Be sure to monitor her tube incision site daily for any signs of infection. You will know if it's infected by seeing redness, swelling, puffiness, oozing of blood or pus, and if the skin is warm/hot to the touch. While rare, infections do occur at the incision site, so you have to be really watchful of that area. Contact your vet ASAP should any of the above signs occur.
6) When feeding with a syringe, it is best to start with at least 2 cc's of water first, to clear the tube and make it more viable for the food feeding. Of course, mix the food with water to a consistency that allows easy passage through the tube, and follow each feeding schedule with 2 more cc's of water to flush it and making sure there is no clog. Because esophageal tubes are somewhat smaller, you might want to add a 1/2 cc of water at least in the middle of each feeding session to keep the tube clear. Again, go as slow as necessary so that she doesn't vomit, and so that the tube doesn't clog.
7) Absolutely no additional stresses, keep stress minimized at all costs. Stress will further exacerbate the problem and will slow her recovery time.
*** Contact your vet immediately should she show signs of infection, fever, lethargy, continued vomiting, discomfort during feeding, gagging (which could indicate the tube shifted out of the stomach, you don't want to risk that), depression or withdrawal, progressing jaundice, dehydration, or progressive symptoms.
The key to recovery is quick diagnosis, very agressive treatment approach, compliance with your vet's strict instructions, followup on lab work and notifying your vet should any unusual sign or symptom occur during treatment. Once she fully recovers, she will probably never develop HL again. However, some cats may later on develop other types of liver disease, or if treatment of HL is ceased too soon.
Hang in there, it might be some time yet before she fully recovers, but she's depending on your to keep to her schedule to a T,.......
1) As you've found, slow feeding is best, if you feed too much too fast, vomiting WILL occur, and this is not good. The more frequent the vomiting, the less likely the feedings are going to work. The goal is to reduce vomiting at all costs, so feeding slowly is ultimately the best. If it takes a half hour or an hour, so be it, she must be comfortable with it first and foremost.
Your vet should have given you a feeding amount schedule to base kitty's nutrition on, if he didn't, call him immediately and confirm that... this is based on kitty's weight, severity of disease, tube size used, and assuming vomiting is not a problem. It's so important that she receives her required amounts at each feeding session, and do not miss any, this will defeat the purpose of the schedule. You said you are feeding 40 cc 4xdaily (160 cc) so this might actually be too much for her, again, please confirm with your vet.
Assuming kitty has a nasoesophageal feeding tube placed, expect the feeding to go much slower than a gastro-parenteal tube, as they are somewhat smaller to accomodate the esophagus. Also, you need to be aware that if you force the syringe/food too hard, this can cause the tube to shift and can cause displacement, gagging or vomiting.
2) Frequent blood profiling is paramount to monitoring her success. I would recommend at least every two weeks checking her liver enzymes. The bloodwork will tell you how fast her liver is regenerating and/or if additional antibiotics, fluids, anti-emetics, etc may be necessary.
3) Expect anywhere from 4 weeks to 6 months for a full recovery. Recovery depends on her liver's ability to regenerate itself, depending on the severity when she was diagnosed. Other factors include proper and sufficient tube feeding amounts (no missed feedings), no additional stress and no secondary bacterial infections. Frequent blood monitoring will tell your vet and you how she is recovering and/or if additional measures must be implemented.
4) Don't expect her to eat on her own too soon. Again, depends on the severity of the liver failure, but she will let you know on her own when she develops interest in her own food again. Until then, continue with the feeding schedule as per your vet's instructions.
Once she does start eating her normal food on her own, you may still need to continue the tube feeding until she is completely eating on her own. Your vet will only remove the tube when he feels she is eating a sufficient amount of normal food over a period of a week or more.
5) Be sure to monitor her tube incision site daily for any signs of infection. You will know if it's infected by seeing redness, swelling, puffiness, oozing of blood or pus, and if the skin is warm/hot to the touch. While rare, infections do occur at the incision site, so you have to be really watchful of that area. Contact your vet ASAP should any of the above signs occur.
6) When feeding with a syringe, it is best to start with at least 2 cc's of water first, to clear the tube and make it more viable for the food feeding. Of course, mix the food with water to a consistency that allows easy passage through the tube, and follow each feeding schedule with 2 more cc's of water to flush it and making sure there is no clog. Because esophageal tubes are somewhat smaller, you might want to add a 1/2 cc of water at least in the middle of each feeding session to keep the tube clear. Again, go as slow as necessary so that she doesn't vomit, and so that the tube doesn't clog.
7) Absolutely no additional stresses, keep stress minimized at all costs. Stress will further exacerbate the problem and will slow her recovery time.
*** Contact your vet immediately should she show signs of infection, fever, lethargy, continued vomiting, discomfort during feeding, gagging (which could indicate the tube shifted out of the stomach, you don't want to risk that), depression or withdrawal, progressing jaundice, dehydration, or progressive symptoms.
The key to recovery is quick diagnosis, very agressive treatment approach, compliance with your vet's strict instructions, followup on lab work and notifying your vet should any unusual sign or symptom occur during treatment. Once she fully recovers, she will probably never develop HL again. However, some cats may later on develop other types of liver disease, or if treatment of HL is ceased too soon.
Hang in there, it might be some time yet before she fully recovers, but she's depending on your to keep to her schedule to a T,.......
..........Traci
Re: Hepatic Lipidosis
Thanks Traci - we have found that after the 40cc I've been putting in 5 cc of water to clear the tube and this has not been sitting well. I'm not waiting 5-10 minutes and THEN adding the water - this seems to be working on the vomiting.
It's only been 4 days but we're learning the tricks to make things smoother as we go. A couple of stumbles along the way but each day is getting a little easier.
It's only been 4 days but we're learning the tricks to make things smoother as we go. A couple of stumbles along the way but each day is getting a little easier.
Re: Hepatic Lipidosis
Hi Rod, I am glad you made it over! Best of luck with this!
MA
(aka hissy)
MA
(aka hissy)
The smallest feline is a masterpiece.
Leonardo da Vinci
Leonardo da Vinci
Re: Hepatic Lipidosis
Rod, could you verify that the 5 cc's of water are what you feel are causing the vomiting? If so, simply reduce it to 2 cc's, this is usually sufficient in clearing the tube before you're done and ready to cap it off. Again, depends on the consistency of the food you're mixing with the water. Make sure it's soupy, but not watery.Grinder wrote:Thanks Traci - we have found that after the 40cc I've been putting in 5 cc of water to clear the tube and this has not been sitting well. I'm not waiting 5-10 minutes and THEN adding the water - this seems to be working on the vomiting.
Don't mean to alarm you, but if ever anything occurs out of the norm, don't be afraid to notify your vet at once, no matter how slight. As for the feeding schedule, you sort of work around it to modify it to fit her needs, but don't overmodify and don't go outside of your vet's strict instructions, this is the key to her recovery, nutritional support is the number one plan of action in her treatment.Grinder wrote:It's only been 4 days but we're learning the tricks to make things smoother as we go. A couple of stumbles along the way but each day is getting a little easier.
Don't be afraid to ask questions here if you need, we're here for you. Hang in there....
..........Traci
Re: Hepatic Lipidosis
vet's strict instructions? Didn't get those! We are both working people so I feed Gabby in the morning and the 3 times when we get home 9 hours later.
She threw up last night 5 hours after feeding which was odd. We're having a check up tomorrow (Friday) so we'll see if there is progress.
She seems good sometimes and miserable at other times (just like us).
What I'm worried about now is the lack of poop. We're not sure if Blake is cleanign the box for us (YUCH) or if she is just not pooping. She is peeing everywhere
The only vomit yesterday was at 3:00 this morning. Afterword we put her up on the bed and she purred and purred and purred. oh oh sorry - getting teary
49 year old guys do having feelings I guess!
She threw up last night 5 hours after feeding which was odd. We're having a check up tomorrow (Friday) so we'll see if there is progress.
She seems good sometimes and miserable at other times (just like us).
What I'm worried about now is the lack of poop. We're not sure if Blake is cleanign the box for us (YUCH) or if she is just not pooping. She is peeing everywhere
The only vomit yesterday was at 3:00 this morning. Afterword we put her up on the bed and she purred and purred and purred. oh oh sorry - getting teary
49 year old guys do having feelings I guess!-
Tina B and crew
- Posts: 2536
- Joined: Fri Apr 25, 2003 9:48 am
- Location: Virginia
Re: Hepatic Lipidosis
Grinder...I found that Gizmo had a constipation problem when he had HL...the vet gave us a stool softener for him to help him along.
Are you going 9 hours between the feedings??? Or am I interpreting that wrong? Maybe Traci can correct me if I'm wrong, but isn't that too long between feedings for a cat with HL? Our vet told us it was best to space the feedings out evening through the day. I know it's tough when your working...we had to take turns coming home from work during the day to give Gizmo his feeding. I don't know for sure, I'm just going by what our vet instructed us to do, but it seems like 9 hours is a lot.
Are you going 9 hours between the feedings??? Or am I interpreting that wrong? Maybe Traci can correct me if I'm wrong, but isn't that too long between feedings for a cat with HL? Our vet told us it was best to space the feedings out evening through the day. I know it's tough when your working...we had to take turns coming home from work during the day to give Gizmo his feeding. I don't know for sure, I'm just going by what our vet instructed us to do, but it seems like 9 hours is a lot.
Tina B and "what a crew!"
How we behave towards cats here below determines our status in heaven ~Robert A. Heinlein
How we behave towards cats here below determines our status in heaven ~Robert A. Heinlein
Re: Hepatic Lipidosis
It seems like a lot to us also but they didn't say anything about it. I'll ask tomorrow at the visit. Kind of tuff to get lunch off as we both are pretty far away from home.
hmmmm!
hmmmm!