Cleo's Progress

One Cat's Struggle with Feline Hepatic Lipidosis

Wednesday, September 8, 2010

Cleo's story

This blog was originally started as a way to update friends and family on Cleo's status when she was sick with feline hepatic lipidosis, also known as fatty liver disease. However, I got so many emails and comments over the years that I kept the blog up to help other people going through the same thing with their cats.

Because I've continued to update the blog periodically, however, over the years it has gotten to be a little more difficult to navigate. This will make the 91st post, and as I add posts, it's getting increasingly more difficult to find the original posts about Cleo and my experiences with fatty liver disease.

So I've created a label just for those posts. Click on the label below this post for "Cleo's story" to read all of the posts in the same place. Then be sure to scroll all the way down, as the oldest posts will be at the bottom!



  • At September 26, 2010 at 12:31 AM , Blogger Brownie's Mom said...

    My husband and I have a 6 year old female cat named Brownie that used to weigh about 14 lbs and dropped to her current weight of 11.6 lbs because she stopped eating her recommended daily intake when I switched her to an organic human grade food.

    On 9/22, after work, we noticed that she looked yellow around the ears, and immediately took her to a 24 hour vet.

    They said all they would do for her is observation overnight, so we took her home and got her into the vet the next day. Our vet gave us Omega 3 oils, antibioltics, Lcarnatine and ursidiol. The vet's only advice so far is that she needs to eat whatever she wants and if she won't, the only way to save her is a feeding tube.

    After that advice, I was really nervous when she didn't eat at all on her own on 9/24. However, I read an article online that suggested forming min-meatballs out of wet cat food and force feeding them like pills. We successfully got a 3.5 oz can into her that night.

    On 9/25, we force-fed a full 6 oz can (split over 2 feedings, morning and night)with this method and she kept it down. Only problem is that now she is refusing to drink on her own and I noticed some tenting on her scruff.

    We have a couple of questions: 1) If we are considering fluid injections, did you use Ringer's or Saline and how much did you give per injection and how frequent were the injections? My husband is a people doctor and can give them but we need these answers first. 2) If she tolerates the meatball method of feeding, should we listen to the vet and get a tube installed so she doesn't come to resent us later on as the vet suggested or is this OK if she isn't vomitting?

  • At September 26, 2010 at 12:12 PM , Blogger Katharine Swan said...

    If she is tolerating some form of force-feeding, I would NOT put a feeding tube in. However you will need to give her fluids if she isn't drinking on her own. You might be able to syringe feed her some water, but it's hard to get enough into them that way, especially if her stomach is upset.

    When I was giving Cleo fluids at home, the vet sent me home with an IV bag. I believe it was a saline solution, but I couldn't be sure, especially I don't know what the other kind you mentioned is. :o)

    Also, in my experience and from what I've heard from other people, after about a week of force-feeding, many cats have a setback. She may start vomiting more, or she may start acting more lethargic. Keep on force-feeding her and giving her fluids, and don't get discouraged! It can take weeks of force-feeding before a cat with FLD will recover.

    Really, the only reason for a feeding tube is if a cat doesn't tolerate being force-fed by mouth. If your cat is doing well with being force-fed, and you are able to get enough food into her every day, I see no reason to put her through a traumatic surgery to have a feeding tube inserted. And if she is doing well with being force-fed and your vet still won't support your decision, in my opinion it is time to find a different vet!

  • At September 26, 2010 at 12:16 PM , Blogger Katharine Swan said...

    I should also mention that you should not be discouraged if she does start vomiting. Fatty liver disease makes the cat feel nauseated, which is why she won't eat on her own. By feeding small meals more frequently, and by being careful when you feed so that you don't trigger her gag reflex, you can minimize the vomiting. Even the feeding tube doesn't eliminate vomiting altogether, though. The point of the feeding tube is to help you feed a cat who struggles against being force-fed, to the point where you can't manage to get any food into them, which it doesn't sound like your cat does.

  • At November 4, 2010 at 6:38 PM , Blogger Hope10 said...

    First I want to thank you for your blog. You are giving me hope. My cat, Madison has been diagnosed with hepatic lipidosis. The vet believes it was brought on by me going on vacation for longer than I've been before. She stopped eating. I thought she woudl start when I got back but after a few days I took her to the vet and got the bad news. Obviously now I wish I had never gone away and I wish I had taken her to the vet right when I got back, but I had never heard of this disease before. Anyways, I'm not sure how old Madison is because she's a rescue cat, but I do know she's between 6-8 years. Right now I'm feeding her Hills l/d (that's what my vet wanted me to give her). I'm feeding her with a syringe and she's doing well. She does not struggle, she actually just lays there and laps up whatever I put in her mouth. What I am worried about is her fluid intake. She is not drinking water on her own. I am mixing water with her food and also syringing some into her mouth but I still don't think it's enough. Do you have any suggestions? The vet wants me to bring her in every day to have her hooked up to an IV (we did that for 4 days straight) but I just can't afford the $100/day for the next month. Plus, I think she likes being home with me and my family, I think it's better for her. I'm just really concerned about the fluids. Any suggestions would be greatly appreciated. Again, thank you for the blog!

  • At November 4, 2010 at 7:20 PM , Blogger Katharine Swan said...

    Hope, that's wonderful that she isn't resisting syringe feeding. Cleo wasn't drinking either, so I actually asked to bring the IV bag home with me. They gave me a week's worth of needles at a time, and I gave her the sub-Q fluids myself. It's a little freaky putting a needle that big into your cat yourself, but I figured I could handle it, since I am diabetic and give my own shots.

    I'm surprised it costs that much to have the fluids given. If you don't think you can handle doing it yourself (you also need a helper to hold the bag up and open and close the valve), why don't you ask your vet for recommendations to a low cost clinic that can do it for less?

    Hopefully you can figure out a way to get her the sub-Q fluids -- it's hard to get enough water into them by mouth, especially since cats with hepatic lipidosis are really prone to nausea. The more you put in their stomachs, the greater the risk of them vomiting!

  • At December 6, 2010 at 2:48 AM , Blogger La Conejita said...

    This comment has been removed by the author.

  • At December 6, 2010 at 2:48 AM , Blogger La Conejita said...


    I stumbled upon your blog when searching for different information on FHL (as most of your readers apparently have been too).

    I have a 10 year old boy who suddenly started losing weight roughly two months ago. I suspected either hyperthyroidism or possibly dental pain (his teeth are pretty bad, previous owners never had them cleaned). About the time when I noticed his weight and inappetance, he proceeded to vomit a yellow-ish colored liquid with some fur in it... I assumed a hairball or slight upset tummy. We had just moved into a new apartment. He bounced back to normal after that, but it didn't go unnoticed. We also adopted another, younger, cat with whom he's not too pleased with but will tolerate.

    I have been struggling with low income and have not been able to take him to the vet, so I had been offering him wet food to make sure he got some nutrition. He'd only lick at so much of the food and then stop. He drank normally though.

    While researching the costs of dental procedures and such at various vets, I discovered Care Credit... applied, got a $700 limit, and made an appointment to have Carson's (my cat) bloodwork done. He hadn't vomited in a while prior to bringing him in.

    The next day I got a call with the results. The vet said that his billirubin was higher than normal for cats, and also appearing in his urine, so they recommended an ultrasound on his abdomen as all his other vitals were healthy.

    The afternoon after his bloodwork, he vomited once before I left to work, and three times more while I was away. Upon hearing this from my fiance when I left work, I called the vets. They suggested I bring him in to give him IV fluids and anti-nausea meds, but I didn't know if I could afford that. I wanted to see what the vomit looked like and Carson's condition before taking him in.
    The vomit I saw was foamy and yellowish, and poor Carson was hiding under the bed looking miserable. After getting estimates from the vet, I brought him in. He vomited while there at the vet's, and also made several motions like he was trying to defecate (unsucessfully). They decided to give him a shot of sub-q fluids, and an anti-nausea shot. I couldn't afford to hospitalize him that night, so we brought him home. The remainder of the night he crouched under the bed and yowled if I tried to move him. I ended up scheduling an ultrasound for him the next afternoon, after I was able to get a credit increase for the care credit.

    The ultrasound revealed an abnormality of his liver, which I had suspected. They aspirated his liver, but I couldn't afford the extra $190 just to send it out to be biopsied. Given all his prior and current symptoms, the vet is 95% sure that he's suffering from FHL. They also noted that his pancreas looked a little inflamed on the ultrasound, so he could also be dealing with some pancreatitis as well.

    After a very long 3.5 hours at the vet, numerous adjusted estimates and discussions with the vet about the prognosis of recovery for FHL, and a FIV test (negative) to rule out another condition, $1171 in bills; I agreed to leave Carson there to have IV fluids started, medicine shots given, and for them to attempt syringe feeding (I didn't want to give him a feeding tube if he was keeping down the food), and hospitalization for 24 hours. I was so worried that I would get a phone call with the news that he was going downhill... I had signed do-not-resuscitate papers if his heart were to fail...

    I called that night to check up on him and to my happiness, they said that he was doing well. He was taking and keeping down the food, and he was alert and not lethargic.

    We brought him home last night, with several cans of Hills A/D food, Lactated Ringer's fluids, Famotidine (antacid), Clavamox (antibiotic), and Cyproheptadine (appetite stimulate, which I've only given once). He's on a rigorous every 12-hour meds/fluids schedule, and a every 4-hour feeding schedule.

  • At December 6, 2010 at 2:49 AM , Blogger La Conejita said...


    He really detests being force-fed, but he has kept all of it down. The only sign of nausea he has shown since bringing him home yesterday was a little drool before we fed him the first time. He's using the litterbox to urinate (no poop yet). He's not showing interest in food/water yet... in fact he yowls when I put the food in front of him as if he's saying "not the feeding again...", but otherwise he's resting quietly under the bed.

    To restate, we do not have a confirmed diagnosis for FHL, but I trust the vet's word that she believes that this is what we're dealing with. I decided to go ahead and treat for it and see how he responds, and so far it's been good. Just after two days his fur is starting to feel softer and shine again. He'll occasionally groom himself (which I take to be a good sign, because normally sick cats tend not to groom themselves).

    Let me wrap this up as it's been rather long-winded and I'm sure there's a few run-ons in there... I just wanted to say thank you for documenting Cleo's progress for others with similar situations to read through and gather hope that our little ones will pull through. The weird thing is that Carson isn't jaundiced at all, so I have hope that I caught this before it caused his liver to fail. I know I'll be losing sleep over caring for him, but if it means that he can enjoy more than 10 years of life, then I will do everything I can.

  • At June 26, 2011 at 7:38 PM , Blogger Megan said...

    Hi! First, let me just say that your blog has been enormously helpful. My cat, Katanah, was diagnosed last Monday with HL. She was in a severe state of jaundice and she was admitted to the vet for 3 days of force feeding and fluids via IV. She was discharged home Wednesday night and I continued to force feed her a high-calorie food through a syringe that my vet recommended many, many times per day for the next two days. Miraculously, she began to eat on her own on Saturday morning, but would only eat her regular food, not the vet-recommended one. She's gone through over 6 oz. of food today on her own and seems to want more. My question involves recovery. I'm unsure how much to let her eat since she obviously has her appetite back, but she is not eating "high-calorie" food. In addition, I'm concerned about bowel movements and the like. She drinks on her own and uses the litter box to urinate, but she hasn't had a bowel movement in a couple days and I'm wondering if it's a matter of letting her system catch up with the food or if she's constipated or if there is something else wrong. Any suggestions/advice?

  • At July 27, 2011 at 1:38 PM , Blogger Sue said...

    My 15 year old cat Petey was diagnosed back in April (second opinion) with FLD. We switched his diet to wet food only and dry z/d and added milk thistle but he still kept losing weight and vomiting every other day instead of everyday. He started at 15 pounds and now is down to 7 1/2 pounds. At the vets on Friday the vet showed us where his ears have become jaundiced. Also as of Friday he stopped eating and seems very wobbly on his feet. he looks so thin and bony. He has gone downhill very quickly. I want to try everything before I give up on him. I began force feeding him yesterday and he has kept it down- no vomiting. He is also drinking more. I am also giving him a denamarin pill once a day in the morning and Actigall in the morning as well. He has diarrhea and is urinating. Do you think he has a chance? I am so devastated. I feel like I should have been aware of all he symptoms before I got the correct diagnosis with the second opinion. is there anything else I could be doing? please write back.

  • At July 28, 2011 at 12:46 AM , Blogger Katharine Swan said...

    I am behind on responding to comments! Sue, if he just stopped eating on Friday, I definitely think he has a chance of recovering. Keep force feeding him and try to set a quota of how much he should have each day.

    Also, it sounds like this has been coming on for a while -- it's very important to identify what's causing this. Most likely although he just stopped eating, he hasn't been eating enough for months. Find out why! He may be sick with something else that has caused him to lose his appetite, or it could be situational (a new dog or cat, a new house, or something else that has upset him and caused him to stop eating). With Cleo it was a dog moving in with us -- she was too intimidated to eat.

    Keep force feeding him to keep his strength up, but also try to figure out what else is going on with him. You can help keep his strength up with force feeding, but before he can get better and stay better, you'll need to identify and treat whatever caused him to lose his appetite.

  • At September 10, 2011 at 12:06 AM , Blogger lacednotes said...

    Hello! Thank you, thank you, thank you for this blog! The information is great. My 12 year old cat - also named cleo- was diagnosed a week ago and your information has been so helpful. I have hope that she will recover.

    Cleo has lost half her body weight and stopped eating all together. I didn't notice a problem at first because she started losing weight just after I changed things and gave her access to a room she loves so she was no longer sitting by her food bowl eating out of bordom. It made sense that she was loosing weight. Little did I know that actually wasn't all that great a thing.

    Well, in just a week she has turned around fast, and I know she will recover. A week ago she was 5lbs and now she's almost 9lbs again. She just started to eat a bit today and is going to the bathroom again. Yeah! I know she has a ways to go and that it'll take a while for the liver to be healthy again. I've been force feeding her and will continue until she's eating completely on her own.

    One thing I haven't found on your site is how to give a cat a pill. What an experience that is.

    Again, thanks for making this site.

  • At October 12, 2011 at 12:45 PM , Blogger Ed W. said...

    I just found this site, and am so glad I did. Our cat Felix has been loosing weight for a couple of weeks now, but we thought it had to do with a chance in diet. He is very lethargic, and we took him to the vet yesterday and they want to do more tests and another ultrasound (we did 2 of these in the summer for another event that happened, which found nothing out of the ordinary and cost a LOT of money). As he is pushing 14, I really don't want to do another ultrasound, and we were going to try and comfort him and make the "tough call" later this week. But having read all the comments, I am convinced that he has this condition, and have been force feeding him for a couple of days...hopefully things improve. If anyone has any input on how many CC's to try and get into him each day, I welcome any feedback.


    Ed W.

  • At October 12, 2011 at 12:55 PM , Blogger Katharine Swan said...

    Ed W. - It's hard to say how many CCs, especially if you are mixing the food with water. All food has different nutritional content. Check the can to see if it says how much to feed per day according to weight (it should, but if it doesn't you can call the manufacturer). Aim for that amount, but don't worry if you don't quite make it. I usually fell a little short of the full can Cleo was supposed to get a day, and she still recovered. Just remember to split the total quota for the day into lots of smaller feedings -- 6 or so if you can manage it.

    A couple of cautions -- you should still take him to the vet. Fatty liver disease is usually caused by something else. Could be something as simple as a food change that caused him to stop eating as much and get sick, or could be that he has something else wrong that's making him stop eating because he doesn't feel well. If it's the latter, he won't get better until the problem is resolved. It sounds like you changed his food recently, so that may have been the cause -- but it's good to take him to the vet to be sure.

    Another reason to take him to the vet -- a blood panel will show if his liver is the problem. If the liver numbers are normal, there may be something else going on.

  • At October 12, 2011 at 1:00 PM , Blogger Katharine Swan said...

    lacednotes, Sorry for the late response, but I'm glad to hear that Cleo is doing well! It sounds like you caught it early -- which is always a good thing. Do you think she stopped eating because of the room change? Watch for a relapse once she starts eating again -- if it happens again, there may be something else that's causing her to not want to eat.

    As for giving a pill -- yes, that stinks, especially if they don't want to eat much in the first place! I usually wrapped Cleo up in her towel and cradled her in my lap, just like for force-feeding. I used my fingers to get her mouth open, and then dropped the pill towards the back -- it gave her no choice but to swallow. If you do that, you might want to follow up with a couple bites of food or a small feeding to make sure the pill washes down!

  • At December 23, 2011 at 6:57 AM , Blogger chrinsky said...

    I just wanted to tell you, and everyone else who shares their stories here as well, thank you! This blog has been incredibly helpful to me and my little Meowzers who is currently struggling with hepatic lipidosis. We are force feeding her with a syringe and so far (it's only been two days) she's been taking the food and keeping it down. All of your down. All of your stories really give me some support and hope that my little Mewozers will make it through this!

  • At February 15, 2012 at 9:00 AM , Blogger lynneblw said...

    I enjoyed your posts tremendously, your cat is so lucky to have you take care of her and nurse her back to health! I also loved seeing your photos, Cleo is a doll.

    Last Sunday (2/5/11), I noticed that my 12 year old Siamese Jasmine was yellow on the skin under her ears and inside her ears. I took her to the vet the next day, they kept her overnight, put her on IV as she was dehydrated and did bloodwork and an ultrasound.

    She was diagnosed with HL and a urinary tract infection, which may have been why she stopped eating. She was given Cerenia (anti nausea) and steroid injections to keep the inflammation down.

    I give her antibiotics Clavamax twice daily, she doesn't like it but seems to be keeping most of it down.

    Per the vet, I gave her Hills a/d but thankfully have not had to force feed her as she went straight for the food the minute she came back from the vet on Tuesday (2/7). The next 2-3 days after, she didn't have much of an appetite, and would just lick the gravy off the food and nibble here and there. I tried to tempt her often with various types of wet cat food as she seemed a little bored with the Hills a/d (I looked for those without any corn/wheat fillers or meat by products) and she wasn't drinking either, so I gave her dropperfuls of water which she tolerated.

    On Saturday, she seemed to get her appetite back and ate at least 5oz of food. I was really happy to see that. However, the next day, she threw most of it up.

    It's been up and down from there. Where she would eat as much as she could and then she would throw quite a bit up.

    She had a rough day yesterday and could not seem to keep anything down, even the water she drank.

    Today, I'm trying to control her food intake better. She may be overeating because everything tastes so good ;-) and her system needs time to adjust to food again after not eating for so long.

    I found a dry cat food which has a 32% protein content (more than Hills or the rest of the cat food she ate) which is also wholistic. She takes it but not as enthusiastically as I've seen her go for the Meow Mix Salmon and Crab Meat wet food. Hopefully, she can keep that down better.

    She is still yellow, but seems a little less yellow than before, ever so slightly. I am glad to read that it takes a few weeks before the bilirubin gets broken down enough for the color to go away, so, it doesn't mean that she is not recovering.

    She does seem to have a little more energy than before and has started grooming herself again in the past few days and would come when called like she used to before she became sick. So, those are positive signs!

    The vet wasn't sure if her HL was due to the UT infection or that she may have other more serious underlying problems like liver cancer. She doesn't seem to be in any pain and since she showing interest in food again, I'm hoping that this is not the case.

    We have been really lucky that she helped herself get better as much as she has by voluntarily eating but don't feel like she's totally out of the woods yet, until the yellow color is gone and she can hold her food down again.

  • At February 15, 2012 at 11:27 AM , Blogger Katharine Swan said...


    I don't know what it is about the condition, but the liver problems cause nausea, and that's why they have a hard time keeping food down. She probably isn't overeating; in fact, it sounds like she goes back and forth with not eating enough! My advice to you is to find out from the food manufacturers how much she should have a day, and make sure she is eating at least close to that amount on her own. If not, you may still need to force feed her. Getting enough food into her is vital!

    It's interesting that she is getting steroid injections. I wonder if that is why she is eating better than most cats do with hepatic lipidosis? Steroids do cause an increase in appetite!

    Hang in there and let us know how Jasmine is doing!


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