Dr. Norsworthy's Approach for Treating Hepatic Lipidosis
| 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. |
Gary D. Norsworthy, DVM, Dip ABVP - TX Veterinary Medical Association Seminar 1999
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