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Tube feeding for liver disease??
We have a "rescued" cat, Katie, who became nauseated and was retching, and
not eating. She is overweight. Our vet did blood work, and then an abdominal sonar and fine needle liver aspiration biopsy, and tells us that Katie has hepatic lipidosis, and cholangiohepatitis, and pancreatitis. (her total bilirubin was about 2.5, alk phos 350 or so, AST slightly up). We have tried to "force feed" her pureed wet cat food, but it is a struggle, and unpleasant for Katie, and does not seem to get very many calories in her. The vet advised placing a feeding tube (probably a gastrostomy) to get her adequate nutrition. Does anybody have experience with cats who have this seemingly nasty combination of problems? Our vet, who is helpful and sharp, seems a bit vague about the chances of her surviving. I've done google searches and one article suggested that cats with hepatic lipidosis and pancreatitis have only a 20% chance of survival with optimal treatment. We are struggling with the decision- to have a feeding tube surgically implanted, and put Katie through the pain of anesthesia, surgery, and then daily care of the gastrostomy tube site -- versus just letting nature take its course (which seems to be a fatal one...). A friend of ours had a cat with hepatic lipidoses, several years ago, and had an esophageal feeding tube placed in the neck (our friends husband was a vet so I would suppose it was done with appropriate care etc) - but the outcome was not good. There were lots of complications at the site of the tube placement (abscess, drainage) and the cat ultimately died anyway. Katie does not seem to be physically in pain currently, just tired and doesn't eat anything. Thanks for any suggestions or ideas! |
#2
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In om,
Bill from Tampa composed with style: Does anybody have experience with cats who have this seemingly nasty combination of problems? Our vet, who is helpful and sharp, seems a bit vague about the chances of her surviving. I've done google searches and one article suggested that cats with hepatic lipidosis and pancreatitis have only a 20% chance of survival with optimal treatment. Hi Bill. Sorry Katie is not doing well. I went through the same thing this time last year and it's all in the archives of this group on google if you want to read my ordeal with Shadow. He had severe hepatic lipidosis which took 2 months of feeding through a tube to bring him through, but he did very well. Once the tube site healed a little (PEG tube), he didn't really seem to notice it was there most of the time, and it was easy to get the amount of food into him he needed but you have to take it slow. If Katie is nauseous, you'll likely have to build up to getting enough food into her. Most of the meds were fed through the tube as well -- the ones to heal the liver. The only one that wasn't was Denasyl which has to be given whole by mouth. Shadow made it through his feeding tube ordeal but he was diagnosed with Inflammatory Bowel Disease (IBD) when he had a biopsy done while he was under for the feeding tube placement. This disease is proving harder to deal with. Good luck. |
#3
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In om,
Bill from Tampa composed with style: Does anybody have experience with cats who have this seemingly nasty combination of problems? Our vet, who is helpful and sharp, seems a bit vague about the chances of her surviving. I've done google searches and one article suggested that cats with hepatic lipidosis and pancreatitis have only a 20% chance of survival with optimal treatment. Hi Bill. Sorry Katie is not doing well. I went through the same thing this time last year and it's all in the archives of this group on google if you want to read my ordeal with Shadow. He had severe hepatic lipidosis which took 2 months of feeding through a tube to bring him through, but he did very well. Once the tube site healed a little (PEG tube), he didn't really seem to notice it was there most of the time, and it was easy to get the amount of food into him he needed but you have to take it slow. If Katie is nauseous, you'll likely have to build up to getting enough food into her. Most of the meds were fed through the tube as well -- the ones to heal the liver. The only one that wasn't was Denasyl which has to be given whole by mouth. Shadow made it through his feeding tube ordeal but he was diagnosed with Inflammatory Bowel Disease (IBD) when he had a biopsy done while he was under for the feeding tube placement. This disease is proving harder to deal with. Good luck. |
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#6
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"Bill from Tampa" wrote in message om... We have a "rescued" cat, Katie, who became nauseated and was retching, and not eating. She is overweight. Our vet did blood work, and then an abdominal sonar and fine needle liver aspiration biopsy, and tells us that Katie has hepatic lipidosis, and cholangiohepatitis, and pancreatitis. (her total bilirubin was about 2.5, alk phos 350 or so, AST slightly up). Which type of cholangiohepatitis - Suppurative cholangiohepatitis, nonsuppurative cholangiohepatitis? The biochemical abnormalities for both are similar. We have tried to "force feed" her pureed wet cat food, but it is a struggle, and unpleasant for Katie, and does not seem to get very many calories in her. The vet advised placing a feeding tube (probably a gastrostomy) to get her adequate nutrition. Force feeding is usually not a good idea. Most cats resent force feeding and usually are uncooperative. They also become stressed and rarely eat sufficient amounts of food for effective treatment. Cats with HL are very ill and severely stressed and additional stress should be avoided. Cats also seem to develop food aversions rapidly -- the association between food and the unpleasant experience of forcing may delay the cat's return to eating o her own. So in the initial phase of the disease the only reliable treatment is tube feeding - PEG tube. Sometimes nasoesophageal (NE) tubes are used to get sufficient calories into exceptionally weak and debilitated cats to stabilize and strengthen them before PEG tube placement. NE tubes are easy to place through the nose into the stomach and require no surgery and minimal or no sedation. NE tubes are best suited for short-term feeding (a few days) - but sometimes its long enough to jump start the cat's appetite. Does anybody have experience with cats who have this seemingly nasty combination of problems? About half of the cats that survived the first 3 months after diagnosis (cholangiohepatitis/hepatic lipidosis) survived between 1 and 5 years (this is not an absolute because some cats died from other, non related causes) - some cats survived even longer than 5 years. A lot depends on the type and seriousness of the cholangiohepatitis. Our vet, who is helpful and sharp, seems a bit vague about the chances of her surviving. I've done google searches and one article suggested that cats with hepatic lipidosis and pancreatitis have only a 20% chance of survival with optimal treatment. Odds are for horse races... not cats. I learned a long time ago to take the "odds" with a grain of salt when they pertain to cats! I suggest you do the same. Cats are amazingly resilient creatures - *never* underestimate the resiliency of the cat! We are struggling with the decision- to have a feeding tube surgically implanted, and put Katie through the pain of anesthesia, surgery, and then daily care of the gastrostomy tube site A PEG (percutaneous endoscopic gastrostomy) tube can be endoscopically placed through the body wall directly into the stomach, its a relatively safe, simple, procedure (providing the vet knows what he/she's doing). Here's how its done: http://www.maxshouse.com/percutancou...my_tube_pl.htm Removal is even simpler. PEG tubes are considered the treatment of choice for cats with HL by the vast majority of vets. Most cats adapt so well to PEG tube feeding that you'll have to withhold tube feeding occasionally to see if her appetite returned! -- versus just letting nature take its course (which seems to be a fatal one...). A friend of ours had a cat with hepatic lipidoses, several years ago, and had an esophageal feeding tube placed in the neck (our friends husband was a vet so I would suppose it was done with appropriate care etc) - but the outcome was not good. There were lots of complications at the site of the tube placement (abscess, drainage) and the cat ultimately died anyway. Esophagostomy tubes are rarely used in cats today since the advent of the PEG tube. Cats are very uncomfortable with Eso tubes and the neck wrap that goes with it - which can cause moderate to severe stress -- and stress is the one thing you want to avoid the most in cat with HL. Katie does not seem to be physically in pain currently, just tired and doesn't eat anything. Thanks for any suggestions or ideas! I've been through it more than a few times -- I'd go with a PEG tube without hesitation. Here's some more information. http://www.maxshouse.com/Feline_Hepatic_Lipidosis.htm http://www.maxshouse.com/managing_pe..._feeding_t.htm http://www.maxshouse.com/Enteral-Assisted_Feeding.htm I wish you and Katie the very best of luck. Keep the faith! Phil. |
#7
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"Bill from Tampa" wrote in message om... We have a "rescued" cat, Katie, who became nauseated and was retching, and not eating. She is overweight. Our vet did blood work, and then an abdominal sonar and fine needle liver aspiration biopsy, and tells us that Katie has hepatic lipidosis, and cholangiohepatitis, and pancreatitis. (her total bilirubin was about 2.5, alk phos 350 or so, AST slightly up). Which type of cholangiohepatitis - Suppurative cholangiohepatitis, nonsuppurative cholangiohepatitis? The biochemical abnormalities for both are similar. We have tried to "force feed" her pureed wet cat food, but it is a struggle, and unpleasant for Katie, and does not seem to get very many calories in her. The vet advised placing a feeding tube (probably a gastrostomy) to get her adequate nutrition. Force feeding is usually not a good idea. Most cats resent force feeding and usually are uncooperative. They also become stressed and rarely eat sufficient amounts of food for effective treatment. Cats with HL are very ill and severely stressed and additional stress should be avoided. Cats also seem to develop food aversions rapidly -- the association between food and the unpleasant experience of forcing may delay the cat's return to eating o her own. So in the initial phase of the disease the only reliable treatment is tube feeding - PEG tube. Sometimes nasoesophageal (NE) tubes are used to get sufficient calories into exceptionally weak and debilitated cats to stabilize and strengthen them before PEG tube placement. NE tubes are easy to place through the nose into the stomach and require no surgery and minimal or no sedation. NE tubes are best suited for short-term feeding (a few days) - but sometimes its long enough to jump start the cat's appetite. Does anybody have experience with cats who have this seemingly nasty combination of problems? About half of the cats that survived the first 3 months after diagnosis (cholangiohepatitis/hepatic lipidosis) survived between 1 and 5 years (this is not an absolute because some cats died from other, non related causes) - some cats survived even longer than 5 years. A lot depends on the type and seriousness of the cholangiohepatitis. Our vet, who is helpful and sharp, seems a bit vague about the chances of her surviving. I've done google searches and one article suggested that cats with hepatic lipidosis and pancreatitis have only a 20% chance of survival with optimal treatment. Odds are for horse races... not cats. I learned a long time ago to take the "odds" with a grain of salt when they pertain to cats! I suggest you do the same. Cats are amazingly resilient creatures - *never* underestimate the resiliency of the cat! We are struggling with the decision- to have a feeding tube surgically implanted, and put Katie through the pain of anesthesia, surgery, and then daily care of the gastrostomy tube site A PEG (percutaneous endoscopic gastrostomy) tube can be endoscopically placed through the body wall directly into the stomach, its a relatively safe, simple, procedure (providing the vet knows what he/she's doing). Here's how its done: http://www.maxshouse.com/percutancou...my_tube_pl.htm Removal is even simpler. PEG tubes are considered the treatment of choice for cats with HL by the vast majority of vets. Most cats adapt so well to PEG tube feeding that you'll have to withhold tube feeding occasionally to see if her appetite returned! -- versus just letting nature take its course (which seems to be a fatal one...). A friend of ours had a cat with hepatic lipidoses, several years ago, and had an esophageal feeding tube placed in the neck (our friends husband was a vet so I would suppose it was done with appropriate care etc) - but the outcome was not good. There were lots of complications at the site of the tube placement (abscess, drainage) and the cat ultimately died anyway. Esophagostomy tubes are rarely used in cats today since the advent of the PEG tube. Cats are very uncomfortable with Eso tubes and the neck wrap that goes with it - which can cause moderate to severe stress -- and stress is the one thing you want to avoid the most in cat with HL. Katie does not seem to be physically in pain currently, just tired and doesn't eat anything. Thanks for any suggestions or ideas! I've been through it more than a few times -- I'd go with a PEG tube without hesitation. Here's some more information. http://www.maxshouse.com/Feline_Hepatic_Lipidosis.htm http://www.maxshouse.com/managing_pe..._feeding_t.htm http://www.maxshouse.com/Enteral-Assisted_Feeding.htm I wish you and Katie the very best of luck. Keep the faith! Phil. |
#8
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In ,
Phil P. composed with style: A PEG (percutaneous endoscopic gastrostomy) tube can be endoscopically placed through the body wall directly into the stomach, its a relatively safe, simple, procedure (providing the vet knows what he/she's doing). Here's how its done: ^^^^^^^^^^^^^^^ I'm glad you added that. I'm sick of rehashing what happened to Shadow because it was probably rare for so many complications to happen, but it definitely needs to be said. http://www.maxshouse.com/percutancou...my_tube_pl.htm Removal is even simpler. [repeat your comment about competence of the vet] PEG tubes are considered the treatment of choice for cats with HL by the vast majority of vets. Most cats adapt so well to PEG tube feeding that you'll have to withhold tube feeding occasionally to see if her appetite returned! |
#9
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In ,
Phil P. composed with style: A PEG (percutaneous endoscopic gastrostomy) tube can be endoscopically placed through the body wall directly into the stomach, its a relatively safe, simple, procedure (providing the vet knows what he/she's doing). Here's how its done: ^^^^^^^^^^^^^^^ I'm glad you added that. I'm sick of rehashing what happened to Shadow because it was probably rare for so many complications to happen, but it definitely needs to be said. http://www.maxshouse.com/percutancou...my_tube_pl.htm Removal is even simpler. [repeat your comment about competence of the vet] PEG tubes are considered the treatment of choice for cats with HL by the vast majority of vets. Most cats adapt so well to PEG tube feeding that you'll have to withhold tube feeding occasionally to see if her appetite returned! |
#10
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Force feeding is usually not a good idea. Most cats resent force feeding
and usually are uncooperative. They also become stressed and rarely eat sufficient amounts of food for effective treatment. Cats with HL are very ill and severely stressed and additional stress should be avoided. Cats also seem to develop food aversions rapidly -- the association between food and the unpleasant experience of forcing may delay the cat's return to eating o her own. So in the initial phase of the disease the only reliable treatment is tube feeding - PEG tube. I think you have to also look at your cat's tolerance level. Joel was dx when he was about 4 years old. He was jaundiced and lost from 20 lbs to 13 lbs. We were never offered the option of a PEG tube (our vet never mentioned it could be done) so we force fed him with soft food and water in a 60cc syringe. We were very persistent and when we thought we might be stressing him we would just love on him a while and try again. A majority of food was more on us and him than in his tummy but small amounts got in and along with meds he starting eating on his own. That was 10 years ago and he is still doing great. Good luck with your sweetie. Try not to worry about statistics, you have good thoughts coming your way. Our vet, who is helpful and sharp, seems a bit vague about the chances of her surviving. I've done google searches and one article suggested that cats with hepatic lipidosis and pancreatitis have only a 20% chance of survival with optimal treatment. Odds are for horse races... not cats. I learned a long time ago to take the "odds" with a grain of salt when they pertain to cats! I suggest you do the same. Cats are amazingly resilient creatures - *never* underestimate the resiliency of the cat! We are struggling with the decision- to have a feeding tube surgically implanted, and put Katie through the pain of anesthesia, surgery, and then daily care of the gastrostomy tube site A PEG (percutaneous endoscopic gastrostomy) tube can be endoscopically placed through the body wall directly into the stomach, its a relatively safe, simple, procedure (providing the vet knows what he/she's doing). Here's how its done: http://www.maxshouse.com/percutancou...my_tube_pl.htm Removal is even simpler. PEG tubes are considered the treatment of choice for cats with HL by the vast majority of vets. Most cats adapt so well to PEG tube feeding that you'll have to withhold tube feeding occasionally to see if her appetite returned! -- versus just letting nature take its course (which seems to be a fatal one...). A friend of ours had a cat with hepatic lipidoses, several years ago, and had an esophageal feeding tube placed in the neck (our friends husband was a vet so I would suppose it was done with appropriate care etc) - but the outcome was not good. There were lots of complications at the site of the tube placement (abscess, drainage) and the cat ultimately died anyway. Esophagostomy tubes are rarely used in cats today since the advent of the PEG tube. Cats are very uncomfortable with Eso tubes and the neck wrap that goes with it - which can cause moderate to severe stress -- and stress is the one thing you want to avoid the most in cat with HL. Katie does not seem to be physically in pain currently, just tired and doesn't eat anything. Thanks for any suggestions or ideas! I've been through it more than a few times -- I'd go with a PEG tube without hesitation. Here's some more information. http://www.maxshouse.com/Feline_Hepatic_Lipidosis.htm http://www.maxshouse.com/managing_pe..._feeding_t.htm http://www.maxshouse.com/Enteral-Assisted_Feeding.htm I wish you and Katie the very best of luck. Keep the faith! Phil. |
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