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How do you feel about feeding tubes? *UPDATE*
Sorry this is so long, I just want you to know the whole back story.
So early morning last Sunday we brought our 2 and a half year old cat in to the animal hospital because she pooped on our floor (she's never done that) and was breathing funny. I was expecting them to tell me I was over reacting, give her a pill and send us on our way. Except they immediately put her on oxygen, gave her X-rays and sat us down to tell us, she has fluid in her lungs and her heart didn't look right and they were going to keep her all day and all night to run more tests, and start explaining possible heart disease to me and the possibility of throwing a clot and becoming paralyzed, and they just hope she makes it through the night. I was in complete shock.
So then she made it through the night, we brought her to our regular vet who set us up with a cardio specialist same day in another state. He tells us she has very severe hypertrophic obstructive cardiomyopathy with massive concentric hypertrophy of the left ventricle and congestive heart failure. He assured us it wasn't our fault and that it's hereditary. Her changes of survival are pretty low, but we should give medication a shot. So then we get her home and she won't eat. So per vets recommendation we try real chicken, turkey, tuna, sardines, several different brands of wet food, dry food, even kitty crack (aka meow mix) just to get her to eat something, ANYTHING, but nothing.
So as I'm crying my eyes out as I'm told she's going to go into liver failure if she doesn't eat and we'll have to bring her in to get a feeding tube, someone suggests baby food. Finally she ate that on her own Tuesday night. Then the next day would only eat it off my fingers, then she'd only eat if after I smeared it on her face, and then the vet tells me she's going to talk to the cardio specialist to see if we can take her off some of her meds to hopefully bring back her appetite, and maybe give her a stimulate to get her to eat, but she'll again have to clear that with the specialist. She calls me back and tells to take her off one of the meds, and to call her back Saturday.
So this morning our cat won't eat the baby food at all and growled at me (she never does that) when I tried to give it to her, and I called the vet, she of corse is not in, and the specialist isn't in until Monday. The vet that is on duty today tells us to force syringe feed her with a high diet cat food, and to give her a stimulant, and just HANGS UP before we can question her. So I go in there and am told the vet will come out to talk to me, and never does. I ask them if our regular vet left any notes for her or if anyone talked to the specialist to clear the appetite stimulant with the other drugs, and am told, no, no one ever checked, but they THINK it's fine. Everything I read online says to be careful with stimulants and heart failure, and with mixing medications. So I am very hesitant to get her a stimulant until either my regular vet or the specialist says it's okay. For all I know the vet that is in today didn't even look at her chart.
So now we have been force syringe feeding her and she cries and struggles like crazy. We were told by the specialist NOT to stress her out. Some things I read online say that feeding tubes are torture for animals when they are that sick. I don't know how to feel anymore. We don't have kids, she is our baby, she's so young, she's such a good cat, but I don't want to torture her either. I don't know where to draw the line between giving her a fighting chance, and not just dragging this out and torturing her. WWYD?
**UPDATE**** the cardio specialist approved the stimulant, and within an hour of giving it to her, she started eating on her own!!!!!!!!!! I'm so freaking happy right now!!!!!
Re: How do you feel about feeding tubes? *UPDATE*
My cat had a feeding tube for 3 months. She had a ruptured eardrum and a host of other problems that we were able to overcome but getting her to eat was a real b!tch. She was totally fine with a feeding tube. It didn't seem to stress her out at all. She was a Persian though so the feeding tube went directly in her esophagus. It was far, far, far less stressful to have a feeding tube than to force feed her. I would do it again in a heartbeat. Seriously. I say go for it. The feeding tube gave me many more years with my dear cat that I wouldn't have had otherwise.
I don't know if 3 months is crazy long, but I think it is but my cat was uber stubborn and played me like a fiddle. It took me going away and getting some tough love from her 'grandma' but she was eating on her own when I came back.
She stopped eating because of a ruptured ear drum but they told me she had severe polycystic (sp?) kidney disease and they thought cancer but I went ahead with the tube because it gave me time to think and see what was really going on with her. Turns out she beat everything and lived with severe PKD for several years. She beat all the odds that they had given her in terms of life expectancy with all of her problems. If it gives you a bit of time to think and see how she responds, I still say 'do it.' She is stressed and if she's stubborn that could outweigh her desire to eat. My cat was a huge fighter. At the end she lived way, way, way longer than the vets thought she would, but she kept going.
The feeding tube wasn't stressful or painful for her.
I am so sorry you are going through this. We thought one of my kitties might have cardiomyopathy and I know how hard it can be to have to make these tough choices.
Anyway, not sure if this is possible with your cat, but my vet taught me how to force feed my kitty when she was not eating due to some stomach bug.
You take some wet cat food (about the size of a chocolate chip maybe? at least to start with, you might be able to get bigger bites later), open the cat's mouth, and smear it on the roof of her mouth. We did this with the high calorie food from the vet to get the most out of our efforts, but you could use any wet food.
My cat is VERY sweet and cooperative, so if you think yours might bite you or claw at you then do this with caution. We were able to get a good bit of food in her over about an hour. So I would do this about 5 times then let her have a short break. Slowly, but surely, she ate a bit. Sometimes she would even start eating it on her own after tasting it.
Our vet also told us that while liver failure is a possibility, as long as something is getting in, the chances are lower. So even if your cat is not eating the normal amount of food per day, getting 1/2 as much or even 1/4 as much is probably ok.
ETA: Probably ok in the short term, I mean.
Our cat has never bitten or scratched anyone, even when she was tortured by a visitor's children. She has her claws, yet has never touched our furniture. She lets us trim her nails without a problem, lets me give her a bath. Would eat on her own (before all this), be fine left alone for a weekend. We've tried several methods of force feeding, and she just cries and struggles to get free the entire time. That's why this sucks so much. I don't think we would have taken it this far is she was a witch, but of corse if she was a bad cat I bet she'd live forever.
Have you tried the baby food again? Any of the step 1 are probably fine (no onions/garlic) and sometimes mixing up the protein helps- ham, turkey, chicken. With some foster kittens we were trying to socialize, we would put the baby food on top of the regular food and they would lick it and sometimes start to eat the regular food.
I have no advice or insight on the feeding tubes. I think you know what is best for your cat. Besides not eating, how is she doing? Still snuggly when not trying to feed her? Finding the right combination of medication might take time. I think until you decide yes or no on the feeding tube to keep trying to force feed in very small increments. Like pet her for a while, feed her a tiny bit, then let her go. Repeat later. Just try to get what you can in her without stressing her out too much.
Again, I am sorry
What a tough spot you are in.
I'm going to shoot straight with you, and it's not going to be what you want to hear.
Its probably time to say goodbye. Once you are at the point with severe breathing issues and not eating, the chances of survival are slim.
We lost our heart kitten Lily at the age of 8 months this time last year to HCM. We thought she had an upper respiratory infection. By the time we got her to the e-vet her temp was 97 degrees and falling and she couldnt breathe. The vet told us she had a 50/50 chance of making it through that night, and IF she made it, only a 20-30% chance of making it to her 2nd birthday.
I am SO sorry you are going through this. It's not fair, especially when they are so young.
I pretty much gave in whenever she wanted to eat. I got some appetite stimulants from the vet and my mom was more stubborn than the cat was. She still had to spoon feed her to get her to start eating on her own, but then she started eating. My mom gave her the stimulant and then kept offering her food every time she wanted to eat versus just using the feeding tube.
I agree with this.
I'm really glad your kitty is eating now! I have experience with both syringe force-feeding (I do this daily with one of my Persians who has polycystic kidney disease - he eats on his own, just not enough to maintain a healthy weight) and a feeding tube (my Norwegian forest cat had hepatic lipodosis from not eating, and was fed every 6 hours through a feeding tube for about 5 weeks with high cal prescription food). Feeding tubes sound and look a little scary, and it was really rough, but it was the best/only chance we had of Nimbus recovering. He was REALLY sick. He was lethargic. He lost weight. But with the feeding tube and a lot of medication, he got better (though he developed congenital heart failure about a year later and eventually dislodged a bloodclot in his leg, at which point we made the decision to put him to sleep at the age of 14 - but I can talk about the progression of that disease as well if you have questions).
I know people who have had cats with hepadic lipodosis (liver failure due to not eating and the liver processing too much body fat) and other issues who have decided that they do not want to do the feeding tube, my mother included. That's completely legitimate, and with the work involved (including either my husband or I having to come home from work in the middle of the day and spend our lunch break giving Nimbus his food, and waking up in the middle of the night to give Nimbus his food) I do not blame anyone who is not up to it and chooses euthanasia instead. I think there's also a difference between something your cat might recover from fully, even if the chance is less than 50%, and something that is terminal and will worsen, and probably quickly (the prognosis for congenital heart failure is from 2 weeks and on - Nimbus was with us for 6 months after his diagnosis, though his prognosis was originally 2-12 weeks).
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I know in the situation my cat was in, once he was diagnosed with congestive heart failure, had they recommended another feeding tube, we wouldn't have done it, especially since he had had one a year before. The difference being that we DID know that the CHF was the beginning of the end. BUT he was 13, almost 14 years old when diagnosed. Our maintenance involved some medication, including a diuretic to help with fluid in his chest cavity, and a blood thinner to help with clots (plavix). He also had his chest cavity "tapped" every month or so to remove some of the fluid that accumulated. Given those issues with his chest/breathing, I think the feeding tube would have really complicated things.
But like I said, we knew he wouldn't be able to manage the congestive heart failure long terms and that in his case, it would just get worse.
If they bring up a feeding tube again, I'd ask about the logistics. Would they want to keep it in indefinitely? For a few weeks to get her eating again and gain a little more weight? If it's the latter, and they think her prognosis is pretty good, I wouldn't necessarily rule it out. Cats need to eat to feel better, and once she eats normally, you'll probably see a big improvement. But I would worry about her going down hill again after it comes out, and I would NOT want to have it in forever.
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Thank you very much. That is very helpful, and sounds like a good plan.