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Hi to you all - I thank you in advance for sharing your wealth of knowledge. I have had cates my entire life and this is the first time I've encountered liver problems in my beautiful boy Alfie.
Details. Domestic Short Hair.
Alfie has always been slender by nature, but had weight loss in May, resulting blood tests showing elevations as seen in the attached files. To summarize elevated levels:
May 30th, 2023
PHOS: 3.0 mg/dL LOW (3.0 mg/dL)
CA: 11.8 mg/dL HIGH (reference range 7.8 -11.3)
Glob 6.0 g/dL HIGH (reference range 2.8 - 5.1)
ALT 409 U/L HIGH (reference range 12-130)
ALKP 246 U/L HIGH (reference range 14-111)
June 13th. 2023 after 2 weeks on Denamarin, and Clavamox.
PHOS: 2.8 mg/dL LOW (3.0 mg/dL)
CA: 11.4 mg/dL HIGH (reference range 7.8 -11.3)
Glob 5.8 g/dL HIGH (reference range 2.8 - 5.1)
ALT 347 U/L HIGH (reference range 12-130)
ALKP 155 U/L HIGH (reference range 14-111)
July 12th. 2023 after Denamarin and Clavamox were stopped due to stress caused by administering meds *values went up without Denamarin, down with it.
PHOS: 3.7 mg/dL Normal range (3.0 mg/dL)
CA: 11.2 mg/dL Normal Range (reference range 7.8 -11.3)
Glob 5.9 g/dL HIGH (reference range 2.8 - 5.1)
ALT 399 U/L HIGH (reference range 12-130)
ALKP 211 U/L HIGH (reference range 14-111)
All other values are in the normal range.
Urinalysis not completed due to empty bladder
Fecal not completed
Free T4 and was in normal range - waiting on actual results from the vet.
Alfie had an ultrasound on July 17th, 2023, results were not provided until 8.5.23
The ultrasound results are overwhelming and I can't quite figure out how to interpret them; even the vet said there is a lot to process and nothing conclusive.
They would like to do a biopsy, but as they already said his liver was very vascular, I am very concerned about him bleeding out and inconclusive results which has happened so many times with my cat (promises of a diagnosis that didn't arrive).
The vet said it could be liver disease, liver cancer, lymphoma, or none of those. No masses were detected but lots of inflammation. Spleen normal.
The good stuff:
He has been back on Denamarin and we've added in daily b12.
He was 7.5 lbs and weighed in at 8.2 lbs yesterday. He isn't a big eater but has been eating enough to put on some weight.
He's bright in himself and playful.
Poop is normal
Pee is a normal amount
The not-so-good stuff:
He didn't eat well today though he seems hungry and keeps checking for food which when offered he is walking away from.
He threw up 4 times today, which is new:
2 clear liquid vomits in quick succession with cat hair (not a hairball) but not any food.
The 3rd time he threw up, he had eaten a decent amount of food, but then he regurgitated it within 2 minutes and there was grass in it.
4th time he ate grass and threw the grass up shortly thereafter, no food as he hadn't eaten
*He ate a little this evening and has kept it down
He is stretching a lot, like his little tummy might be hurting?
I spoke with the vet today and she wants me to give Cerenia pills and start Mirataz transdermal, both seem reasonable to support Alfie, but I read that Cerenia is not always advised with liver issues as it makes the liver work harder.
The vet doesn't seem overly concerned, which seems odd? But that may be because today is the first day of vomiting.
Would love all advice about the next steps. I've attached his bloodwork and the ultrasound results and I would be so grateful for all of your suggestions.
Food wise, the vet gave us the i/d prescription diet, but we are also giving some for struvites. Really he just wants to eat Meow Mix which is crap, and we were able to switch all of our cats over to wet food until recently and it has definitely helped Alfie put on some weight I would say, despite my serious reservation about any dry food.
What food suggestions do you have to keep him eating?
I have found that those on a forum usually have the best advice due to living these experiences and I thank you so much for your time.
Details. Domestic Short Hair.
Alfie has always been slender by nature, but had weight loss in May, resulting blood tests showing elevations as seen in the attached files. To summarize elevated levels:
May 30th, 2023
PHOS: 3.0 mg/dL LOW (3.0 mg/dL)
CA: 11.8 mg/dL HIGH (reference range 7.8 -11.3)
Glob 6.0 g/dL HIGH (reference range 2.8 - 5.1)
ALT 409 U/L HIGH (reference range 12-130)
ALKP 246 U/L HIGH (reference range 14-111)
June 13th. 2023 after 2 weeks on Denamarin, and Clavamox.
PHOS: 2.8 mg/dL LOW (3.0 mg/dL)
CA: 11.4 mg/dL HIGH (reference range 7.8 -11.3)
Glob 5.8 g/dL HIGH (reference range 2.8 - 5.1)
ALT 347 U/L HIGH (reference range 12-130)
ALKP 155 U/L HIGH (reference range 14-111)
July 12th. 2023 after Denamarin and Clavamox were stopped due to stress caused by administering meds *values went up without Denamarin, down with it.
PHOS: 3.7 mg/dL Normal range (3.0 mg/dL)
CA: 11.2 mg/dL Normal Range (reference range 7.8 -11.3)
Glob 5.9 g/dL HIGH (reference range 2.8 - 5.1)
ALT 399 U/L HIGH (reference range 12-130)
ALKP 211 U/L HIGH (reference range 14-111)
All other values are in the normal range.
Urinalysis not completed due to empty bladder
Fecal not completed
Free T4 and was in normal range - waiting on actual results from the vet.
Alfie had an ultrasound on July 17th, 2023, results were not provided until 8.5.23
The ultrasound results are overwhelming and I can't quite figure out how to interpret them; even the vet said there is a lot to process and nothing conclusive.
They would like to do a biopsy, but as they already said his liver was very vascular, I am very concerned about him bleeding out and inconclusive results which has happened so many times with my cat (promises of a diagnosis that didn't arrive).
The vet said it could be liver disease, liver cancer, lymphoma, or none of those. No masses were detected but lots of inflammation. Spleen normal.
The good stuff:
He has been back on Denamarin and we've added in daily b12.
He was 7.5 lbs and weighed in at 8.2 lbs yesterday. He isn't a big eater but has been eating enough to put on some weight.
He's bright in himself and playful.
Poop is normal
Pee is a normal amount
The not-so-good stuff:
He didn't eat well today though he seems hungry and keeps checking for food which when offered he is walking away from.
He threw up 4 times today, which is new:
2 clear liquid vomits in quick succession with cat hair (not a hairball) but not any food.
The 3rd time he threw up, he had eaten a decent amount of food, but then he regurgitated it within 2 minutes and there was grass in it.
4th time he ate grass and threw the grass up shortly thereafter, no food as he hadn't eaten
*He ate a little this evening and has kept it down
He is stretching a lot, like his little tummy might be hurting?
I spoke with the vet today and she wants me to give Cerenia pills and start Mirataz transdermal, both seem reasonable to support Alfie, but I read that Cerenia is not always advised with liver issues as it makes the liver work harder.
The vet doesn't seem overly concerned, which seems odd? But that may be because today is the first day of vomiting.
Would love all advice about the next steps. I've attached his bloodwork and the ultrasound results and I would be so grateful for all of your suggestions.
Food wise, the vet gave us the i/d prescription diet, but we are also giving some for struvites. Really he just wants to eat Meow Mix which is crap, and we were able to switch all of our cats over to wet food until recently and it has definitely helped Alfie put on some weight I would say, despite my serious reservation about any dry food.
What food suggestions do you have to keep him eating?
I have found that those on a forum usually have the best advice due to living these experiences and I thank you so much for your time.
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