My kitty and Hepatic Lipidosis

Catlover0188

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My 5 year old cat Izzy was acting weird end of last week and this week Wednesday I noticed her ears were yellow and rushed her to the ER vet. I didn't realize how frail she was until I picked her up. She had definitely lost weight, but was still pretty upbeat. She has been diagnosed with Hepatic Lipidosis. Her bilirubin was through the roof (15 exactly) and the vet says she is a very sick cat. She ended up getting a feeding tube yesterday as she turned away from oral nutrition.

Her medications include:

Gabapentin every 8 hrs
Reglan every 12 hrs
RenaKare Gel every 12 hrs
Amoxicillin/Clavulanate every 12 hrs
Elura every 24 hrs
Ursodiol every 24 hrs
Denamarin every 24 hrs

Her TF is Purina Veterinary Diets EN Gastroenteric. I started her on 30 ml every 4 hrs. She ended up throwing up twice, so I started giving her tiny volumes more frequently so she was still hitting that 30 mL mark every 4 hrs. That seemed to have really helped and I am going to try 15 mls every 2 hrs. Part of the problem I think is that she had so many of her medications due at once with water flushes that it didn't sit well. I have been separating them, so there isn't so much effecting her tummy.

I have been having a REALLY hard time with guilt. I thought she was acting funny even last week, but she was sniffling, so I just thought seasonal allergies or a little cold. I REALLY wished I would have took her in last week. The vet assures me that this condition can happen in a matter of days and that they have seen cats as sick as her recover, but it just depends how she does this few days. She has lab work on Sunday to recheck her bili and electrolytes. If she throws up any more, I may just have her spend the night in the hospital. Everything has been super expensive and I do have savings, but I'm just trying to minimize the cost as much as possible without putting her in any danger.

She's very weak and frail. Just curious if anyone else has taken care of a very sick Hepatic Lipidosis kitty.
 

mrsgreenjeens

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Yes. Unfortunately, many of us have. But your Vet is correct in that many cat do survive this :alright:. Some cats have survived when the Vets thought there was very little chance. Do they have any idea what caused this in the first place? I see she is on an antibiotic...is that for a suspected infection, or a known infection? We never figured out the cause for our guy, and often that is the case.

I see your girl is on Reglan, but not on a specific anti-nausea med. Is there a reason for that? Or has the nausea completely stopped now that you are feeding and medicating her differently? There is definitely a trick to the feeding with a tube. Nice and slow is the way to do it. I used to give 30 ml at a time, but would go very slow or it would come right back out. Plus I would warm up the food first before giving it. And when I say slow, I mean S L O W. Took probably 5 - 10 minutes just to push that 30 ml, just to make sure it didn't come back up.

Hang in there. Sometimes the numbers actually get worse before they get better, but that doesn't mean they aren't healing. As she gets more food in, you should see her start improving. Are you to increase the amount of food as you go along?
 
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Catlover0188

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Yes. Unfortunately, many of us have. But your Vet is correct in that many cat do survive this :alright:. Some cats have survived when the Vets thought there was very little chance. Do they have any idea what caused this in the first place? I see she is on an antibiotic...is that for a suspected infection, or a known infection? We never figured out the cause for our guy, and often that is the case.

I see your girl is on Reglan, but not on a specific anti-nausea med. Is there a reason for that? Or has the nausea completely stopped now that you are feeding and medicating her differently? There is definitely a trick to the feeding with a tube. Nice and slow is the way to do it. I used to give 30 ml at a time, but would go very slow or it would come right back out. Plus I would warm up the food first before giving it. And when I say slow, I mean S L O W. Took probably 5 - 10 minutes just to push that 30 ml, just to make sure it didn't come back up.

Hang in there. Sometimes the numbers actually get worse before they get better, but that doesn't mean they aren't healing. As she gets more food in, you should see her start improving. Are you to increase the amount of food as you go along?

The vet isn't sure what caused it in her. They said often they don't know the cause. The one vet said that her pancreas looked just a tad inflamed.

The Reglan is to help with GI motility and for nausea as well. I have been feeding her slow, but with one of her feedings she received so much medicine at once. I think that in combo with the food and water flushes were just way too much for her tummy which caused her to get sick right away. I just get worried because she most likely threw up all of that medicine, too. I have been spacing out her medication so that she isn't getting so much at once. That seems to be working, too.

She's on the antibiotic because her pancreas was inflamed and possibly an infection in her liver. They also did an Xray which showed some lung consolidation, but she was also laying on that site mostly for feeding tube insertion. They said they couldn't rule out pneumonia, but that the antibiotic she's on would cover it.

With her feedings; I have been blending it with water and warming it up each time before a feed. The second time she threw up; I fed her in every hour increments for 4 hours to reach her 30 mL goal. Then I waited 2 hours and doing 15 cc every 2 hours. I will do that and then increase again.

How sick was your cat? Mine almost couldn't get her tube due to bruising. :(. Thank God all of her clotting and blood values were normal and I took the risk. This was her only fighting chance.
 

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Hi. mrsgreenjeens mrsgreenjeens will likely be on site later today, so I am sure she will respond. I think you sound like you have all your bases covered! The only thing I can even think of to offer is to ensure she takes food with the antibiotic, and keeps food coming around the clock like you are doing. Antibiotics can be nasty to the stomach - something you are most likely already aware of!
 

mrsgreenjeens

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Feeding tubes are the best. You have an E-tube, correct? It's in the neck vs the tummy? If that's what you have, do you have a KittyKollar also? They are great to keep the end of the tube contained plus their website has lots of helpful info when it comes to working with the tubes.

My cat was extremely ill. He was so yellow, so lethargic, barely moving. He was on the feeding tube for four months, being tube fed every four hours. We were exhausted, but luckily I worked days and hubby worked nights so we were able to work those feedings into our schedules.

One thing to be aware of is that even after she starts eating on her own, you need to leave the tube in for awhile just to make sure she doesn't turn around again. Don't remove it until she is eating fully on her own and has regained her health back. She will be able to eat even with the E-tube.

Keep us posted on how she is doing.
 
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Catlover0188

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Feeding tubes are the best. You have an E-tube, correct? It's in the neck vs the tummy? If that's what you have, do you have a KittyKollar also? They are great to keep the end of the tube contained plus their website has lots of helpful info when it comes to working with the tubes.

My cat was extremely ill. He was so yellow, so lethargic, barely moving. He was on the feeding tube for four months, being tube fed every four hours. We were exhausted, but luckily I worked days and hubby worked nights so we were able to work those feedings into our schedules.

One thing to be aware of is that even after she starts eating on her own, you need to leave the tube in for awhile just to make sure she doesn't turn around again. Don't remove it until she is eating fully on her own and has regained her health back. She will be able to eat even with the E-tube.

Keep us posted on how she is doing.

We are now on bigger feedings every 6 hours instead of every 4. She was only one every 4 hr feedings the first day. Because she vomited that first day, I started her every 6 hr feedings to every 3 hrs at smaller volumes. Then I upped her when i knew she could tolerate to the full amount every 6. Her stomach was pink a couple days ago and that has turned yellow too, so I'm worried. She's very lethargic. She does get herself to the litter box still but she has no strength.

She gets lab work tomorrow so we shall see. She's been walking very oddly and the vet thinks it may be the gabapentin, so I'm reducing it to twice per day instead.

I work 12 hour shifts on 3rd shift so just trying to find how to fit her feedings in while gone. Luckily my sister and bf have offered to help.

Did you ever have to do sub q fluids for your cat or were they getting enough water in their feeds?
 

mrsgreenjeens

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We did not ever do sub-q fluids, but most people now do. As I said, our experience was many, many years ago and HL was not as well known as it now. We even had to go to a specialist to even get a diagnosis of it and get the feeding tube installed. We were never even given any meds to administer, just food. It's kind of shocking now that I look back on it.

The gabapentin may be the cause of some of her lethargy along with her walking funny. And her tummy turning yellow may not be cause for worry yet. Remember I mentioned that sometimes even the bloodwork will look worse as they recover than at the start, so try not to get discouraged. Additionally, recovery takes a lot of down time, so resting for her is imperative.
 
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Catlover0188

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We did not ever do sub-q fluids, but most people now do. As I said, our experience was many, many years ago and HL was not as well known as it now. We even had to go to a specialist to even get a diagnosis of it and get the feeding tube installed. We were never even given any meds to administer, just food. It's kind of shocking now that I look back on it.

The gabapentin may be the cause of some of her lethargy along with her walking funny. And her tummy turning yellow may not be cause for worry yet. Remember I mentioned that sometimes even the bloodwork will look worse as they recover than at the start, so try not to get discouraged. Additionally, recovery takes a lot of down time, so resting for her is imperative.
She has been more upbeat tonight now that we decreased the gabapentin. She even wanted to lay in some of her favorite spots. Her weird walking has improved, too.

She is tolerating her feeds like a champ. She even had some brown stools apart from her bright yellow ones for past couple days. I think that's good!

She does have some dark bruising where she had IVs and I can see some petechiae on her belly. Did your cat have that, as well?

I'm looking into the Kitty Kollar. The vet did give me a nice collar, but the tube is really long and kind of sticks out. I also see Kitty Kollar has supplies, which is really cool! I will for sure give updates when we go to the vet tomorrow!
 
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Catlover0188

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I didn't receive the best news about Izzy today. Her sodium dropped pretty low and her bilirubin went from 15 to 22. The vet thinks her liver may be failing.

She is now starting B12 injections and her sodium needs to be rechecked in 48 hrs. All of her other labs were good.

I asked if her sodium was low due to spacing out meds and when I was giving feedings more frequently meaning she was getting lots of water flushes. The vet doesnt think so, but I'm ordered to strictly give feedings only and reserve excess water flushes.

I know people have said sometimes their bilirubin gets worse before better, but her pink belly has now turned yellow.

The vet said there's still a chance but chances of recovery have become a little slimmer with these labs.

Just curious if anyone else has experienced this, as well with their kitty. I'm worried.
 

mrsgreenjeens

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What did he say about the petechiae? I don't remember seeing that on our guy, but as I said, it was many years ago.

The liver is one organ that can heal if given an opportunity, so we'll keep our fingers crossed that things will get better now that she is getting meds and FOOD. It takes time. My little guy was on the feeding tube for four months! It's a slow go, but many cats do survive.
 
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Catlover0188

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What did he say about the petechiae? I don't remember seeing that on our guy, but as I said, it was many years ago.

The liver is one organ that can heal if given an opportunity, so we'll keep our fingers crossed that things will get better now that she is getting meds and FOOD. It takes time. My little guy was on the feeding tube for four months! It's a slow go, but many cats do survive.
She had petechaie on Thursday and they were concerned, but her clotting labs and all her blood levels have been normal. Those were normal again today. They were worried today because she's yellow all over her body vs just her ears.

They also saw some fluid around her belly and they're worried this is where her sodium is going. She just threw up her 50 cc tube feeding. I was told to try to strictly keep tf to 4 times a day to avoid excess water intake, but now that she threw up I am slowing down a bit. The vet really didn't feel I caused her low sodium but she's just trying to give my kitty the best chance.

My kitty does have bruising from where they've poked her so that's also worrisome.
 

mrsgreenjeens

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Bruising is a sign of a damaged liver. Hepatic Lipidosis is what I would call "damage". As far as her being yellow all over, my guy was VERY yellow all over...ears, mouth, eyes, tummy, anywhere I parted his fur wasn't the normal color :frown:.

As to her food, I am wondering why they have you feeding the Gastro food versus the Critical Nutrition, which is Purina's "recovery" food. Is it because they suspect possible inflammation of her Pancreas? Just asking because most H/L cats are put on a recovery food. I wonder if she would take to that better :dunno:. Hopefully she will do better with the next feeding :vibes::vibes::vibes:

I'm a little concerned with no water flush after tube feeding just because the reason is to clean out the tube. The last thing you want is to get a blockage in that tube and have to have another one installed :sigh: Am I misinterpreting what you are to do here?
 
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Catlover0188

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Sorry if I'm being unclear. They still want water flushes, but they wanted me to try to stick to every 6 hr feedings because that would increase her water flushes.

I also asked about hospitalizing her. The vet felt that there's nothing they would do that I couldn't do at home other then they'd check her labs more frequently. The vet was also concerned because they'd potentially have to put a central line in her for blood draws and they worry because of her bruising. She does have petechiae and bruising, so I do worry very very much.

Yes they said they saw some mild pancreatitis. I just know that they said this food is a bland food that's easy on the gut.
 
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I'm having a really hard night. I messed up so bad when it came to my cat. Was working a lot and ignored her warning signs last week.

She was sleeping in weird spots and I found it odd, but then I heard her sniffling and thought she had a cold.

I didn't realize when she stopped eating. I failed her horribly. I am so mad at myself. Had I brought her in last week, I could have avoided this whole mess. Now, she may die. The vet says there's a chance, but she may have been without food for God knows how long and I didn't even notice. My bf has always said how I spoil my cats rotten. How did I miss this?

Has anyone else had these feelings?
 

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Aw, hugs to you. I am willing to bet anyone on this site has had those feelings before!! I've had them multiple times. But I echo those who have posted here in that cats are true masters at hiding their illnesses. Honestly. As pet parents we are kept on our toes and have to guess when we think our kitties are not feeling well since they can't tell us. When Sadie was sick back in March, she had the beginning stages of HL and she was yellowish on her ears and face... I think even with her extremely mild case it still took three weeks for her body to heal itself.

Stay strong, your baby knows you love her and are trying to help. Give her time to heal, and lots of love. ❤
 
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Catlover0188

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Izzy is perkier today. She followed me in the bathroom like she normally does. She also contemplated taking a drink of water. She does do a lot of wandering so I worry about hepatic encephalopathy. She gets her sodium rechecked tomorrow and I just want to get that visit over with.

She does have some pretty dark bruising on her paws from lab draws. She did throw up tube feeds yesterday, but today has been doing well. Tomorrow she'll be up to her full daily caloric intake. Gosh, I hope her liver is healing.
 

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Catlover0188

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These are some pictures of her jaundice and bruising. The petechiae has faded some today. Her belly looks a little bloated, so I really worry. Please excuse her gnarly fur. She isn't liking brushing so much right now and gets urine all over. I use a waterless cat shampoo on her.
 

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mrsgreenjeens

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I think every person whose cat gets H/L wonders how they didn't see it coming :alright:. We didn't notice our big guy wasn't eating and of course, felt so guilty. Why didn't we notice? You just get so busy with everyday life that you just miss certain things. Now, I know exactly who's eating and what they are eating because everyone has their own bowl and we feed in separate rooms to keep track. But back them they all shared food bowls and I just figured everything was fine :headshake:. All we can do is learn from our missteps and try not to do them again.

I'm glad Izzy seems perkier today. That seems like a good sign to me.
 
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Catlover0188

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Today is Izzys repeat sodium level. Not sure if they'll check for anything else. I'm very worried and hope it goes well.
 
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