Feeding a cat with Megaesophagus

runekeeper

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I found out recently my 14-year-old cat has megaesophagus (or that's what the vet is suggesting - they didn't know for sure). This seems to be a rare condition in cats. I have to ask....is this a death sentence for my poor cat? She's racked up quite a bill already and surgery for both the esophageal problem and a lung mass that was found recently would be no lower than $5000. I've already spent about $2000 on other various tests.I don't mean to make it sound like I'm putting a price on my cat's life, but I have no job and I can't afford such expensive bills. I've been using student loan money to pay for her current care.I don't even know yet if I want to have the lung mass removed since it doesn't seem to be causing any issues (and to be honest, I would draw the line at chemo if it turned out to be cancer). But my short term concern is getting food in her belly. I've been feeding her very watered-down wet food, and the vet sent me home with a few cans of Hill's Science Diet A/D and told me to water it down a lot, feed her for about 1 minute, then hold her upright for about 15 minutes. This worked earlier today, but not the second time.Basically, I do not want for my cat to suffer two surgeries - one of which is invasive - with the possibility that she may not wake up from the anesthesia. I want her to live, but I don't know if the surgery would do more harm than good. I don't want her to starve either - I'm definitely willing to feed her a liquid diet, but sometimes even diluted food does not stay down.Anyone who knows more about nourishing a cat with this condition, can you offer any guidance? Is it possible to get a cat to live a bit longer with a proper diet? What can I do to help keep her fed and control the regurgitation? And, upsetting as it is, should I consider putting my cat down? Aside from the vomiting, Kitty is still very much alert, moves around, cleans herself, etc. She's not at full power, but she still has spirit, which is why I don't want to think about euthanasia unless she's beyond help. But I also don't want her to suffer and waste away.
 

mrsgreenjeens

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Did your Vet give you any medications to help with the regurgitation?  Also, did they advise you to raise her water and food dishes?  In the meantime, did they run some test in order to confirm that it truly IS  megaesophagus, since you stated that are only suggesting that's what it is.  It's kind of important to know for sure before you commit to any kind of surgery, I'm thinking!

From what I've just read simply by googling this condition, it is quite rare in cats, and what you've said you were advised to do (holding her upright after eating) is definitely advised.  The article I read said "sometimes, surgery is advised".  What kind of prognosis did your Vet give you?  Was the surgery they discussed actually to put in a feeding tube to bypass the esophagus?  (that's what I read about)

for your old girl.  Keep us posted as to what is going on.
 
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runekeeper

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Thanks for your response, mrsgreenjeans!

I was given some meds for the regurgitation (I admit I do not remember the name off the top of my head), but I don't know if they actually do anything. From what I read about them, though, they're used more for pets that are on feeding tubes and are not very effective in controlling regurgitation when pets take food orally.

But my kitty did get an endoscopy today and got through the surgery just fine. She was found to have a stricture (though I'm not sure if that explains the dilation of the esophagus too), but since the vet doesn't know what caused it, he does not recommend balloon catheter dilation surgery just because he fears a rupture would be a considerable risk. But he found not tumors or blockages IN the esophagus. So if there is a tumor, it would be somewhere outside the esophagus. Where or what kind, I have no idea. He wants to maybe do a CAT scan to see if there's something pressing on the esophagus. Also, surgery in general on the esophagus is usually not a wonderful choice because the esophagus rarely ever heals properly and I worry surgery would do more harm than good.

Right now, Kitty does have the esophageal feeding tube, inserted beyond the stricture, and if she does well enough with it, I can take her home tomorrow and feed her at home (3x a day). The surgery was initially for the scoping, but I also asked about the feeding tube because I was concerned with her immediate need for nutrition.

So now I'm wondering: Would it be healthy to keep a feeding tube in long-term? The vet really did not give a prognosis, but I already know there really is no cure or recovery from the stricture (that I'm willing to risk). However, if I can keep my kitty comfortable, happy and nourished until such a time when her quality of life is too low to allow her to continue living, then I'd like to go that route. Based on her behavior and current symptoms, her biggest issue is the stricture. In terms of breathing, mobility, hygiene and hydration, she's fine. I'm not sure HOW happy she is, but she certainly looks cozy when she's snuggled in my sweater or asleep beside me.

I will likely be asking loads more questions once I have her home with her feeding tube. The vet told me I could continue feeding her the Hill's Science Diet A/D food, but I also wonder if there are better options? I also have a bottle of Viyo - I wonder if I could give her that as well for added nutrition.
 
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runekeeper

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I have my kitty back, and now I'm presented with the challenge of feeding her properly. Her feeding tube, unfortunately, had to come out because she was having a bad reaction to it (but was taking food through it just fine). I was told I could bring her home and feed her watered down food again.

Here's the challenging part: The vet was feeding her a bit over one can of Hill's Science Diet A/D every day (166 mL). I have absolutely no idea how I'm going to get that much food into her per day, nor do I know where I will be able to get more cans for her since I only have 4 left and I don't know if the local clinic even has it. If her food isn't watered down enough, she will vomit. If I let her eat for longer than a minute before picking her up, she will vomit. I think I'm going to have to feed her about every 1-2 hours.

Folks, I desperately need help if you can offer me some guidance. I have no idea how I'm going to do this. I have no idea how to go about a liquid diet for a kitty with digestive limitations like mine. As far as I know, she has an appetite....it's just she can't eat very much at a time. Even doing everything perfectly, it's no guarantee she'll keep everything down. She's been a little icky feeling since she woke up from her surgery, so I don't even know if she'll want to eat on her own. I don't think force feeding will be a possibility either considering the issues the stricture causes.
 

mrsgreenjeens

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Some Petsmarts sell Hills A/D, but you must have a prescription for it. 

Is the issue really that you need to hold her upright AFTER she eats otherwise she will regurgitate?  What did they do at the Vet before they installed the feeding tube?  How did they handle it is what I mean...or did they install the tube almost immediately?

And do you have to hold her upright for 15 minutes after 1 minute of eating, then repeat the same over and over, or what.  I would think she would actually be able to lap up quite a bit in 1 minute, but may be wrong...guess it depends on how hungry she really is. 

Gosh, I wish I had some ideas for you other than where to buy the food
 
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runekeeper

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The issue isn't holding her up - it's getting an entire can of food into her using this feeding method per day. Due to the stricture in her esophagus, anything too thick can't stay down (Viyo doesn't stay down either), so holding her up allows gravity to guide the food down the esophagus. I guess kinda like if you fill a bottle with water and tip it totally upside down. Same effect.

They did not do this at the vet's at first - even though I told them exactly how and what she threw up, they still gave her food normally and she vomited. They certainly weren't going to hold her for 15 minutes after eating just because they have so much other stuff to do. The first time she stayed at the vet's, she didn't get any nutrition because she kept throwing her food up. This second time she stayed, the tube was installed while she was out for the endoscopy. I don't know if it would have made a difference had she gotten the tube directly to the stomach since she seemed generally sensitive to the presence of a tube. I don't know why the heck they put in an esophageal tube since they knew her esophagus was the problem. I even said I was looking at a long-term feeding tube, but they still decided to put one in her neck.


I wonder if there's an alternative to A/D that can be purchased OTC. Unfortunately there are no pet stores where I live, so there's nothing fancy to be had - basically KMart, WalMart, and the grocery store. And she can usually lap up all I give her within a minute, but if I let her have much more than a minute, she vomits. I even tried holding her upright and feeding her in hopes I could feed her longer, but she still vomited, so that didn't work.

I really don't want to put her through more surgery for another feeding tube because I have no idea how she would tolerate it. She's also quite out of it despite getting tube fed and I'm not sure what's causing that. The only thing I can think of is maybe if I feed her every hour for the first half of the day, but then she'll be hungry the second half. It's just I have so much homework to do and I don't know how I'm going to feed her and do work and do anything else.
 
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runekeeper

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Alright, I take back what I said about force feeding. I think due to my kitty's cold, she's not only got less of an appetite, but she can't really smell her food as well. So I tried using the mouth syringe the vet gave me (small - 3 mL) and just kind of feeding her a milliliter at a time of the slurry I normally make her. And she kept it down! Since I was already holding her in an upright position to feed her, I only held her for about 10 minutes afterward. I don't even know if I'd need to hold her afterward, honestly. I hope I'm doing the right thing for her. She's not spitting her food out or anything, and right now, she mostly just wants to rest. If she's sick with a cold of some kind, I don't blame her.
 

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Alright, I take back what I said about force feeding. I think due to my kitty's cold, she's not only got less of an appetite, but she can't really smell her food as well. So I tried using the mouth syringe the vet gave me (small - 3 mL) and just kind of feeding her a milliliter at a time of the slurry I normally make her. And she kept it down! Since I was already holding her in an upright position to feed her, I only held her for about 10 minutes afterward. I don't even know if I'd need to hold her afterward, honestly. I hope I'm doing the right thing for her. She's not spitting her food out or anything, and right now, she mostly just wants to rest. If she's sick with a cold of some kind, I don't blame her.
Well, at least this is good news!  As far as not being able to get more A/D, I think it's higher in fat, low carb and easily digestible,  plus it just seems to make a better slurry than most.    But when I fed it and checked the can, I noticed it didn't really have any more calories than other brands.  Less, in fact, than some others.  When you run out, I would just look for a good grain free (if possible) pate style food with not a lot of fillers.  (Even Fancy Feast might work...they have a line that is grain free, I believe)  Unfortunately, they don't always list calories on the can, so you might have to go to their websites to get the caloric value.  Oooh!  It just dawned on me!  Try kitten food.  It's usually a LOT higher in calories and protein, and I would think pretty easy to digest.  And it's sure to be packed with nutrients!!!
 

minka

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When did kitty get a cold? Did the vet diagnose it?

If you're able to hold her up and feed her consistently, then you're doing the right thing. I would keep at it so she can build up her strength.
 
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runekeeper

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Does kitten food come in pate/canned form? I was feeding my kitty Kitten Chow (from Purina) in kibble form for years before she got sick to keep her weight up (and because she could swallow kibbles whole and not vomit). But if I can get canned kitten food from the store and eliminate the need to get a prescription, that would be great.Unfortunately, feeding did not go well today for her. Yesterday she kept everything down, but today, I tried giving her Viyo and she threw it up. I gave her a little A/D mixed with water and that came up too. And I tried giving her just plain water, but she even threw that up! Even though I did exactly the same thing as yesterday with holding her and feeding her a milliliter at a time. I don't know if today was just a bad day for her or if she's back to throwing everything up.Is it right of me to be force feeding my cat while trying to provide palliative care while she has terminal cancer? I know the feedings are stressful for her. Also, no, the vet did not diagnose a cold. When I got her back from the vet following her surgery, she was sniffling and wheezing. Considering her condition was being monitored all the time, I can only imagine the vet did not feel this was a major issue and/or if it was an infection, the antibiotics she was on would knock it out.I just worry because now she won't even drink on her own - but she's also pretty listless and doesn't want to move around much, and even when I set her in front of her water, she won't drink. Is it safe to give her water via mouth syringe? I worry she'll choke and/or aspirate the water into her lungs. She's very lethargic all day, but she sure puts up a fuss when I try to feed her.
 

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I'm so sorry you're going through this. There are canned pate kitten foods. Blue Buffalo Wilderness and Wellness make them. EVO and Innova canned pate is for cats and kittens. I think Royal Canin has canned kitten pate too. You can give her water with a syringe, if you put the water in the side of her mouth instead of the front . If it goes in sideways it will land on her tongue instead of down her throat and she will swallow it without choking. There is a video on this site about force feeding cats. I would post it but I don't know how. Try a search for it.

Good wishes for you and your kitty.
 

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Since the only stores available to you are Wal-Mart, K-Mart, and grocery stores - Fancy Feast sells a pate kitten food (I think it has a pink label - FF distinguishes different flavors with different color labels.) If the stores don't stock it but do sell FF they should be able to order it for you. 24 3 ounce cans / case. Estimate your cat would need two 3 ounce cans / day.

Call Purina's 800 number (on the label) and ask about Purina Pro-Plan kitten food. Perhaps the stores could special order a case for you (24 of the small 3-ounce cans) but ask if there is any way Purina could send you one or two to try on your kitty before you order a case.
 
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runekeeper

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@smitten4kittens, getting food in her mouth via syringe isn't the hard part. I get most of it in, give or take a couple milliliters (because she puts up a bit of a fight when I have to feed and water her this way and some of the food/water gets on her fur). And watering down the food is the only way I can actually get it down her throat without her regurgitating. @Catapault, thanks very much for the info! I checked out some nutrition facts for Fancy Feast's kitten food and the most calorie-laden one would be the turkey kind, at about 30 calories per ounce. I don't know if it's shredded or pate, though.My biggest concern is that my cat is not getting adequate nutrition OR hydration from syringe feeding. I do my best, but I can't feed her constantly for the rest of her life just because of life stuff getting in the way. I can try my hardest, but feeding a cat every 2 hours long-term is not realistic when I'm the only one doing the feeding. It's not that I don't want to do it - it's just I don't think I can. I need to figure out how to make what I can feed my cat as nutritionally packed as possible, hopefully reducing the number of feedings (and thus reducing how much stress I put her under from feeding). Unfortunately, water has also become a concern because she will not drink on her own now either. I would say, per feeding, I can get about 15 mL of food and 15 mL of plain water in her system. The food is comprised of one spoonful of A/D and 3 spoonfuls of warm water (since the food is refrigerated, it's probably cool or lukewarm when she gets it). I don't want to make it too thick because she'll throw it back up. If I feed too much in one sitting, she throws it back up..not to mention she hates force feedings. And no matter what I do to it, Viyo will absolutely not stay down. From what I have found on my own (and I could be mistaken), a cat's daily nutritional needs should be roughly 20-30 calories per pound and 5-10 ounces of water (which is about 150-300 mL). In terms of calories, my kitty would need 240 calories a day to meet minimum calorie requirements. Since her system is likely out of whack from cancer, she likely needs more calories than that. She also has a hard time keeping weight on in general.
 
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runekeeper

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I don't see much info about this online, but can I ask how much would be okay to feed my kitty per feeding? Today I tried doubling the amount of food for one feeding (so 2 spoonfuls) and she kept it all down nicely. She could easily eat a whole can by herself before she got sick, but I don't know how much to feed her per feeding without making her sick. I'd say she got maybe 20-30 mL of watered down food (I only added on extra spoonful of water than normal).I think I'm also going to try incorporating raw egg yolks into her diet. I'm guessing maybe 1-2 per week would be okay. ETA: My kitty was picking kibbles off the floor, so for the heck of it, I tried giving her some of the sensitive stomach kibbles the vet sent me home with a couple weeks ago. She ate a bit of it and, shockingly, it did not come right back up 2 minutes later! Not only that, but she showed no signs of impending regurgitation (like making sour faces, sticking her tongue out, making gurgling sounds in her throat). I'm not getting my hopes up too much since she did keep kibbles down before, but only for about 5 hours and it was obvious they had just been sitting in the esophagus the whole time. But I also held her upright when that incident occurred, whereas this time I wasn't holding her at all. I'm immediately thrilled to see she has an appetite still, and secondly thrilled to see she did not immediately vomit up dry kibbles. I can only hope she continues doing this well (knock on wood).
 
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mrsgreenjeens

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As far as how much at a time, the only thing I can suggest is to experiment with her by increasing the amount a little at a time. 

Wonderful news that she seems to be improving, and ate kibble with no issues (still no issues, I'm hoping
?)
 
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runekeeper

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Still no issues with the kibble - she picked at her kitten food several times today. She seems to be eating slowly and actually chewing her food (she tends to just kind of inhale it normally). I broke up her kibbles into smaller pieces just to be sure. I'm also still giving her the A/D slurry, which she eats happily on her own and licks the bowl clean. I would like to keep going with the liquid food and maybe just make it thicker. But also feed her kibbles since she's been taking both well, but she seems to prefer the wet food. Perhaps her throat is a little sore and kibbles are a little uncomfortable? Since I'm no longer force feeding her, I think I may just let her eat her fill each feeding. I have not been giving her controlled portions for the last 2 days - she eats a little out of a full bowl and goes on her way. Her appetite is not totally back to normal, but I'm just so glad to see she not only has an interest in food, but is able to keep down what I feed her. She has not regurgitated anything in several days and is also back to drinking water on her own. Her sniffles seem to be mostly gone too (I still hear her sniffle a little once in a while).I still would like to maybe incorporate raw foods into her diet, so I'll be doing some reading in the raw diet section. Now that feeding itself has been resolved, I would like to focus on getting some weight back on her, so I think she will be getting wet kitten food, dry kitten food, the rest of the A/D, maybe some poultry baby food, and a weekly egg yolk.
 

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Still no issues with the kibble - she picked at her kitten food several times today. She seems to be eating slowly and actually chewing her food (she tends to just kind of inhale it normally). I broke up her kibbles into smaller pieces just to be sure. I'm also still giving her the A/D slurry, which she eats happily on her own and licks the bowl clean. I would like to keep going with the liquid food and maybe just make it thicker. But also feed her kibbles since she's been taking both well, but she seems to prefer the wet food. Perhaps her throat is a little sore and kibbles are a little uncomfortable? Since I'm no longer force feeding her, I think I may just let her eat her fill each feeding. I have not been giving her controlled portions for the last 2 days - she eats a little out of a full bowl and goes on her way. Her appetite is not totally back to normal, but I'm just so glad to see she not only has an interest in food, but is able to keep down what I feed her. She has not regurgitated anything in several days and is also back to drinking water on her own. Her sniffles seem to be mostly gone too (I still hear her sniffle a little once in a while). I still would like to maybe incorporate raw foods into her diet, so I'll be doing some reading in the raw diet section. Now that feeding itself has been resolved, I would like to focus on getting some weight back on her, so I think she will be getting wet kitten food, dry kitten food, the rest of the A/D, maybe some poultry baby food, and a weekly egg yolk.
All wonderful news!!!!
AND a great plan!  IF she would eat raw...even better.  You can buy already finely ground nutritionally complete meals...I add water to some of them to thin them down, but on the other hand, some of them are nice and bloody
on their own...just depends on the brand.  When you get over on that forum, just ask questions and we'll be there to answer them.  Just be aware that not all cats know whats good for them and look at you like you've lost your mind when you try to serve them raw food
 
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runekeeper

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Well so much for the egg yolk idea - my kitty didn't even try it, and none of my other cats wanted it. One of the dogs ended up eating it, but then again, he eats absolutely anything, so that was no big shock to me. But I do think my kitty prefers wet food to dry food. Those were her preferences even before she got sick, but I mean when I feed her her kibbles, she only eats a little bit (and she loves her kitten food). Whereas earlier today, she ate an entire can of A/D by herself and a half can of Meow Mix a few hours before that. Maybe her throat is sore and dry food is too difficult to eat right now?I don't want to go full raw food just because I have no idea if my cats will actually eat it, but I would like to try and incorporate something besides cat food into their diets...even if that means occasional baby food, egg yolks and goat's milk (if I can find it). Every little calorie and protein helps. :)
 

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Don't expect your cat to be keen on raw foods right away. Even egg yolk. You'll have to teach her to learn to like it, tiny piece by tiny piece. :nod:
 

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:clap::clap::clap::clap::clap: Yey!!!!
Ok - my opinion FWIW.... I am a raw feeder, and I am 100% pro raw.... But I also think the kitty should be healthy to be transitioned - for one thing, as strange as it might sound, kitties don't associate raw meat with food, and when they feel sick they might start associating that bad feeling with the food - not a good combo when transitioning to raw :nono:

Also, A/D is a recovery food - there is a reason IMHO it has been good for her. This kitty went through hell and back. A/D is balanced to give her the highest nutrition she can get - it is concentrated stuff..... I don't particularly like Hills, but A/D has its place, and I think this is one of those cases..... It has been helping your kitty..... She was in a dire situation until a couple of days ago.... IMHO changing anything at this point is much too soon.
If this was my kitty I would continue on A/D only, no kibbles..... Give her all she wants to eat.... Until she is stronger..... Then start introducing raw - ONE protein at a time VERY slowly. Probably start with chicken. Tiny pieces - Like a fingernail worth at a time.
Take it very slow.... See how she goes, follow her lead. This is a very very sick kitty who is just starting to heal - don't move too fast :vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 
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