||It has been
this author's observation that lipidotic cats that die do so within the
first 1-4 days of hospitalization. Therefore, the author categorizes the
treatment of hepatic lipidosis into 2 distinct phases. Phase I is the
stabilization phase. The activities of the stabilization phase are designed
to be minimally invasive and provide maximal supportive and nursing care.
These cats are not sent to surgery for a liver biopsy and placement of
a gastrostomy tube. Instead, diagnosis is based on clinical findings,
lab tests, and fine needle aspiration. Supportive care includes IV or
SQ fluids, orogastric tube feeding several times per day, famotidine (0.2
mg/kg) if vomiting is present, injectable B-complex vitamins including
thiamine, injectable vitamin K1, and antibiotics, i.e., amoxicillin, metronidazole,
etc. This approach is taken for 3-7 days. During this time the cat should
get stronger, feel better, and stay hydrated. However, it is not reasonable
to expect the appetite to return. Phase II is the long-term phase. It
begins with esophagostomy tube placement and hospital discharge. Antibiotics
are continued for a total of 2 weeks, and famotidine is used on a PRN
basis. Other medications are discontinued. The owner is equipped to feed
the cat at home.
Norsworthy, DVM, Dip ABVP - TX Veterinary Medical Association Seminar
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