Discouraged (feeding tube for fatty liver disease)

Discussion in 'Feline Health - (Welcome & Main Forum)' started by ChinoBear, Aug 19, 2013.

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  1. ChinoBear

    ChinoBear New Member

    Aug 19, 2013
    Hi Everyone-

    I am a new poster here, and hoping to get some guidance about my cat, Chino, who has fatty liver disease and a feeding tube.

    From reading this and other message boards, I realize this sounds like a broken record, but Chino stopped eating for no apparent reason a few weeks ago, and quickly became very lethargic, so we took her to the vet. She was diagnosed with fatty liver disease, but no underlying cause was identified. My wife and I think it may have had something to do with switching her food to reduced calorie Science Diet, but have no way of knowing for sure.

    Anyway, she's had the feeding tube for almost 3 weeks now, and the vet has us attempting to feed her 240cc of AD food with water and meds per day. I use the word "attempt" because Chino has been very nauseous, and has been vomiting after roughly every 3rd feeding. We have been breaking up the feedings to 4 or 5 times a day, giving her about 30-60cc each time. And within the feedings, we are going super slow and taking periodic breaks.

    The meds we are giving her are Ursodiol, Milk Thistle, Cerenia for the nausea, and, starting a couple days ago, some holistic liver supplements and amino acids we got from the natural pet store. We were giving her Zantac for stomach acid, but decided to stop as it didn't seem to help.

    Well despite all of this, 2.5 weeks into treatment, Chino is, if anything, worse. She is very lethargic, rarely gets up from her chosen sick bed, breathes shallowly, remains very jaundiced, and generally seems to be slowly deteriorating. I've read about so many cats that have recovered from this disease, but my wife and I are losing hope fast, and starting to consider putting her down, which is an absolutely heartbreaking thought, as I'm sure you all can imagine.

    So before we make that decision, we want to make sure we have exhausted all of our humane and economically feasible options. Does anyone know of other medications we should try? Our vet mentioned steroids as a last ditch option, does anyone have experience with that? Also, I just discovered in my research tonight that AD is perhaps not the best food, and there are other foods with higher caloric concentrations (not to mention it's a Science Diet product, which is the brand we think may have been involved in the initial issue). Any recommendations on food options?

    Also, have others had the experience where 3 weeks in, your cat didn't seem to be getting any better, but then eventually recovered? We have the patience to stay the course as long as we need to, we just don't want to be prolonging Chino's pain for an inevitable bad ending.

    Any thoughts, stories, or advice are GREATLY appreciated.

  2. Dyana

    Dyana Well-Known Member

    Dec 28, 2009
    I have not had experience with fatty liver disease, but have been on this board a long time. Have you checked out the Feline Assisted Feeding Group?
    I sent an email to Karrie and Maverick who knows a lot about this disease. I hope she can help you.
    I'm sure you have seen this video.

    I wish you the best of luck with your Chino and hope he pulls through just fine. Is he diabetic, too?
  3. ChinoBear

    ChinoBear New Member

    Aug 19, 2013
    I'll check out that group for sure. Also, thanks for reaching out to Karrie and Maverick. She seems to be the unquestioned authority on this topic!
  4. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Jan 11, 2010
    I immediately thought of Karrie, too. She is very knowledgeable about Fatty Liver Disease; assisted feeding, etc. I also sent her a P.M. with a link to your condo. I hope she is home and can help you. In the meantime, see this post, in which Karrie gives lots of very good advice:

    I hope that your kitty will get better.

    Sending healing vines,

    Ella & Rusty
  5. Karrie and Maverick

    Karrie and Maverick Well-Known Member

    Oct 22, 2010
    Maverick almost died from FHL in July of 2008 - he was so yellow - almost orange and extremely weak. The Yahoo Feline Assisted Feeding group saved his life. He had a feeding tube for ten weeks. Can you join this group right away and post an in intro?

    FDMB can help with everything diabetes. You need to make sure your kitty isn't in Diabetic Keto Acidosis and is managed closely for blood glucose.

    1. FHL is horribly nauseating and most vets don't realize it. My Dad got liver disease a year after Maverick recovered and he was able to verbalize how utterly horrible he felt. He didn't eat solid food for six weeks before he went to the hospital and received a diagnosis. Anti nausea medication is very important. Ondansetron or dolasetron is the drug of choice for Nausea. It is a true antinausea medication. Cerenia is good for acute vomiting. Reglan is not effective in cats unless it is due to the stomach not moving food through to the intestines. Costco has Ondansetron affordably - 1mg twice a day (1/4 of a 4mg pill) - and you don't have to be a member but you do need a prescription.
    2. Calories are critical. I would do Iams Max Cal over AD. It has almost double the calories and is very low carb which is perfect for a diabetic kitty. It is worth its weight in gold at 330 calories a can. Maverick needed a can and a half of high calorie food to maintain his weight. Cats often need a lot more calories when they are unwell than when they were well. You need to feed enough to make sure your cats liver isn't resorting to body fat to make up a deficit in calories. Calories and keeping them down is critical.
    3. A liver supplement improves survivability significantly.

    There are a lot more critical items the group experts on FAF can help with. Other complications from FHL, pancreatitis and what to ask your vet.
    Make sure to post if there is vomiting, if your vet has your cat on any appetite stimulants, any fluids etc. How much are you feeding at a time, how often? Also do you know why Chico stopped eating enough? Did you switch his food, stress in the home (loss or addition to family, renovation etc), change in litter etc.

    There is no need to do a preflush. Just make sure to do an 8 to 10ml post flush.

    Maverick was so sick it was heart breaking but he pulled through. I had two and a half amazing cuddle filled years with him. The jaundice lasted for two weeks after getting enough calories.

    You aren't in this alone. There are many of us who have been where you are and they will help keep your feet on the ground.

    Big hugs to you and your Chino.
  6. Karrie and Maverick

    Karrie and Maverick Well-Known Member

    Oct 22, 2010
    The Yahoo Feline Assisted Feeding Group and the FDMB are incredible. You are in good hands.
  7. ChinoBear

    ChinoBear New Member

    Aug 19, 2013
    Thank you so much for the info and reference to the yahoo group. I just signed up! Chino is not diabetic as far as we know, so I will into over there. Thanks everybody!
  8. KPassa

    KPassa Well-Known Member

    Oct 23, 2012
    My previous cat, Patrick, required a feeding tube for about 2-3 months or so before he started eating on his own again. He had this terrible head tilt that first tipped me off that something was wrong. It was one of the most heart-wrenching things to see him so sick! They only discovered it was his liver ("completely white") when they opened him up to do exploratory surgery to see what might be going on with his kidneys (what they thought was initially causing the problem). The first two weeks was spent mostly at the vet's because he was so touch-and-go (vet only gave him a 5% chance of surviving).

    One thing my vet had me do was mix in some KMR into the food I was syringe feeding (I believe it was Hills AD) to give him an extra boost of calories. You can ask your vet if supplementing with that might help.

    Once he started eating on his own again (on Thanksgiving Day, no less!), I was able to remove the tube and he lived another 10 years. :D
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