You switch your cat’s diet, and she turns up her nose at the new kibble. Figuring your finicky feline won’t be able to hold out for long, you stand firm. Don’t. While a dog’s hunger will finally get the better of her, a cat may very well not come around. And going even just several days without any food can set her up for a potentially life-threatening disease known as hepatic lipidosis. In lay terms it’s called fatty liver disease.
Ironically, it’s overweight cats who are most prone to developing the condition when they undereat. What happens when a cat won’t consume food is that her body begins breaking down fat for fuel. The liver becomes overwhelmed trying to process the fat, and with all the extra fat in that organ, liver disease ensues. Overweight cats, of course, have more fat than other cats to send the liver’s way.
The condition is one of the most common types of liver disease to strike our feline pets.
Diagnosing the disease
If your cat has not eaten a single morsel in several days, you should be consulting with a veterinarian. Cats start refusing to eat for a variety of reasons — not just dislike of a new food but also emotional stress or an underlying disease that decreases appetite.
The veterinarian will make a definitive diagnosis with a variety of tools, including blood work and possibly a needle biopsy of some of your pet’s liver cells. If a cat has hepatic lipidosis, a veterinary pathologist will find a large amount of fat in and among those cells.
Once a cat has gone too many days without eating, she most likely is not going to be willing to eat again on her own, even if you serve her the food she finds most delectable. The illness can leave her feeling nauseated. It’s for that reason that treatment using a feeding tube is required. It sounds drastic, but feeding a cat through a feeding tube is something you can (and must) do at home to return your pet to health.
The tube will either be placed in the cat’s esophagus through her neck or directly into her stomach through the abdominal wall. A tube placed into the neck is called an E-tube (the “E” is short for “esophagostomy”). One placed in the stomach is called a G-tube (for “gastrostomy”).
You will be taught how to blend special food (often a therapeutic high-calorie diet) with a specific amount of water so that it turns into a slurry that can easily be pushed through the tube with a feeding syringe. The process has to take place very gradually. Each feeding requires at least 5 to 10 minutes, and cats with tubes are fed three to four times a day. When the tube is first placed, feeding amounts will be small, and it will take several days until the cat is up to her normal calorie intake. “The slow return to the usual amount of calories is what will enable a cat to shift her metabolism away from using her own fat stores for energy,” says veterinary nutritionist Cailin Heinze, VMD.
The tube should be flushed with warm water before and after feedings to prevent clogging, and it should also remain capped between feedings. You’ll need to monitor the site daily, too, to check for signs of possible infection and to clean it if necessary. None of it is difficult; you just have to stay on top of it.
The tube will likely have to remain in place for a number of weeks. As the cat returns to health and the amount she takes in is back to normal, she will begin eating out of her bowl once more. But it takes a while for a cat to eat enough from the bowl to ensure adequate nutrition once the tube is removed. Typically a tube is left in for at least a week after a cat is eating enough on her own to maintain body weight. You don’t want to rush things.
If there are no underlying health conditions, most cats treated aggressively with a feeding tube will survive hepatic lipidosis and regain their appetite. That said, it’s important to continue to monitor your cat’s intake so that any small changes in the future can be addressed before they become serious.