Saturday, March 06, 2010

Deducting Calories for Self Feeding, a Math Challenge. Are We Passing the Test?

If you have a moment, I have a big question I need help with. We have been instructed by everyone (new vet, old vet, hospital vet) to try to feed Arthur normally before each tube feeding. This is good, but making the situation very very tricky, because he is eating on his own, but not an equivalent amount of calories to the tube so we're having to do some math to try to figure out how many tube calories to deduct based on what he consumed.

Here's how we're doing it. If you have any ideas, please tell us how we can do it easier and better. About an hour before each tube feeding, we offer Arthur a can of wet food we think he'll like. Before we give him the bowl, we weigh both the empty bowl and the bowl with the food in it (strangely the same empty bowl seems to vary at between 2 1/8 and 2 5/8 ounces). We sit with him in front of the bowl stroking him and encouraging him to eat. Usually, he actually DOES EAT for a good 5 min, but I guess he is not putting a lot in his mouth at once, because when we go back to weigh the bowl, maybe it ends up being .5 ounces or 1 ounce less than it was before.

We leave the food out for a good hour and sometimes he goes back for more. This morning, for example, we had a bowl of solid golid tuna out for him for an hour. When it first went down, he ate like .5 ounces (not enough), but when I came to take it away an hour later, he ran into the kitchen and stuck his head in and ate about another ounce. We don't know if we did the right thing, but we skipped his morning tube feeding, because we know that the 3 oz can of solid gold tuna has 100 calories (we actually had to call solid gold to ask) and so we figure he ate about half or 50 calories in that sitting. That's a bit less than his tube feeding of 64 calories, but we spotted him the 14 calories this time.

Are we doing this right? Even if we are, it's driving us nuts. Leaving food down, sitting on the floor and nudging him toward the bowl, hoping he eats enough and then trying to deduct the calories from his next tube feeding. Also, we're not sure if our digital scale is accurate enough to really get this down to the ounce. For example, at one point, I weighed the bowl after he had eaten a noticeable amount, and the weight came out higher than before I put it down.

We would love to just stick to the convenience of tube-only feeding, but we want Arthur to eat on his own and, somewhat uniquely for a cat with Fatty Liver Disease, he actually has an appetite and leads us into the kitchen to give him food.


Anonymous said...

Hi again Avram, and once again my hat is off to you for your wonderful loyalty to your furry kids and your persistence to overcome obstacles to getting the best care. I don't know anything about Fatty Liver (I did ask a friend who knows a lot about cats to post in here but I don't think she has, yet)... anyway... seems to me you don't want Arthur to get out of the "habit" of eating on his own and that sounds right to me. Have you asked your new vet if there are any supplements/meds which could increase his appetite (or pain killers, which might suppress the appetite, but ask anyway). I know you and Liz will be on top of this until Arthur gets better. It's so touching to see Beowulf adding his support. Keep up the excellent care! (from socidoc) My thoughts are continually with you these days and it's so encouraging to see so many people posting their good thoughts and ideas.

Boots, Ozzie and Brenda said...

Even though I don't have much to add as far as information about Arthur's condition, I just want to say that when I was faced with treating my precious Ninja for feline diabetes a couple of years ago, I felt totally overwhelmed at the beginning. But, I got good information, made a few judgment calls and got my precious girl off of insulin for good after about 50 days.

I know it is not the same situation, but it is clear that you are giving Arthur the best care he could get. I can only suggest that you take in all the info and use your best judgment. It is not an exact science. I can only agree with the previous poster that you wouldn't want Arthur to lose his desire to eat on his own. I would certainly encourage him to continue to eat as much as he wants himself.

We will keep you and Arthur in our thoughts and prayers.

All the best

Brenda, Boots & Ozzie

ABBY said...

I think you are doing the right thing. Keep encouraging Arthur to eat on his own. At this point unless you felt you were going totally overboard, I think erring on the side of giving him a bit too much may be better than not giving him enough.

It truly sounds to me like you and Liz are doing an exceptional job.

Zippy, Sadie and Speedy said...

Sounds like things are under control now. Has the new vet requested the old vet's records? We had called our old vet at the time we rescued Zippy and told him we were going with someone else and why. His suggestion that we put the kitten down because she would never "be normal" with the paw damage done was, well, assinine. He said he already knew because the new vet had asked for copies of her records which he refused to release. It sounds like the new vet may have better communications skills, clinical skills and plain old people skills than the old vet. We're with Abby, a little more won't hurt, neither will a tiny bit less. As long as he eats and you make up some calories. We're praying for Arthur and for you.

Happy Cat Family said...

Hi Avram,
I just want to drop a quick note here agreeing with Abby... When it comes to Fatty Liver, to err on the side of giving more is always best... You are right in offering him food first, so he doesn't lose the habit of eating, and I think it is great to not let too long time elapse in between his feed and the tube feeding, so that some good time has passed until his next feeding and he is actually hungry. I think what you doing is perfect.
Are you warming up his food? Make sure his food is always warm... It's more appealing to him...
Are you keeping a journal? I find that writing it down makes it much easier... This way you can just see how many calories he ate on the previous feeding, and adjust the next one accordingly... Keeping things on paper help me not worry as much - I can just refer back to the paper, make adjustments, and hit the daily targets. Just an idea that works very well for me :) It's on paper, so I don't need to think all the time about it.
Good job, you guys are true angels!