Alfie, 12, Elevated Liver Enzymes. All advice gratefully received.

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sebbyz1969

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Hello! I am so sorry for the delayed update. Alfie is holding his own, he's on minimal medication at the moment, Denamarin for his Liver, B12, and lactulose, occasional mirtazapine, and ondansetron. Weight is stable at 8lbs. Minimal vomiting, usually clear fluid, and grass. He's happy and playful. The course of antibiotics did not improve the liver results so those were stopped. The hypercalcemia diagnosis seems incorrect. The specialist wants to do a Fine Needle Aspirate as I did not want to do the biopsy because of the risk factors. The specialist said the results may be enough for a diagnosis, but obviously not as good as a full biopsy; she says that the FNA isn't very risky and she's only seen one complication in 16 years, and the cat needed a blood transfusion and survived and they would run a clotting test before taking the aspirate. I am still freaking out about it. It's scheduled for December 15th, 2023. Should I do it? Blood results compared below. Lots of high liver values.
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fionasmom

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The specialist said the results may be enough for a diagnosis, but obviously not as good as a full biopsy; she says that the FNA isn't very risky and she's only seen one complication in 16 years
This is basically true. FNAs are not as helpful as the full biopsy, but in the case of my Chelsea who had SCL, I also declined any invasive biopsy. FNAs are generally safe and it does sound as if your vet is willing to take precautions.
 

silent meowlook

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Are you talking about a fine needle aspirate of the liver? If so, I would do it. I might also want to repeat the ultrasound. Did the specialist mention anything about a bile duct obstruction?
 
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sebbyz1969

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Hi S silent meowlook

Thank you so much for your insight! The specialist did not mention anything specific about a bile duct obstruction - I wish I had seen your message before the appointment...drats. I will call and ask about it.

Thank you all for your kindness.

They did an ultrasound-guided FNA of the liver and gallbladder today so we are hoping to yield some results that will help our little guy. He was so brave and is recovering well.

I asked them to run a blood panel before the procedure to see if there was anything that would suggest they shouldn't do it (not that I know what that might be) and the Specialist said that his values are trending upwards but not by much and I must confess, I have missed a few of the Denamarin doses as it's sometimes tricky to catch the 3 hour 'no eating' window as he's so slender that I feed him whenever he asks.

Must do better.

Here's a little Alfie in the carrier face on the way home. Might be the cutest picture ever.
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cosima53

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One of my cats is at the beginning of what seems like a similar situation to your sweet Alfie. Have you learned any more about the cause? I've found your thread really helpful for trying to figure out where to start with my kitty. I hope you're both doing well!
 
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