Twinkle: Feline Eosinophilic Gastrointestinal Sclerosing Fibroplasia (FEGSF)

Growing weaker, losing weight and unable to eat normally, Twinkle was a far cry from her chubby cheery self. At her lightest, she was 2.92kg. Twinkle’s family fought alongside her, through sickness and surgery, until she was fit to go home.  

“One night, 11 years ago, we were driving when a kitten dashed across the street. My husband got out immediately & found the kitten huddling in a drain. We are not cat people but we just had to take her home. It was difficult caring for her initially but we learned along the way & got used to it. We named her Twinkle.

A year later, Heidi joined our family. She gets along very well with Twinkle. Like children playing together, no one tells them they are different. Same for Twinkle and Heidi. Ebony and ivory living together in perfect harmony!” ~ Julie

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Few months ago, Twinkle started vomiting frequently (vomiting is the primary sign seen with a variety of diseases affecting the GI tract). She was losing appetite & losing weight. Early September, Twinkle was hospitalised for a few days before being discharged with a naso-esophageal feeding tube.

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A naso-esophageal feeding tube is passed through the nose into the esophagus. Only very liquefied food, water & some medications can be given through the narrow tube. An Elizabethan collar is necessary to prevent Twinkle from interfering with the tube.

feeding tubes are useful for animals who are ill & have lost their appetite

The sight of your cat or dog with a feeding tube might be unpleasant. However, feeding tubes are very useful for animals who are ill and have lost their appetite, or are keen to eat but have difficulties swallowing or keeping food down. 

13 september 2016 – consult with dr nathalee prakash

Twinkle was referred to Dr Nathalee Prakash, veterinary specialist in canine medicine, at Mount Pleasant Vet Centre (Gelenggang). Cat physiology is very different compared to dogs or people. The consequences of not eating are much more significant. If your cat does not eat for as little as forty-eight hours, she can develop a potentially life-threatening form of liver malfunction known as hepatic lipidosis.

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“Twinkle has always been healthy. When she started losing weight, we have to find out what was wrong & do whatever we can to help her get better.”

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Twinkle’s body condition score was 3/9. Upon abdominal palpation, there was a mass in the mid-abdominal region. Exploratory laparotomy was advised, with a possibility that surgical intervention could help Twinkle.

15 september 2016 – surgery by dr patrick maguire

Dr Patrick Maguire, veterinary specialist in small animal surgery, performed exploratory laparotomy to examine Twinkle’s abdominal organs. A mid-jejunal mass was identified, measuring 1 to 2cm in diameter, which appears to be causing partial obstruction.

A jejunal resection and anastamosis was performed – fully excising the diseased section of the intestine and suturing the remaining sections together. The mass was sent for histopathology examination, together with the mesenteric lymph node and a section of the liver. 

Note: The small intestine is the major digestion and absorption site. It is divided into three sections – duodenum, jejunum and ileum. The jejunum is the longest section of the small intestine.

“Surgery is risky but there is a chance it would heal Twinkle so we go ahead. We will do whatever we can to give her a fighting chance.”

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To provide nutritional support, an esophagostomy feeding tube is inserted when Twinkle was still under GA. This tube is slightly larger than a naso-esophageal tube & enters the esophagus through a small incision in the neck.

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Back home with her full-time best friend & part-time bodyguard!

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The larger diameter of the esophagostomy feeding tube allows thicker food to be fed, in lesser time & with fewer clogs.

proper nutrition is critical for successful recovery from any disease

If your cat refuse food for more than two days, consult your veterinarian immediately. Force-feeding is unpleasant for cats. There is an increased risk of your cat inhaling food into the trachea or windpipe and developing aspiration pneumonia.

how to encourage your cat to eat
  • Slightly warm the food prior to feeding.
  • Offer frequent, small meals of odorous, highly palatable food.
  • Hand feed or gently place small morsels of food on your cat’s tongue.
  • Feed in a quiet and comfortable area.
26 september 2016 – back for review

Twinkle is eating about 20g of kibbles on her own daily, supplemented with tube feeding.

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Dr Patrick Maguire examined the incision site at her abdomen which has healed nicely. The sutures were removed.

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The area where the tube enters the skin should be checked every day to make sure it is not clogged Any sign of infection (e.g. pus-like discharge or foul smell) requires veterinary attention.

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“So what did you say I have…?”

Histopathology revealed feline eosinophilic gastrointestinal sclerosing fibroplasia (FEGSF), an uncommon inflammatory disease affecting the stomach or intestines. This condition is treated with steroids and antibiotics to control inflammation and prevent recurrence.

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Twinkle listens patiently as Dr Nathalee Prakash explains her condition

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“Twinkle is family. When we choose to welcome an animal friend into our lives, we have to commit to the animal for the rest of his or her life.” ~ Mr Chia & Julie

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Rest & recover, Twinkle!

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One of her favourite spots

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Still thin but we will get there!

18 October 2016 – recovering well

Twinkle now weighs 4kg (up from 2.92kg). She is eating about 80g of dry food on her own in addition to 4-hourly liquid food and medication through tube feeding.

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“Twinkle has started to venture out of our study room/recovery room to the living room & various favourite spots.”

24 october 2016 – off with the feeding tube!

Twinkle returned for review and ultrasound. The feeding tube is removed as her appetite is good. She is eating well on her own!

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Well done Twinkle. Keep getting stronger!

“Twinkle is family. When we choose to welcome an animal friend into our lives, we have to commit to the animal for the rest of his or her life.” ~ Mr Chia & Julie


In the earlier days….

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Ebony & ivory

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Twinkle’s 1001 positions!

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“It fits I sits”

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“Let me out. I smell dinnerrrr!”

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“Let meow help you…”

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No one tells them they are different. So they live together in perfect harmony – Twinkle & Heidi. Ebony & Ivory!