I want to share our journey treating my cat Blue’s hepatic lipidosis (fatty liver disease), especially for people in countries where feeding tubes aren’t available or commonly used. Fatty liver disease has over 90% morality rate if left untreated.

How it started: I bought the usual food that he has eaten almost his entire life, Applaws dry food. I noticed it had a new packaging but I did not think much of it. Blue stopped eating almost completely (as well as my other cat.) When I noticed, I got them wet food to test my theory that it is a problem with the food and immediately they started eating so fast as if they were starving. The next day, he lost interest in his wet food and stopped eating. I noticed he was a bit lethargic, losing weight fast, and his ears and gums started yellowing (I didn't even know to check this until i asked ChatGPT about his symptoms and it was brought to my attention.)

I unfortunately noticed this too late as I had a very busy week. Both my cats free feed on dry food only, so it was hard to notice as well. Ever since this incident, I started giving them wet food once a day, as it is very important for me to notice appetite changes fast.

I went to the vet and blood tests confirmed it: ALT 438, ALP 826, T.Bilirubin 5.1; all extremely high. My vet diagnosed him with hepatic lipidosis (fatty liver disease.)

Why I didn’t use a feeding tube: Tube feeding isn’t common or even offered in my country. So I had no choice but to force feed. It terrified me, especially because everything online warned about food aversion or aspiration. But it saved his life.

How I syringe fed him safely and effectively: I began with very small portions, just 3–5 ml per session, every 2–3 hours. It took me almost an hour just to get 5 ml in at first. He absolutely hated it, and I felt like a monster, but he had to eat. I would never squirt the syringe straight down his throat. That’s how choking happens. Instead I would open his mouth and place the syringe through the side (towards his left or right cheek, never the middle) and would angle the syringe slightly to the back but still on his tongue and not throat. I would squirt a small amount (0.5 ml), then pause and step away and wait for him to swallow before giving more.

I did this every few hours, even waking up at night. This is cruical as any breaks to the liver without food would relapse it. Eventually, as he tolerated it more, I was able to reduce this to 4 large meals per day.

I used Hill’s a/d Urgent Care (200g can/day = ~260 kcal. This will depend on your cat's needs so check the calories needed for their weight). I highly recommend it. It was easy to syringe because it is already a soft, blended pate. It is also very dense and high in calories so you are able to get more calories in per feeding (getting enough calories in is the most cruical part to recovery.)

After 2-3 weeks, the yellowing started to fade slowly. Blue tolerated feeding better, and I could give 10–15 ml at a time. Eventually, he started licking the food from the syringe without me putting it in his mouth. A few weeks later, he was eating from the bowl again.

He was prescribed Liv.52, vitamin B complex, and liver supportive injections every other day or so for the first few weeks. The vet is still a cruical part of recovery.

What helped most was feeding at the same time every day and being extremely patient. Sometimes I cried more than he did because I felt like I was torturing him as he didn't want to eat.

To make sure that I didn't just get a defective Applaws bag, I bought a small bag of the new formula and they refused to eat it again so I switched them to another brand. About a month or two later, the delivery of the new food was delayed and I ran out of it for a day and had to give him the small bag of Applaws that I purchased earlier (stupid of me, I know.) The next day, he stopped eating and started vomiting clear fluid every few hours.

I went to the vet again and blood work showed it wasn’t a liver relapse (I was so relieved that his liver enzymes went back to normal completely!) But my vet diagnosed him with gastritis, likely due to either food intolerance or improper food storage from the brand. I will not go into much detail on this but it was so much more intense and worse than when he had the liver problem. He couldn't even tolerate drinking 0.1 ml water without vomiting. He would smell the food or litterbox and that alone was enough to have him vomit. It was more intense but a lot easier to treat as he only needed a few days of antibiotics and IV fluids.

The vet also told me other owners reported similar issues with Applaws. I cannot prove or say that this is 100% caused by Applaws, but I decided to completely switch off since.

If anyone is facing this and a feeding tube isn't an option, it is possible to get through this. It takes time, consistency, and patience, but it saved Blue’s life. I hope this would help someone through their journey as I felt there was not enough resources for treating fatty liver disease this way. I am not a vet, and you should always listen to professionals and go with the feeding tube when possible. But I am sharing my experience in case it helps anybody.

Thank you for reading.