Hepatic lipidosis, feeding tube and getting worse

[anon442]

Hi,
I have a 4 year old beautiful domestic longhair about 6.5 lbs who stopped eating for a few days about a month ago. I took her to the hospital where they gave her some anti nausea med, IV fluids, and appetite stimulant. After a night, she was eating some food again so they sent her home with me with a diagnosis of hepatic lipidosis, an appetite stimulant, anti nausea med, and advice to feed her lots. At home, I was getting her to eat steadily more over 3 weeks until she was eating about 7 oz of canned food a day but she was still a lot less energetic than before and spent most of her time in her bed. This all got worse when she threw up 3 times after breakfast one morning. I took her back to the hospital where they put a feeding tube in her and I took her home again with the same diagnosis. This time she was prescribed prednisolone for the liver swelling and ursodiol for liver recovery. However, even with the meds, food through the tube, and lots of love for 3 days, she seems to be getting less and less energetic. I don't understand what the problem could be as her blood tests showed nothing abnormal other than the liver values and an ultrasound revealed nothing but an enlarged liver. I can't keep taking her back to the hospital for the same diagnosis and a $3k bill each time and nothing they do seems to be helping. I'm starting to think that she's dying and it's breaking my heart. She spends more and more of her time in bed and seems weaker and weaker. Does anyone have any idea about this? I feel like the vet must be missing something since hepatic lipidosis should be cured by food.

[Mollycat]

Firstly I'm sorry for the stress and expense you're going through right now, it's so hard when they can't talk to us.

Recovery from HL takes weeks, count 2-3 months, it's a very serious life-threatening condition that can take just days to develop with very little warning, and not all cats do recover as you know. Perhaps being sick has triggered a food aversion while she is still in delicate stages of recovery and she could have been sick for any reason a cat can be sick including furballs or just too much food in one go.

How did your cat get HL in the first place though? Has the cause been addressed or even considered? If the cause is still there this might be hindering her recovery.

[anon442]

I had that thought too. I don't know why she stopped eating. She did throw up about 2 weeks before the start of all this due to what looked like a hairball. I wonder if that triggered a food aversion. The doctors did not find anything from her bloodwork and ultrasound other than the liver issue.

I found the feline grimace scale for measuring pain and she seems to be doing ok based on that. She just has no energy for much more than purring when I pet her and using the litter box. I will continue to keep a close eye on her.

[Mollycat]

I see what you're thinking especially if she then stopped eating again after vomiting again. I presume this isn't her first hairball though? I've never heard of an emetophobic cat but anything is possible!

Did you notice any strange colour or texture to her poop before she crashed? And most important what sort of questions has your vet asked?

[anon442]

Not her first hairball but they are quite rare. She has only thrown up 2 or 3 hairballs in the two years I've had her.

When she first stopped eating, nothing looked out of the ordinary. The second time she stopped eating, I thought her poop was slightly whiter than normal but still mostly brown. Now that she's being tube fed, her poops look normal.

At the beginning, the vet asked about changes in environment, new food, litter box contents, possibility that she ate something poisonous. There were no changes around my house, she's been eating the same food, litter box looked normal, I have no plants, and she doesn't try to eat non-food things.

She might be a bit better today. She sat next to me for a good while but didn't do much else. At least she came out of her bed. She still looks very tired.

[Mollycat]

Ok I can't think of anything else obvious, presumably the vet is satisfied that the not eating has caused the HL and it wasn't a liver issue first, the only other idea was some gastrointestinal issue or stress. Beyond that, maybe it's just the gradual normal recovery process from HL.

Only one thing still bothering me a bit though because of something that happened to my girl at the end of 2018. She had a sudden crash, didn't eat for several days and from overweight she went to thin in just a few days, plus yellow D&V. HL was my big fear. As she is hard to catch and take to the vets we did a full range of tests and the vet spotted hyperthyroidism plus she thought there might be an underlying liver issue as some readings were higher than expected plus there was high bilirubin. Although the vet said the bilirubin wasn't hyperthyroid, it certainly can be. And gall bladder, digestive tract and liver are also all connected. VCA Animal Hospitals have really good online resources for info on this kind of thing.

[anon442]

I will ask about hyperthyroidism. I don't remember seeing thyroid levels in the blood tests. I did ask about gallbladder and they said it looked fine. Thank you for your help so far.