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Liver issues, force feeding & teeth grinding

#1
This is a continuation of stuff I have posted in other threads... I started describing my kittens problems in the thread
Picky unpredictable eater, which then continued in a thread titled
Whipworms, Juvenile Roundworms, what is this?

I have just learned my 8 and a 1/2 month old kitten has some kind of serious liver issues. His main symptom has been anorexia. The blood work is not in yet but the vet said his liver is so small he can't even feel it. Also his blood serum is a yellow color, and he is slightly jaundiced and quite pale suggesting anemia.

I have been trying to hand feed him many times a day the past month as he generally doesn't eat without encouragement, but the bit I have been getting him to accept has not been nearly enough. When he was 4 months old he weighed 5 and a 1/2 pounds. he made it up to 7.2 when he was 6 months old but he is now only 5 lbs 10 oz.

The diagnosis isn't in yet, but the vet suspects a hepatic shunt which is a congenital defect that causes the blood to by pass his liver and his liver to fail to grow as he does. If this is what is going on, it may be possible to manage this through diet, so for now I am force feeding him and giving him lactulose to try and get him stabilized, but it is not easy. He does this strange teeth grinding thing and turns his head to the side seeming to have difficulty swallowing. He does this when he eats on his own too, but then it is more of a peculiar gentler purring/ grinding/ vibrating noise coming from his mouth. The vet thought this was due to nausea but he did not see it himself, and I am still wondering if it might be a clue as to what is making him sick.

Video of what it is like trying to force feed him and the strange teeth grinding he does. Any ideas besides nausea why he might be doing this? The vet looked in his mouth and everything looks OK. (obviously I have not got a very good feeding technique going yet!)

https://drive.google.com/file/d/0ByDQ9QuQRArsQ05HR3c3blV2M1E/view

The happy news is between me and the vet has has eaten more than a can of high nutrition prescription cat food in the past 24 hrs. And the time I recently force fed him and he acted like I was another cat attacking him and made cat fight sounds looking in my eyes and threatening to bite me, may have been the build up of toxins affecting his brain. Usually he is a total sweetie, and tries to be gentle, even when I am doing something he doesn't like.
 
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Brigitte Cowell

Moderator
Staff member
#2
I am so sorry if it turns out to be a shunt, poor kitten :-(

I really don't like lactulose in general... it's nasty and sticky to use but it also can really cause stomach discomfort to the cat. Consider maybe using Miralax as alternative, it's a tasteless powder that can either be mixed in food or dissolved in a tiny bit of water and syringed in without them hating you. It's the laxative of choice on forums for feline constipation. Ask your vet, but lactulose is often prescribed as it was the main choice up until a few years ago.

The video link wouldn't work for me, but I agree with the vet that it sounds like nausea.

In terms of him fighting being force fed, that's a pretty normal cat reaction. When they aren't feeling close to death, they will struggle. He doesn't want to eat therefore he doesn't want you to make him eat. Has your vet given him anything for nausea and for appetite stimulation?
 
#3
Brigitte, Thanks for your advice and kind words. My kitten doesn't seem to mind the lactulose but I will ask about Miralax as an alternative if it turns out he needs this. The vet hasn't suggested anything as an appetite stimulant or anti nausea. I will ask if he thinks this would help.

I edited the post above and think I fixed the video link...

The teeth grinding is actually usually worse than this. I have been gently holding him mouth so this can't happen and he seems to appreciate that. Or at least he sat in my lap without restraints and let me feed him doing this. Didn't try to leave. And I don't think he is near death. He is still following me around the house, and has a routine where he follows the sun. as it warms up various cat perches around the house. But he just wants to sleep once he arrives.
 

Rob1984

Savannah Super Cat
#4
i don't think he is grinding his teeth i think he is trying to get whatever is stuck in his mouth out
once in a while my cat will just sit there chewing on nothing i think its hair or food stuck and he is trying to get it out
 

Moggiesnewmom

Site Supporter
#5
Rob, I think you are partially correct. When there is something stuck in their mouth or teeth, I have seen cats do that same exaggerated open mouth chewing you have seen. And I agree that is probably what Moggie is trying to do. But if you listen towards the end of the clip when he does the open mouth chewing, there is a few times his teeth are also crunching and grinding that I have never heard a cat do. Do you mean your cats teeth made loud bone on bone grinding sounds when he did this? When I force feed Moggie this is often more extreme. He seems to respond well if I comfort him and try to help keep his mouth from moving sideways while he swallows. But it makes getting enough food in him very slow.

Using google I saw where cats grinding their teeth while eating can be a symptom of kidney failure. But I am not sure if that is the same as what Moggie is doing. But now I am wondering if insufficient liver function can lead to kidney failure too? Hopefully I will hear the results of his blood work soon so I have a better idea of what course of action is best for him.

I was reading through where liver issues have come up in this group before and I found where John Popp explained why lactulose is used instead of Miralax. The lactulose has the unique ability to help de toxify the blood if the liver can't manage this.

http://www.savannahcatchat.com/thre...random-thoughts-comments-thread.1887/page-159

But yeah, lactulose is super sticky and messy and even if my cat doesn't mind me putting it in his mouth, it invariably gets on his fur where it hardens into spikes, even if I try and wipe it off with a wet cloth right away.
 

Moggiesnewmom

Site Supporter
#6
Moggie is gone...

When I went to get him out of bed this morning he had a seizure that lasted a 1/2 hour. He then hung on in vegetitative state for a couple hours and passed away in my arms.

I talked to the vet while he was having the seizure, and there was nothing in the blood work they have got back so far that gave any hope of recovery.

His cornea virus info and titter ? is not back yet but his organ function was all shockingly bad, his blood albium was really low or high, consistent with possible FIP and his globulin was at 79 and the vet says normal high globulin is in the upper 60’s. So he is thinking it might be FIP which will be confirmed one way or another by the titter count, or maybe a ?B cell carcinoma. None of the possibilities would have been treatable.

His bile acid was really high before he was given a fatty meal so it was inconclusive for a hepatic shunt. So maybe I started another thread with the wrong title. Sorry about that....

I am just glad he seemed to get a bit of enjoyment from his life right up to the end... yesterday he was still following me and the sun around and was delighted when I made a fire for him to enjoy. And I am also glad that he made the choice as to when it is his time to go. It would have been really hard to make this for him.

I am very sad, but also relieved it is over. The past month has been heartbreaking but I had a feeling about where this was going...

Thanks for all the support and information. It was helpful.