Hepatic Lipidosis: Or, Should I Put a Feeding Tube in My Cat?

I’ve gotten quite a few hits from people searching for information on hepatic lipidosis, so I thought I’d put together one convenient entry for people wanting to read about a specific case to help them decide whether to use a feeding tube to cure this liver disease.

My short answer to, “Should I put a feeding tube/peg tube in my cat?” is yes, if you can afford it, have the time and energy to feed the cat through it, and the cat isn’t about to die from their primary disease. The experts say that implementation of a feeding tube has a 70-80% chance of curing hepatic lipidosis/fatty liver. It worked for my kitty and, although it was rough going for the first week or so, it was worth it. I wasn’t ready for my lovely kitty to die, if he could be made well again, and it’s great having the spunky bugger back in full form.

My kitty, Cherubino, was diagnosed with moderate feline lymphoma and inflammatory bowel syndrome. Whether from the stress of the cancer, the stress of the chemo, or the stress of having pills shoved down his throat, Cherubino, an erstwhile glutton, stopped eating. Fat at over 19 lbs. before the cancer, down to 16.5 at the time of the diagnosis of the lymphoma, he was checked into the hospital weighing 10.5 lbs., not so much on death’s doorstep but in death’s foyer. He was severely dehydrated and very much a shadow of his former self. Not grumpy, just pathetic and scrawny.

He received fluids, vitamins and his cancer was checked. The oncologist strongly suspected hepatic lipidosis (later confirmed by cytology and biopsy). Once Cheru was strong enough and his blood counts sufficient for anesthesia, his liver was aspirated to ensure that the lymphoma hadn’t spread. It hadn’t and a feeding tube was put in.

When the oncologist first told me that a feeding tube was basically the only cure – I didn’t think appetite stimulants and syringe feedings would work, since Cheru may have been stressed out by popping the pills -- I was a bit creeped out. After talking to my primary vet about his success with feeding tubes, learning that cats object to this a lot less than an oral tube, realizing it was either this or a dead kitty, I decided to go ahead. Besides, at this point we had spent so much money already, that there was no point of not going all the way.

Cheru had the tube put in on a Friday and came home on Monday. The tube was in for 7 weeks total, although I didn’t feed him through it the last 2 weeks but kept it in for a bit after a round of chemo just to make sure he was continuing to eat on his own. It took him a few weeks to eat on his own again once the tube was in, and then just a little bit, but by 4-5 weeks he was eating full meals on his own.

He never fought the tube feedings. He would let me pick him up and snuggle in my lap as I slowly fed him, often purring once the warmed food started reaching his stomach. He vomited a bit at first (see my tips below) and had a few bouts of diarrhea, which was very embarrassing for him, but after the first couple weeks all that stopped.

I gave Cheru Reglan about ½ hour before each feeding and mixed Denosyl/SAMe in his food once a day. We discontinued the leukeran and prednisone treating his cancer until he started eating on his own again.

Tips for tube feeding at home:

If you haven’t already, buy a bottle of Nature’s Miracle. It removes vomit odors like magic. And buy a huge pack of cat wipes for grooming under the sweater and in case of diarrhea. A clean cat is a happy cat.

GO SLOWLY! The vet techs aren’t kidding. Go slower than you think is slow enough, at least the first few days at home. If you’re using Feline A/D, that stuff smells even worse coming back up than going down. And there is nothing more discouraging than spending 15 minutes feeding your cat only to have to clean up puke minutes later.

If your cat vomits more than once, reduce the amount of the feeding. I figured rather than giving my cat the 90 cc prescribed, having him puke it up, and then having to skip the next feeding, it would be better to keep him at 60 cc for a few feedings and then gradually increase 5-10 cc’s a day.

Flush warm water before and after each feeding and each medicine. You really want to keep the tube from blockages. If it blocks, 1 cc of carbonated beverage should clear it out (I never had to do this.) Also shooting the last cc of water in your syringe really fast help clean everything out.

Get a few extra sweaters/surgical socks from the vet. They will get soiled and unravel and it’s undignified enough for a cat to wear a sweater, let them at least be clean. Wash them by hand, they’ll last longer. Tie them with a hair tie or rubber band at the top, behind the head where they can’t get to it, if your cat is sporting the low rider look. You want to keep that sweater on, so they can’t mess with the tube.

Beg your vet, purchase, or ask any friends in the medical profession to score you as many syringes as possible. I found loading up all the syringes for the next day(s) and putting them in a Ziploc bag in the fridge saved a lot of time every day – versus having to wash and load them three times per day.

Isolate your cat. This way you can cover the furniture with old sheets and towels and not have to clean up cat ick from more than one room. It was difficult for me, as I was used to Cheru having the run of the house, but he really was happier in the guest room away from the other cats. The other cats could tell he was sick and didn’t really want much to do with him, anyway. We visited him throughout the day. At night, we would carry him down to watch a movie with us (plop him in our laps) or I would read in his room. Often, I would sleep part of the night with him in the guest room. Love helps kitties heal.