Liver Values Off The Charts In Spoon. Any Ideas What I'm Looking At Dealing With?

[daftcat75]

If she stops eating long enough, she may develop a liver condition that is treated by aggressive re-feeding. Unless the vet says you should specifically withhold food for a test or procedure, feed away. As often as she will eat. You may have to start with small portions more often depending on how long she hasn’t been eating to insure that what she eats stays down. Like people, a cat’s stomach can shrink from prolonged not eating. Take it small and often and slowly grow the portion size as she can tolerate it.

 

[EveAndHerThieves]

Okay, I'll start poking food down her. The vet suggested kitten food because of the higher calorie content. I got a few different brands (it was on super sale) to see if she will eat. I think the problem now is she's VERY skitterish. She doesn't want me watching her eat. And she doesn't like me shoving food at her. She's turned it down most of the day. I'm going to lock her in my room overnight with some canned food and water. We'll see if she pees.

With very wet canned cat food I'm not *as* concerned about water intake. I know from Clyde that canned cat food can have a high water content if you do it right. Last thing I want to do is end up force feeding her. She's so timid I don't want to do more harm than good.

She does seem to prefer smaller portions. If it's tuna she will shove down half the can, which I think is related to fear of someone taking it than hunger. With the canned food she takes a bit or two, then goes off to do whatever it is she does.

She's still VERY active. With Clyde's kidney I saw a massive decrease in activity. Spoon is so active I can't even find out if she's using the litter box. She goes outside often, and is good at vanishing. If she's pooing it's not in a place I can see. Maybe if I lock her in my room overnight she'll pee for me.


I never thought I'd celebrate the day I got crapped on. Cat poo was gross until Clyde started getting stocked up easily. I'd cheer him every night he peed. My cockatiel crapped all over me the other day - a good sign since she was also stocked up due to age. Now I'm waiting for Spoon to poo on me. *Sigh*.

The vet didn't get her meds in today, so we start tomorrow. Those things are freaking expensive! $53 for a 30 day supply.

I think now that the horror of losing my last connection to the past has faded, and the shock that yet *another* cat is sick, I've pulled up my Big Girl panties and got ready for war again. Spoon is going to either hate or love me by the time we're done.

 

[daftcat75]

It’s more important that she eats first before you can get her eating well. If she will eat tuna, give her a treat pot like Pure Bites or Reveal that’s just tuna in water. Or my Krista actually enjoys Tiki Cat Ahi Tuna food more than the tuna treat pot. Which is okay by me. Especially if she hasn’t been eating for awhile, regular cat food may be a tough sale. I’d start with the tuna and when she’s got food back in her and asking for food, you can slowly transition her to regular cat food (or tuna flavored cat food.)

 

[Furballsmom]

...I can't remember if I mentioned this, but (by the way GOOD FOR YOU!!) try flat paper plates. Nobody knows why, but it often works to get a food-stubborn cat to eat.

 

[Kflowers]

have you tried mixing the tuna she likes with the kitten food?

 

[EveAndHerThieves]

Not a great update. Vet says she *has* to have the ultrasound. No payment plans as it's an outside company. And we're going to have to start force feeding her.

I don't know that I can do this again. Every penny I have was budgeted out to try to get my husband immigrated. So I can try to save my childhood feline, who is a literal therapy cat for my brother, or I can get my husband here after 10+ years.

I've no friends/family I can ask, either. I can't let this cat die without trying, but I can't afford to try. Ugh. And what if we get in and find cancer? It's a giant money pit.

 

[Furballsmom]

 

[daftcat75]

Ask your vet about a feeding tube, subcutaneous fluids, a B-12 shot, and an appetite stimulant. The feeding tube isn’t as extreme as it sounds. It will be cheaper than an ultrasound and it buys you time to think over your options. Plus she may very well start to feel better once you can get nutrition back in her. I promise you will be more freaked out by the tube than the cat will. As she gets food in her belly again, she will likely feel more like eating on her own and the tube won’t prevent her from doing that. The feeding tube will be much less stressful than force-feeding. The only time Krista didn’t just sit patiently during the tube feedings until we were done was when I fed too cold or too fast. Once I got this down, she was a breeze. She would never sit still for a syringe feeding (force feeding by mouth.) The B-12 and the fluids will give her an immediate wellness boost. She’ll feel better in the moment. It’s not a long-term or even a short-term plan. But something like a tonic to make her feel better that day. B-12 shots are something you could schedule for weekly or buy a bottle and syringes and learn how to give the shots at home. Not that hard. They go under the skin, not into a vein. If you do the feeding tube, then you can insure she gets enough moisture that the fluids will only be done once. You’re giving her fluids because if she’s not eating, she will be dehyrated and that will make her feel less like eating.

Feeding Tubes For Cats

 

[daftcat75]

Time to get real with your vet or find another vet. Your cat doesn't have to have an ultrasound. An ultrasound is not a life-saving procedure. It's a valuable diagnostic tool. But it also has limitations. If you're running out of money, an ultrasound wouldn't be the end of your expenses. While an ultrasound can also detect changes in the liver and pancreas, usually it is used to look at the small intestine to see if there is thickening consistent with chronic inflammation. The ultrasound's biggest limitation is that it can't tell the difference between IBD and small cell lymphoma, the two main reasons why the intestinal wall is thickened. To make that determination, you would need an even more expensive procedure: an endoscopy with a biopsy. And then? If it's IBD, you'll probably be told she needs prescription food (you can pass on that), steroids, and possibly supportive meds like anti-nausea, appetite stimulant, anti-emetic (prevents vomiting.) If it's cancer, you'll add a chemo drug to that stack. And regardless of which one, she will need B-12 to make a meaningful recovery. If the ultrasound also shows inflammation in the pancreas (pancreatitis), you'll likely need the same supportive medicines and maybe steroids. But you'll also want to aggressively re-feed and make sure she gets fluids to correct for any dehydration.

But all of this is irrelevant if you can't get her eating enough.

So what I would suggest:

1. In the immediate term, as soon as you can get the appointment, get a feeding tube, a B-12 shot, subcutaneous fluids, and possibly an anti-emetic like Cerenia. At least until you figure out which foods to feed her, how watery, how warm, how fast, etc, it would be nice if she didn't vomit up your mistakes.

2. In the medium term (next week or two), ask your vet about buying a bottle of B-12, the syringes, the used needles disposal box, and a tech appointment to learn how to give the shots yourself.

3. In the medium- to long-term, depending on your finances and how well she does with B-12 and re-feeding via feeding tube or on her own via appetite stimulant or both, you can discuss a more long-term treatment plan with your vet. Explain that you appreciate his desire to be thorough and accurate but you just can't afford that level of due diligence. Given that, map out a few possibilities of what she might have and how it might be treated. Ask about starting down one of these paths and re-evaulating after some appropriate amount of time. For example, you can start steroids, and if she continues to lose weight despite eating well (and keeping it down), you may consider the option that it could be cancer and switch to chemo instead. Ask the vet to list a few possibilities, their treatment plan, and break down by (estimated) cost, if possible.

Your vet should be able to have these conversations with you. If he insists on doing it his way, find another vet.

 

[Mamanyt1953]

Second opinions are NEVER a bad idea, especially in cases like this. I know money is tight, I SO get that, but a new set of eyes on the problem might be just the ticket.

 

[Kflowers]

Agree with Daftcat75.

Once the feeding tube is in it's nothing. After the first meal, no trying to edge away. AND the medicine goes right down it without a fight. Our cat - the totally unpillable - had a feeding tube while living and interacting with four others and two dogs. No problem. You get used to seeing it within hours, not days. You put the syringe into the tube and just put one cat mouthful down at a time -- no matter what the people at the vet tell you -- one mouthful at a time. It has to go from the esophagus into the stomach and that is set up to only move so much at a time. Patience and small bites keeps it from coming back up.

The feeding tube is not a dangerous thing. Our vet seemed to think it was safe as safe can be.

 

[Mamanyt1953]

no matter what the people at the vet tell you -- one mouthful at a time. It has to go from the esophagus into the stomach and that is set up to only move so much at a time

YEP! Think about eating rice too quickly when it all seems to jam up in your throat!

 

[daftcat75]

If you go with the feeding tube, I recommend you order a Kitty Kollar first and give it to the vet so they can size the tube to the collar. Krista and I had too much drama and comedy over the tube not being long enough (and the cap flying everytime she shook her head--a problem solved with masking tape.)

Kitty Kollar-Special Hugs for special kitties (Kanine Kollars too)

 

[Kflowers]

Right oh, daftcat75 . We didn't do a collar, which made the fitting business slip my mind. I always like to find the most complicated way to do things, but I'm working on it. Measuring before cutting, measuring before buying, so simple and yet so hard to remember.

 

[EveAndHerThieves]

Sorry for a late reply. I'm hoping it doesn't come to a feeding tube! My sister had one when she was born, so I know how to work one, I think.

All that about testing sounds scary. Just to rule it out for my own sanity - it wouldn't be caused by her teeth being sore, not eating, and the lack of food messing with her liver, would it? Or her being too scared to eat due to Rue in the basement? It's for sure something else to look at, right? I know nothing about livers.

She's eating a little bit, slowly. She will eat SOME canned cat food if I REALLY water it down and she can drink it. I think today she's eaten an entire can of food. She comes down and sits on a stool and asks for it. You can almost see her saying "I'm starving!" The biggest thing against me is her pickiness. She will only eat a FRESH can of food. It cannot go in the fridge, or be wrapped up for later. It has to be FRESH. I don't know if it's the gravy that comes with it, or what. But after it's been a few hours she won't touch it at all. I managed to get some down a few hours later by adding more water to drink.

I put food upstairs for her to eat in case it's the basement. She keeps getting close with her mouth, licking and then dropping it. It took five minutes before she got an entire piece in her mouth. She HATES being watched so it's hard to get video. The vet did show me how her front gums on the top of her mouth were very sore.

I know I'm holding onto the dental thing far too much, but seeing her not be able to eat normal food kind of leads me to believe it may be sore. She will still spend hours trying to get into the treat bag, though. She seems more relaxed and happier today. She even came down to be social.

I'm thinking of shopping around for another opinion. I know it's important to test to rule out cancers, but $500 is just not something I have laying around. I'm glad she's not in pain, at least. She went outside to roll in the dirt earlier. So. Much. Dirt. She also doesn't seem to pace as much.

 

[daftcat75]

Skip the ultrasound and invest in a dental with anesthesia, mouth X-rays, and any necessary extractions. She is most definitely in pain. Cats won't cry out in pain because to do so would be to ring the dinner bell for a predator. Cats also have no knowledge of dentistry and that mouth problems can be fixed. So they will suffer mouth issues in silence until the pain exceeds their hunger. A cat can be eating through mouth pain for a very long time before they finally stop eating. Texture preferences, temperature preferences, showing interest in eating but not being able to, licking food but not biting it, letting solid food drop out of her mouth--these are all signs of potential pain.

I would treat her mouth as the primary problem and the liver as a reflection of how angry her gums are. Here's the thing with any other diagnosis you may seek or receive. She needs to eat to live. Whether it's IBD or lymphoma doesn't matter if she's not eating. She won't survive either treatment plan without nutrition. So either you put a feeding tube in her and take the burden off her mouth or you fix her mouth and hopefully avoid the need for a feeding tube.

It is entirely possible that if you treat the mouth, give her a B-12 booster shot and fluids for dehydration, that she could eat herself back to health without a need for any other intervention. Or the mouth could just be a complicating factor. But it is the most complicating factor right now. Without nutrition, none of the rest of it matters.

 

[daftcat75]

D-Link makes a good webcam that sells for $60. It's about the size and shape of a salt shaker. That could solve the "she hates being watched" problem.

 

[Mamanyt1953]

I'm thinking of shopping around for another opinion.

NO caring, reputable vet would fault you for seeking a second opinion. And if it would ease your mind regardless of the outcome, go for it! It certainly isn't going to hurt a thing.

If you are in the US, you can find a feline specialist at this site, just be sure to select the "Cat Only" option, not the "Cat Friendly", which by law might only mean that the receptionist likes cats!

AAFP | American Association of Feline Practitioners

 

[EveAndHerThieves]

Thank you for the advice! I'm on mobile or I'd tag you all.

Doing research I don't see a single thing that is curable. I keep hoping, though.

For now at least I have her eating.


this is how she eats food/drinks water (including milk when someone has cereal like they do once in a blue moon) she paws, then licks. (Ignore the mess/chickens in the background. I have babies currently)

If I just drop it splat on the floor she will eat it.


Messy, but it gets food down her. My other cats finish it after she's done. You can see she doesn't bite and just licks. Despite having cats for 20 years I can't for the life of me remember if that's normal or not.

I think the medication may have done something, or it's bad timing. She's now sneezing a lot? Non of my other cats are sick. But her voice isn't scratchy/gone like it was last week. She now meows in greeting again. She tried to before, but her voice was shot.

Keeping her in canned food is expensive!! I've been buying Fancy Feast Classic at the store for 66 cents. She usually goes through most of the can before she won't touch it. I figure we need to get SOMETHING down her. We will work on healthy later.

I have noticed she eats warm food but not cold. Where she's a picky eater right now it could be me projecting, though.

 

[Kflowers]

hugs