Mac Stopped Eating, Please Help

[Leomc123]

Feline hepatic lipidosis, also known as feline fattyliver syndrome, is one of the most common forms ofliver disease of cats. ... The disease begins when thecat stops eating from a loss of appetite, forcing theliver to convert body fat into usable energy.

Anorexia always precedes liver disease, with the cat refusing to eat enough food for days, or weeks. This may be amplified by frequent vomiting when the cat does choose to eat. A lack of appetite causes the cat to refuse any food, even after it has purged its system of all stomach contents. Severe weight loss proceeds as the liver keeps the cat alive off body fat, causing a yellowing of the skin (jaundice). When the cat runs out of fat to process, severe muscle wasting (cachexia) takes place as the body converts protein into energy.[2] Eventually the body cannot give the brain enough energy to function properly and the cat dies from malnutrition. In addition, an overworked liver can eventually fail causing total system collapse.

 

[Leomc123]

Acute liver failure is most often caused by infectious agents or toxins, poor flow of fluids into the liver and surrounding tissues (perfusion), hypoxia(inability to breathe), drugs or chemicals that are destructive to the liver (hepatotoxic), and excess exposure to heat. Necrosis (tissue death) sets in, with loss of liver enzymes and impaired liver function ultimately leading to complete organ failure.



Acute liver failure also occurs due to extensive metabolic disorders in protein synthesis (albumin, transport protein, procoagulant and anticoagulant protein factors), and glucose absorption, as well as abnormalities in the metabolic detoxification process. If this condition is not treated promptly, it can result in death.

Abnormally high liver enzyme activity, or liver enzymes spilling out into the bloodstream, signaling liver damage – tests will look for alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzymes in the bloodstream, as well as an increase in alkaline phosphatase (ALP), and declining levels of aminotransferases

Treatment is feeding them with the feeding tube or catheter:
Hospitalization is vital for treating acute liver failure. Fluids and electrolytes, along with colloid (the gelatinous substance necessary for proper thyroid functioning) replacements and oxygen supplementation, are key aspects of treatment and care. Your cat will be placed on restricted activity in order to give the liver an opportunity to regenerate. Catheter feeding is recommended for highly unstable patients, while enteric feeding (feeding directly into the intestines) in small amounts is recommended for otherwise stable patients. A normal protein diet with supplemental vitamins E and K is advised.

 

[basschick]

i wouldn't go to another vet at the same office for a second opinion - i'd go to a totally different office where you don't risk vet2 being swayed by vet1's opinion.

best of luck to you!

 

[daftcat75]

Your vet may not have the machine to do an ultrasound, many vets do not. It isn't cheap but I think it is worth it. It is important that it be read by someone with experience.

He does need to get enough calories in. The blood test your vet wants to do is probably to check his liver enzymes. Cats are prone to hepatic lipidosis when they don't eat enough, also known as fatty liver. Overweight cats are more prone to it. A cats liver is not efficient at metabolizing fat. If the body breaks down and tries to use more fat then the liver can metabolize then fat deposits build up on the liver. That becomes a vicious cycle. The cat becomes more anorexic because of the fatty liver, they eat even less which means the fatty liver becomes worse.

As scary as all of this sounds, the treatment for hepatic lipidosis (fatty liver) is aggressive refeeding via feeding tube. In other words, whether Mac is there or not, you're already on the correct path. The feeding tube will buy you the time to get the ultrasound and the subsequent blood tests to narrow down the diagnosis and find the correct treatment. But no diagnosis or treatment will be successful if he isn't keeping his nutrtition up.

 

[macadamia12]

Hi Guys,

It was quite a busy day for Mac. We got his Tube feeding surgery done in addition to ultrasound, blood tests and pancreatitis tests. Vet said fatty liver had set in and his gal-badder looks inflamed and backed up. We feel a little better today having the tube installed, atleast now we can feed him and avoid his liver condition from worsening.

We also had phone consultations with two other vets(one from Oregon other from CA) as we still want to find the root cause of this situation. We have decided to work with the CA vet in parallel with the HI Vet.

I am truly thankful to all of you.

daftcat75 I really appreciate you reaching out with all the info. Thank you for helping us move forward with the tube feeding.

 

[daftcat75]

So happy he has the tube now. I’m sure you’ll feel better and he will feel better having food in his belly again.

For the gall bladder, ask about ursodiol. Krista went through this. It was fast and effective. Though it also made her nauseated. I always gave that with food by tube. Food first. Then meds.

Check out kittykollar.com for a collar to protect the tube and the stoma as well as other helpful tips and videos for tube feeding and keeping the site clean.

 

[Furballsmom]

 

[macadamia12]

So after a successful day of tube feeding yesterday, his tube got blocked this morning. Called Vet and he wants us to bring Mac in.

daftcat75 did this happen to you, if so were you able to unblock the tube at home?Also our Vet instructed us not to clean the wound site on his neck and leave the bandage wrapped around the tube as it is. Is this right? All others videos I saw online required the wound site to be cleaned everyday. I did order kittykollar although we don't how to use it given we are not supposed to take that thick bandage out.

Thanks in Advance.

 

[daftcat75]

I never had the tube blocked. This is discussed online though. (I think you can use a little Coca Cola to disolve the block?) You do have to dilute the food really thin to prevent this. This is why I suggest to use the high calorie vet food if he'll tolerate it. Because you want as many calories as you can start with if you're going to dilute it that much. Also when making the food liquid for the syringe, blend up the entire can at once including and especially any jelly stuff that's on the top of the can. That is going to help the food blend up smooth. Avoid foods that don't blend up smooth.

You have to clean the site! Every other day is okay, but you can't not clean it. (Pardon the double negative.) The tube site is basically an open wound until the tube is removed and the stoma is allowed to close. Ask the vet for chlorhexidine or similar topical antiseptic. Unwrap the bandage. Look at the stoma site. It should be clean. It shouldn't be crusty. It shouldn't scab. You can pick away the crusties each time you clean. Swab it a little with the chlorhexidine and apply a pad to the stoma site. Hopefully you also bought the circular pads to slide over the tube and keep the stoma site protected. If you didn't, you can fold a gauze pad, make a small diamond cut (just big enough to fit the tube through this hole you're making), and slide the pad down the tube against his neck. Slide the kollar on over the pad and velcro the tube down onto the kollar. Hopefully the vet left you enough length on the tube for that. Otherwise, if you have better sewing skills than I do, you could probably remove that velcro strap and move it closer to the opening.

 

[macadamia12]

Thanks daftcat75 for all the info.

We were able to unblock the tube at home. I will also ensure the wound site is clean. We are still very worried, hoping tube feeding will workout and that he will start eating.

I hope your Kitty is doing well.

Thx

 

[daftcat75]

He could be on a cocktail of drugs that could affect his appetite. Any meds you are giving by tube, if they have to be given with food, give him a food syringe before the meds since you now have a direct line into his stomach.

I got into this bonkers situation with Krista's meds where I was giving her Entyce for her appetite which made her nauseated. So I was giving Cerenia for the nausea but that made her anorexic. I eventually realized what I was doing and stopped both, and she started eating again.

Ask for B-12 shots. If he's been losing weight, he almost certainly needs them. B-12 shots often give the cat a short-term boost that may spark his appetite. B-12 is all reward and no risk. Unless you cound the risk of him not needing it and peeing your money away. If he does need the B-12, he will have a harder time recovering without it. It is extremely important to a number of metabolic functions including absorbing B-12 from food. Once deficient, it's almost impossible to get enough from food alone.

In any case, depending on how long it's been since he's eaten normally and whether there's been a build-up of lipodosis (burning fat for energy) byproducts in the liver (aka fatty liver), it could take some time before he's feeling well enough to have a healthy appetite again. This is why the feeding tube is so important. You don't have to wait for that to happen. You can help him out and keep his nutrition up until he's feeling well enough to eat on his own again. I would keep the feeding tube in longer than that. It's easier to leave it in longer than you need it than to put it back in if you took it out too soon.

In the meantime, keep offering him food at his regular meal times. Give him the opportunity to eat on his own. Everything he eats by mouth is that much less you have to dilute, and put down the tube. You may even find that just getting the first bit of food into him settles his stomach enough that he would like to try more by mouth. Maybe you can leave a syringe off one of the morning and evening feeds to leave room for him to eat by mouth afterwards if he wants to. You can always make up those calories in another feeding if he's not yet up to it.

 

[Leomc123]

I pray mac gets better , poor little thing , hopefully you guys will find out what is really going on with mac and he pulls through this. God bless.

 

[macadamia12]

Hi Guys,

Sorry for the delayed update. My mother in law(Mac's Original Mom) is in a very critical state and it has been a very tough week. Also English is not my first language, so writing takes some extra effort.

Mac has been on feeding tube for 8 days. We have been feeding him between 9 to 12 ts of food( around 20 to 24 (10ml) syringes) daily. He still shows no interest in food. He is still very yellow. He pees frequently but has a very hard time pooping. He tries to poo almost every hour but nothing comes out despite lots of straining. He barely can get out 3 to 4 hard (very small) pieces. He often cries for help when he can't get poop out. This goes on through out the night as well. We don't live him alone at all now and one of us is constantly with him.

Medication wise, we have been giving him: Denamarin, Milk Thistle and goats milk probiotics.

We have been also working remotely(since last week) with a homeopathic Vet who suggested we use pumpkin, Pedialax, Sepia for his straining but none of it has been really worked. Today the homeopathic Vet advised us to take Mac for a radiography and possibly enema with out local allopathic Vet. We called our local vet and they said to try Miralax and fish oil before enema. We did that and hoping this will help him because he is really struggling. We have also ordered PetWell Being's BM gold.

I hope this constipation/straining is not related to his liver/gallbladder problems. Also I wonder if this is really a colon related issue or his body is not really able to digest food because of IBD or other issues.

Do you guys have any recommendations on this?

I am in such a dilemma. We have to force feed him because of the fatty liver issue but what if his body isn't able to digest the food or its just stool stuck in his colon.

daftcat75 ,

We just got Ursodial this morning(Vet had to order it from mainland since no one had it here in Hawaii). Just 5 minutes after giving him Ursodial(mixed in food, fed via tube), Mac vomited all of the food. Mac has vomited around 2 to 3 times in the last week, mostly little amount of food and that too very early morning around 2 to 4 am(couple hours after his last feeding of the day which is between 10 to 11 AM ).

Do you think Ursodial instantly nauseated him, making him throw up? If so, What should we do? Should we not give him that again?

Also the homepathic vet had suggested not to give Ursodial, but I still convinced my husband we give it a try as its very beneficial and now this happened. What should we do?

Also here's Mac's Liver value from last week when we got the feeding tube installed.

Its really painful for us to see our baby boy struggle so much. He is our most precious gift from our dying mom who doesn't remember us or him.

Thanks all in advance.

 

[daftcat75]

Ursodiol is going to make him nauseated. Did you mix it with the food? That’s a problem. The way I did it was give a syringe or two of food only. Then give the medicine. Maybe cut the meal size for that urso meal too. If it’s going to nauseate him even with the food, you maximize the chances of him keeping both food and medicine down if he isn’t struggling with both.

I’m not a vet and I only have one cat’s experience with this. But. Those numbers looked like Krista’s earlier this year. She was hospitalized with IV fluids, antibiotics, denimarin, and ursodiol. When she finally came home with me, we monitored her numbers on a weekly basis. I was never able to give her the denimarin and the antibiotics were messing too much with her poops and her appetite. I gave her a week off all meds including the ursodiol and her numbers looked like that. I decided to try just the urso and her bilirubin and GGT came into range in a week or two.

The urso is probably the most potent medicine (besides food) you can give him. Probably also why he reacted so strongly (besides mixing in the food is a no-no! Food first. Meds after.). Milk thistle and denimarin are the same thing. Basically. Denimarin is more potent supposedly. Milk thistle is the whole plant so anything else that might be beneficial is included. But milk thistle takes time to work. Like weeks or months. If you have a yellow cat, you don’t have that kind of time.

Try the urso again. Food first. Then the urso. Or if this wasn’t the issue, try half the food. If that doesn’t work, talk to the vet and see if you can adjust the dosage. I usually prefer natural solutions as well but ursodiol is that helpful that you should keep trying. Talk to the vet if you need to adjust the dose.

Is he taking Cerenia? That would help with the vomiting.

If you think he needs bulk to poop, you can try pumpkin. If you don’t think bulk is the issue, miralax would bring moisture without adding bulk.

 

[daftcat75]

Thinking here...

If he has sluggish bile flow as those lab numbers and his yellow color might suggest, and bile helps make fat move through his gut, then he could get backed up (constipated) if his bile isn’t flowing right. The constipation can also be a cause of the vomiting and can affect his appetite.

Try the urso again.

 

[denice]

When Patches went through fatty liver the main number the vet watched was his ALT and his is much lower then Patches number was. Mac's level is at 514, Patches level went up to 1300 before it started coming down. His level actually continued to rise after he started eating well on his own then it dropped fast. ALT measures the enzyme that liver cells release when they die. Recovery from this is a long slow process and the main thing for recovery is to get enough calories in so that his body doesn't use it's own fat.

 

[macadamia12]

Thanks daftcat75 .

We had crushed Ursodial into powder form and then mixed into his food which we fed him via the tube. I will try it again tomorrow, first feed him a 10ml syringe of food and then do Ursodial. Maybe we will give half pill in the morning and other half in the evening?

Do you think think I should wait 10 mins or more between food and Ursodial?

Also Mac is impossible to give medications directly through the mouth. Our only option is to crush the pills into powder, dilute with water and then tube feed the solution. Do you think that's ok to do?

We do the same with Denamarin? We make sure no food is given for 2 hr before and 1 hr after Denamarin.

Milk thistle is already in liquid form which we just mix in his food.

Were you giving Krista Ursodial through the mouth or the tube? Curious why were you not able to give Denamarin. We would like to do weekly tests but Mac needs to be sedated for that, so we decide to do that every 3 weeks. How long was Krista on tube feeding?

Mac is not on Cerenia and we r not sure if he needs bulk to poop. Sometimes the small piece that comes out is hard and sometimes it very soft.

Yea based on the lab figures and the yellowness, his bile could most probably be causing constipation. Hope Urso will workout tomorrow. We can't afford to give up Urso at this point.

Thanks again. You have been a great help and we truly appreciate it.

 

[macadamia12]

Thanks denice

Mac is 23 lbs(he was 30lbs last November ) and we are feeding him between 9 to 12 teaspoons everyday. After diluting, this equals about 20 to 24 (10ml) syringes.

Do you think this is enough? We would try for more but Mac seems constipated and heavily bloated.

We are feeding him a mix of (4ts) sciencediet urgent care and 5 to 8 ts of a (Dr Piet Carrien's) recipe mostly containing Organic Turkey and Organic Eggs with some steamed broccoli).

Can you guys please give me some suggestions on what food we should give him?

Also how much time did it take for Patches to recover from this?

Thanks again.

 

[macadamia12]

Also, we have B12 and subq fluids coming soon which we will adminstor from home. Hopefully this will help too.

 

[daftcat75]

I couldn’t give the denimarin because I was told those horse pills can’t be broken up. Something about the coating and I think the SAMe is lost if the pill is broken before the stomach.

For the urso, I had it compounded into a liquid. For pill, yes, powder it up very fine and make a small solution with lukewarm water. 1 or 2 mL. Give about 10 mL of food. Then the urso. Then flush and seal.

Ask the vet if you want to change the dosage (e.g. it may not be effective as two smaller doses.)