BH is still in big trouble after returning from a 3 day ER stay last night - liver and ??

Status
Not open for further replies.

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
Well I'm on the roller coaster again, and it's not the fun kind. I'm pretty frightened.

Getting her to eat right now is top priority. She's not exactly co-operating.

She began this by slowly eating less and less. I watched her. Then the weight started to drop and I called her vet. I wasn't too worried at this point as I have a group of finicky eaters. So they do go back and forth.

Last Monday, the 19th, she saw her doc and her bloodwork was messed up and the liver very high. We decided on an US. I asked if an internist, rather than a regular 3rd party reviewed one would be better. The vet agreed. We managed at date of Sept 10th which was pretty far off but at that point I was worried but not panicked.

After mondays visit - she started to really tank. She went from eating bits to zippo and then zippo water on Wednesday. This happened incredibly fast.

BY thursday morning I was on the phone to her Vet letting them know - she's not going to make it to Sept.

Bless my Vets office and the amazing Vet tech... they fought for her and got her into an ER place with an internist. The kick was it's near 2.5 hours away. I sucked up all the bravery I had in me knowing I was going to have to leave her there without being able to visit and dropped her off Thursday night. I made another horrible choice and signed a DNR after reading all the stats for CPR. THis ER place was freaking amazing in everything they did and how they treated her.

She has a nasal feeding tube placed friday or sat?

They called yesterday afternoon that she had been eating on her own and liver values were going down. I picked her up and we got home last night 8 - 8:30 pm. She hasn't eaten since. When I called last night to find out what time she last ate, it was 9 am and 3 pm a few bites. Well crap. I think they released her back into the wild with me too soon.

I shoved some Mirtz in her about an hour ago. I called her vet and we have arranged tomorrow 8 am to have a tube placed because right now with her liver, this is way to risky to not have access to get food into her.

I'm trying as best as I can to prepare for the fact that I might lose her or have to let her go. I understand that might be the reality... but I'm not accepting that without a fight. No way. She deserves to be fought for.

--------------------------------------------------------------------------

Results of her testing:

There is a lot to this - I'm just giving you the basics

Bottom line is no one is 100% sure what even happened or is happening.

Blood:

To give you one of her liver values on Monday:
ALT 354
AST 131
ALP 114
Bilirubin - Total 4.8

By Thursday of Friday her alt was passed 630
Sat they started to come down and the atl was 524

There were issues in the urine on Monday we did a C and S - no bacteria.

US on Sat:

23-Aug-2024 Ultrasound Abdominal
14:48 Order item: US Abdominal [23.1]
Findings ULTRASOUND FINDINGS:

Routine abdominal ultrasound is performed in dorsal recumbency.

The liver is normal in size and subjectively coarse echogenicity. The gallbladder is normal.

The spleen is normal in size and echogenicity.

The kidneys are normal in size and echogenicity. The left kidney is 3.63cm in length. The right
kidney is 3.98cm in length with mild renal pelvic dilation up to 0.16cm. The urinary bladder is
markedly distended with anechoic fluid.

The adrenal glands are normal. The left adrenal gland is 0.25cm. The right adrenal gland is 0.32cm.

The stomach is mildly distended with echogenic material however amongst this material there is a
region of heavily shadowing material within the gastric lumen that affects a length of ~ 2.66cm.

The stomach can be traced through the pylorus to the duodenum with no active obstruction at the
time of the study. The duodenum is empty with preserved wall layering detail and is mildly
thickened at 0.23cm. The remainder of the gastrointestinal tract is unremarkable.

No other substantial abnormalities are noted.

Interpretation

1) There is a possible gastric foreign body amongst normal appearing ingesta in this study. This
material may be intermittently causing gastric outflow obstruction.

2) There is mild duodenal thickening. This may be secondary to non-specific enteritis, however
dietary sensitivity, IBD/CE, or LSA are also potential differential diagnoses.

3) There is mild right renal pelvic dilation. This may be secondary to partial or previous ureteral
obstruction (d/t ureterolith or circumcaval ureter), or could be secondary to diuresis or
pyelonephritis.

4) A cause of elevated liver parameters is not apparent in this study. Given the patient's history of
chronic gastrointestinal signs, triaditis/cholangiohepatitis, should be considered. Hepatic lipidosis
is also a possible differential diagnosis.

Recommendations Consider ongoing supportive care for non-specific gastroenteritis/pancreatitis.
Consider the initiation of a beta-lactam (ampicillin) +/- metronidazole, ursodiol for
cholangiohepatitis or pyelonephritis

Nasogastric tube feeding is indicated if the patient continues to have a poor appetite.
If patient continues to be anorexiac and/or is vomiting, repeat imaging of the stomach +/- upper
gastrointestinal endoscopy may be beneficial.

---------------------------------------------------------

Meds - she is taking antibiotics in spite of no indication of infection as a precaution.

No one knows what's in her tummy but I would be really shocked to find out she ate anything weird as that would be really strange for her. Charlie - maybe - but not BH.

------------------------------------------------------------------

We will be talking about an endoscopy once we get over this emergency. Right now the main thing is to get her through this critical phase.

--
 
Last edited:
  • Thread Starter Thread Starter
  • #3

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
K Kflowers Nothing is small when it comes to getting our crazy kitties to eat.

They are feeding her kitten food and were kind enough to given me some varieties. Failed.

She did just eat two treats and less than an 1/8th of a can of wellness turkey and salmon, slightly warmed with a tiny bit of water- but it was so very little.

She looks like she wants to eat. I gave here a cerenia in case.
 
Last edited:

Kwik

Animals are Blessings
Top Cat
Joined
May 29, 2023
Messages
11,032
Purraise
22,919
Location
South Florida
Well- I know the story,you have a good Vet and a good plan in place stick to the plan and take one day at a time

Once she's eating well steadily on her own for some time you can remove the feeding tube and by then hopefully she'll be off to a good start

She lost alot of nutrients and they need be replenished pkus the medication controlling the flow of bile will help get her back,just have to keep her from vomiting with the meds prescribed..... you're certainly doing all you can possibly do -stick to the treatment plan you work out with your Vet

I'm a little talked out after last night- lol You know I'm in your corner ❤❤❤❤❤
 
  • Thread Starter Thread Starter
  • #5

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
Kwik Kwik yes lots going on!

and yes, you know all :-) XO edit to add: Bless you.

One day, one minute.

Sticking to the plan. The locum vet she'll see tomorrow is a cool cat and someone I'm comfortable with.

She's passed out again. I have some liver meds to give her at 2:30 so I can try to feed her again at 3:30. (Zentonil) It's hard waiting to try to feed her again.

Posting everything in case someone out there needs this info for their own at some point. Though I truly hope not.

-------
 
Last edited:

Kwik

Animals are Blessings
Top Cat
Joined
May 29, 2023
Messages
11,032
Purraise
22,919
Location
South Florida
Kwik Kwik yes lots going on!

and yes, you know all :-) XO edit to add: Bless you.

One day, one minute.

Sticking to the plan. The locum vet she'll see tomorrow is a cool cat and someone I'm comfortable with.

She's passed out again. I have some liver meds to give her at 2:30 so I can try to feed her again at 3:30. (Zentonil) It's hard waiting to try to feed her again.

Posting everything in case someone out there needs this info for their own at some point. Though I truly hope not.

-------
The meds are likely making her drowsy - especially after what she's been through and all
 

silent meowlook

TCS Member
Staff Member
Forum Helper
Joined
Nov 10, 2014
Messages
4,717
Purraise
8,954
I would definitely have an esophageal feeding tube placed. I don’t know why the ER placed a nasal instead. But, you need an esophageal tube and you have to have it remain in long after her appetite is normal. This will make feeding and medicating much easier. Is she on Denmarin? I would look into that if not.
 
  • Thread Starter Thread Starter
  • #8

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
She ate a few more bites.. and for those who think cameras aren't worth it....

I watched her on the camera recording go into Mia's room (it will forever be called Mia's room), she went to an area where at night I put some dry food and she saw none. The second I saw that I went "Right, let's try some dry" She ate about 1/8 of a cup of that and ... I did give her some ground turkey, extra lean and she ate some of that.

The meds are likely making her drowsy - especially after what she's been through and all
Yes, quite. She's perking up a bit tonight but you are right she is probably completely zonked after everything.

I would definitely have an esophageal feeding tube placed. I don’t know why the ER placed a nasal instead. But, you need an esophageal tube and you have to have it remain in long after her appetite is normal. This will make feeding and medicating much easier. Is she on Denmarin? I would look into that if not.
Hi S silent meowlook nice to see you and thank you.

I think they were trying not to sedate her too much. She's, luckily, very good at taking pills - and very good with 100MG gaba in her at sitting still for x-rays and ultrasounds.

I had to think about this the last few days (why the nasal tube instead) as my brain is somewhat fried. One of the reasons for that, I think, is when I took her in several years ago for pillow foot the clinic knocked her out and she stopped breathing. I made sure the ER place had the info about when, what was used and how they stopped her from dying.

She is on Zentonil, I think that's the same thing different name?

She takes pills like a champ. Even this massive Zentonil one. So this a blessing we have going for us.

------
 
Last edited:

Kwik

Animals are Blessings
Top Cat
Joined
May 29, 2023
Messages
11,032
Purraise
22,919
Location
South Florida
She ate a few more bites.. and for those who think cameras aren't worth it....

I watched her on the camera recording go into Mia's room (it will forever be called Mia's room), she went to an area where at night I put some dry food and she saw none. The second I saw that I went "Right, let's try some dry" She ate about 1/8 of a cup of that and ... I did give her some ground turkey, extra lean and she ate some of that.



Yes, quite. She's perking up a bit tonight but you are right she is probably completely zonked after everything.



Hi S silent meowlook nice to see you and thank you.

I think they were trying not to sedate her too much. She's, luckily, very good at taking pills - and very good with 100MG gaba in her at sitting still for x-rays and ultrasounds.

I had to think about this the last few days (why the nasal tube instead) as my brain is somewhat fried. One of the reasons for that, I think, is when I took her in several years ago for pillow foot the clinic knocked her out and she stopped breathing. I made sure the ER place had the info about when, what was used and how they stopped her from dying.

She is on Zentonil, I think that's the same thing different name?

She takes pills like a champ. Even this massive Zentonil one. So this a blessing we have going for us.

------
She was sent to the specialist in crisis,no specific diagnosis at thst time so the NG is typically preferred especially in an emergency situation like this one- they are inexpensive,do not require gen anaesthesia & they could quickly administer nutrients,meds,adding contrast to view scans better and not meant
for long term use

Since preparations were made by your primary Vet and she is his patient ( they had her records history available from him)could be a factor as well- usually a tube would not be removed until after she's eating on her own for at least a week so I'm not sure why she was discharged so quickly but Im not going to speculate or assume anything as your follow up is with your own Vet and he'd be best to answer those questions

Given the terrible circumstances and no ERs that could help ( after your 200 phone calls) your decision to take the trip was a good one because she was fading fast if you went anywhere they'd of inserted a tube one way or the other to save her life only to make it to Sept 10th.

Now your Vet knows how to treat her and plan for her recovery because the purpose of the Sept appt is accomplished as well- she's already started part of her treatment plan

You've been a real trooper through all of this,so many obstacles yet you stopped at nothing for your little one and would've driven to the ends of the earth for her- it's a Blessing you were able to and God Bless you kiddo❤
 

stephanietx

TCS Member
Veteran
Joined
Dec 1, 2005
Messages
15,065
Purraise
3,843
Location
Texas
From what I read, it seems like they are treating it like gastroenteritis and/or pancreatitis? Did they give you anti-nausea meds for her (Zofran/Ondansetron or Cerenia)? Did they give you prednisolone to decrease inflammation? Did they give her any B12?
 

Kwik

Animals are Blessings
Top Cat
Joined
May 29, 2023
Messages
11,032
Purraise
22,919
Location
South Florida
From what I read, it seems like they are treating it like gastroenteritis and/or pancreatitis? Did they give you anti-nausea meds for her (Zofran/Ondansetron or Cerenia)? Did they give you prednisolone to decrease inflammation? Did they give her any B12?
Imo critical issue is the hepatic lipdosis which is currently being treated with ursodial in which ,with early detection and proper treatment 90% cats fully recover with no recurrence - there is also indication of possible pancreatitis which further testing is required and more specific (fPLI) so the Vet can establish the severity by markers( or mild?)and treat accordimgly- this and the GI underlying issues will most assuredly be treated as well after her follow up with primary Vet

An endoscopy is really the next step after she is in more stable condition.....

What really breaks my heart is the fact that what it comes down to most times is expenses and affordability- even with insurance and what they are willing to pay for and cover the costs of....each issue in of itself is not life threatening with proper treatment for acute or chronic but the tests required and procedures to accurately diagnose are absolutely off the charts plus the risks involved ...
The same scenario for a human would run up around $80,000 and most insurances would cover every penny- are a pets life lesser valued?

Sorry,I'm just venting,pouring out my innermost feelings because if we were millionaires we would not have to make any decisions other than- do it!Feral would not have had to drive 21/2 hours- she could've flown anywhere to a top specialist- kitty would be hospitalized until she was galloping around .....I know I'm going off topic so forgive me,these situations just weigh very heavy on us all
 

Kwik

Animals are Blessings
Top Cat
Joined
May 29, 2023
Messages
11,032
Purraise
22,919
Location
South Florida
This morning my Timmy didn't want any of his wet food and with so many cats and so many of my own health issues going on I just started to cry- crying not because it caused me to worry about an underlying condition ( he likes me to bring his food in the living room away from everyone else and eat on my lap - he's doted on and spoiled terribly) but just thinking of all Feral is going through ,how much it has cost her so far and she's got more to go....it just broke me

I thought" if this was my Timmy or any of them" what the heck would I be able to do?" This girl is a WARRIOR! I don't know maybe when you really really care about someone special it hits that much harder- of course we feel terrible for all cats that have health problems and we can relate to & sympathize with all pet parents but when they are your friends..... Uh boy,you just want to hug them and make it all go away,make it all okay..... Kwim?

For me ,after my Cheech passing and the experience of the ' no appetite" horrors it's a touchy subject by far....I hope and pray NO ONE ever has to experience it- never
 
  • Thread Starter Thread Starter
  • #14

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
Update: Cameras for the win again. She started eating more bits last night and today. She eats a few bites, sometimes more, goes to sleep for an hour, rinse and repeat. She was way more herself late last night and came to sleep with me, which she hasn't done since she started to take the downward spiral.

The wet food - she is completely off that. Doesn't want it but as long as she drinks and eats - I can live with this.

She went to the vets this morning. Her regular Doc is taking a few well earned days off. We ended up getting the clinic owner as the attending. YAY! His Dad was a vet and well respected in the area and taught his son well. He is also well respected in his own right - which tells you a lot. He's very, very good and honest. I trust his judgement. He is good people.

No PEG right now and I understand why. (I'm actually a bit relieved on that one.) Since she is starting to eat more on her own he wants her to try to heal with as little stress and upsets as possible. I'm okay with that and I can respect and understand why he's going this way.

She goes back in Friday afternoon and we will assess and get her liver numbers. I asked about it today but it's too soon to really tell. So that's fair.

She's now up to near 3 pounds lost. 9.6 / 9.7 pounds. She is a small cat and had an extra pound on her for her ideal weight.


She was sent to the specialist in crisis,no specific diagnosis at thst time so the NG is typically preferred especially in an emergency situation like this one- they are inexpensive,do not require gen anaesthesia & they could quickly administer nutrients,meds,adding contrast to view scans better and not meant for long term use
That makes sense about the NG.


Since preparations were made by your primary Vet and she is his patient ( they had her records history available from him)could be a factor as well- usually a tube would not be removed until after she's eating on her own for at least a week so I'm not sure why she was discharged so quickly but Im not going to speculate or assume anything as your follow up is with your own Vet and he'd be best to answer those questions

Given the terrible circumstances and no ERs that could help ( after your 200 phone calls) your decision to take the trip was a good one because she was fading fast if you went anywhere they'd of inserted a tube one way or the other to save her life only to make it to Sept 10th.
Yeah all those calls made, mostly by the Vet tech at my clinic thought I made a bunch too looking to see who could manage her, but she did the bulk of it - the one far away was the only one she could go to that could manage her properly. Side note: That very same tech lost her own wee one over the weekend. Threw a clot. She brought her to our ER down here as there was no time to do anything else. Broke my heart for her after everything she did for BH. She deserved better.

Our ER local clinic is more like an after hours vet clinic. It would have been the last place I took BH if we couldn't do anything else. Not that they are horrible, but the other place was in a better position to manage her with specialists etc.

Sadly, the ER actually did not have the records about her stopping breathing. It's flagged at her vets office but they only sent from 2020. They wanted to make sure the ER clinic had both US, one for 2021 and 2023. During the intake the doc was talking about risks with anesthesia and since she's not had a problem before.. and I stopped him mid sentence and said, yes she did. He asked me to send them when I got home, so I did. Phew on that one.


Now your Vet knows how to treat her and plan for her recovery because the purpose of the Sept appt is accomplished as well- she's already started part of her treatment plan
Yes. Exactly and it looks like multiple issues need to be addressed. One step at a time. :-)

You've been a real trooper through all of this,so many obstacles yet you stopped at nothing for your little one and would've driven to the ends of the earth for her- it's a Blessing you were able to and God Bless you kiddo❤
Thank you. It was like the red sea parted for her and things fell into place. A far difference from what happened with her sister last year where everything that could go wrong, did. The perfect horrible storm.

It felt like I was leaving her at the end of the earth. It was so hard to leave her there knowing that if she died I would be there for her but I knew this was her best chance and as much as it would have hurt for her to die alone in a strange place... she was going to die at home if I didn't.

I was fortunate to that one of my friends drove us as they didn't want me to try to navigate the roads while worried about her and be a second ear that could step in if I forgot something or should ask something and didn't.

God bless you too Kwik for all the support keeping me sane while it was happening. ❤


From what I read, it seems like they are treating it like gastroenteritis and/or pancreatitis? Did they give you anti-nausea meds for her (Zofran/Ondansetron or Cerenia)? Did they give you prednisolone to decrease inflammation? Did they give her any B12?
Yes, same thing.
Yes , that appears to be the main thing they are treating right now. Along with fatty liver that was probably a result of this attack no doubt. She wasn't throwing up - nothing. Literally it was just eating less and less, dropping weight and then eating nothing at all - not even water. The day before she was depressed, hiding a bit, not coming to snuggle at night, lethargic. Not one medication was working to get her to eat.

Cerenia and Mirtazapine are the Anti-nausea meds. I have them on hand at home because I have not one, but two pancreatic kitties.

I have to look at the invoice better today as it is pages and pages and pages long. Very detailed by day, time etc. So I'm not sure on the pred. I know we were avoiding that as SCL was on the table and looks like that's back on the table as a maybe. If we have to test her for that pred will screw up the results.

We did a GI test for the B12 and I have not seen the results yet. I believe the main vet clinic received them last night so I'll get a copy today. or tomorrow to see where those levels are at.

Liver cancer is also on the table due to her age but her doc doesn't think that's it but sadly still a possibility. We will know more once we see her eating gaining weight and those liver numbers coming down.


Imo critical issue is the hepatic lipdosis which is currently being treated with ursodial in which ,with early detection and proper treatment 90% cats fully recover with no recurrence - there is also indication of possible pancreatitis which further testing is required and more specific (fPLI) so the Vet can establish the severity by markers( or mild?)and treat accordimgly- this and the GI underlying issues will most assuredly be treated as well after her follow up with primary Vet
She's not being treated with ursodial at this point. I have to take a good look at the invoice and see if they did at the hospital though. Charlie is being treated with that for his pancreatitis and doing pretty well with it. He's another unstable one though that goes back and forth like a yo-yo.

We did do the fPLI with her blood at the vets office on Monday - came back normal.

Her GI issue hopefully starts to improve.

What really breaks my heart is the fact that what it comes down to most times is expenses and affordability- even with insurance and what they are willing to pay for and cover the costs of....each issue in of itself is not life threatening with proper treatment for acute or chronic but the tests required and procedures to accurately diagnose are absolutely off the charts plus the risks involved ...
The same scenario for a human would run up around $80,000 and most insurances would cover every penny- are a pets life lesser valued?

Sorry,I'm just venting,pouring out my innermost feelings because if we were millionaires we would not have to make any decisions other than- do it!Feral would not have had to drive 21/2 hours- she could've flown anywhere to a top specialist- kitty would be hospitalized until she was galloping around .....I know I'm going off topic so forgive me, these situations just weigh very heavy on us all
No worries about venting - it can be very frustrating.

Her insurance has been pretty good. She doesn't have a lot of insurance, but having it takes at least some of the edge off in these situations. I've heard horror stories from other people about theirs and it's pretty crazy. I don't ever want to experience that. Mines only been as issue once *knock on wood* and it was because they had a hard time believing that my Vets office is as straight forward as they are. No SOAP notes. Everything is directly in the file and I both appreciate and value that they hide nothing. I think open communication, even if you need to slap a client a bit or be very direct because they need to hear something they otherwise may not, is invaluable. Especially when a furry one is sick.

Not everyone can afford insurance either. The girls have it as Charlie is a bit of a mess and uninsurable. After my experiencing with him - I made sure I got the girls some.

I've recommend them to several people, who thankfully have not needed to call on them. I figure that helps balance out my use. :-)

This morning my Timmy didn't want any of his wet food and with so many cats and so many of my own health issues going on I just started to cry- crying not because it caused me to worry about an underlying condition ( he likes me to bring his food in the living room away from everyone else and eat on my lap - he's doted on and spoiled terribly) but just thinking of all Feral is going through ,how much it has cost her so far and she's got more to go....it just broke me
HUGS you. It is the most frightening experience when they stop eating. It's up there as one of my top fears for them.

HAHA he is spoilt - good Timmy you know how to make your mama work for you. Is he eating now?

I'm so sorry you were crying. I am one of those who does believe a good cry is good for us as it releases things we hold in and gives us a chance to release it so we can feel fresh and get ourselves balanced again. You have many things going on as well and a dear heart for others. XOXOX


For me ,after my Cheech passing and the experience of the ' no appetite" horrors it's a touchy subject by far....I hope and pray NO ONE ever has to experience it- never
Same as Mia did the same and with her the meds didn't work either. I ended up hand feeding her. To say it was awful is an understatement. When BH wasn't responding to the meds either - my heart just sank.

I'm so sorry you had to experience that yourself.

I'm with you - it's not something I would wish on any one to have to experience.
 
Last edited:

Kwik

Animals are Blessings
Top Cat
Joined
May 29, 2023
Messages
11,032
Purraise
22,919
Location
South Florida
I'll be there for you for as long as I'm above the ground dear girl!Who else is up after midnight besides us 🤣just kidding- having someone to talk to helps ,it helps just knowing somebody cares and hears you

Well,keep the Red Sea split open Dear Lord so little BH can pass through !!! Love you Feral❤
 

silent meowlook

TCS Member
Staff Member
Forum Helper
Joined
Nov 10, 2014
Messages
4,717
Purraise
8,954
The hepatic lipidosis is always ( as far as what I’ve seen) secondary to another issue that has caused the decline in appetite. Sometimes the initial insult is never discovered but resolves.

You wouldn’t want to do a PEG tube on your cat. It is a more involved procedure with a higher chance of complications. If a PEG tube comes out it can be potentially fatal.

Esophageal tubes are easy to place, takes about 3 minutes for an experienced vet. While there can be complications, it isn’t at all like a PEG tube. If an esophageal tube comes out, it is no big deal.

If your cat is eating well then there is no need for a feeding tube.

When I worked specialty, the majority of liver cats were hepatic lipidosis or cholangiohepatitis. Have they discussed doing a needle biopsy of the liver? Might not want to risk it though. Especially if improving.
 
  • Purraise
Reactions: F+V
  • Thread Starter Thread Starter
  • #17

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
The hepatic lipidosis is always ( as far as what I’ve seen) secondary to another issue that has caused the decline in appetite. Sometimes the initial insult is never discovered but resolves.
Thanks for this S silent meowlook - it means a lot to me. I remember too how much you were there for me and Mia. It's beyond appreciated.

Exactly and that's what scares me a little. We are guessing as to what happened. Gastroenteritis and/or pancreatitis. It think it's a really good guess, and probably the right guess. Next fatty liver happened when she stopped eating. What I'm shocked about is how fast it happened. I knew cats can't go without eating for too long but this was such a fast downward spiral... I was not prepared.

This issue then is I had little to no indication from her that anything was up. That happened once with Charlie too when he had a pancreatic attack.

This is what they share in common:

-I know both of them have sensitive skin to the point where it hurts them to be brushed. I have to be very gentle. Even then I get bitten or hit. or even growled at.
-Both have pancreatitis
-Both have a tummy issue IBS/IBD/ Food sensitivities.
-Edit to add: both also have a cancer watch (differential diagnosis) on their on liver and intestines according to their US. (Possible SCL)
-Picky eaters.

Third kitty BH sister does not share of these. Mia also shared none of these. WL and Mia are/were the opposite. Love brushing, not picky eaters etc. Mia's cancer was completely different.

We know food and cats is not an issues with pancreatitis but IBS/IBD/ Food sensitivities is a food thing mostly.

What scares me is that, and this is not me beating myself up this is a fact, it means I've missed something in them. For her to be in the hospital with the limited indications she gave.... What did I miss? I'm careful with their food but obviously not well enough.

What am I going to feed finicky cats with food issues to help prevent this in the future?

While I hate the only dry food diet thing - I think at this point there is no choice but to only feed them the HP SO food. Nothing else.

The problem there is if they decide they no longer like that. However, I guess that's a problem for another day right now, but I have to think about that at some point as unfortunately it can be a reality. I had one cat do that already.

The questions for the poor vet.


You wouldn’t want to do a PEG tube on your cat. It is a more involved procedure with a higher chance of complications. If a PEG tube comes out it can be potentially fatal.

Esophageal tubes are easy to place, takes about 3 minutes for an experienced vet. While there can be complications, it isn’t at all like a PEG tube. If an esophageal tube comes out, it is no big deal.
I was surprised he had said PEG tube and I wondered why that would be the default thought and not Esophageal. Either way, I'm glad she is eating again and I'll keep a solid watch to make sure she gets enough. MAybe he thought, we I said I'd like to talk about a feeding tube (since she want eating) that I meant that kind? Communication gap maybe? Maybe that's their go to type?


If your cat is eating well then there is no need for a feeding tube.
I think that why they decided no. One the type of tube they were considering vs the fact that she began to start to eat on her own.

When I worked specialty, the majority of liver cats were hepatic lipidosis or cholangiohepatitis. Have they discussed doing a needle biopsy of the liver? Might not want to risk it though. Especially if improving.
We did discuss that this morning and I will preface what I saw with I am not 100% trusting with vets and docs. For a number of reasons. Not that I automatically distrust but I pay attention. My trust is earned, not given. Dr M who saw her today and Dr B that's her normally Doc I would trust them near 100%, and that's a lot coming from me.

And what you said is was pretty much what he said this morning. (About not wanting to risk it right now.)Plan currently is to watch. We check her liver on Friday, and then again in about two weeks. The numbers will tell us what comes next. We want to try to let her heal her body as much on her own as we can.

If they are going down and stabilizing - then we monitor AKA I hawk eye chicky boo boo. If she does not stabilize and the numbers don't go where they should - then we will have to consider and endoscopic biopsy of her liver and possibly a tube. I don't want that for her. One it's scary and risky and two - it means bad things.



I'll be there for you for as long as I'm above the ground dear girl!Who else is up after midnight besides us 🤣just kidding- having someone to talk to helps ,it helps just knowing somebody cares and hears you

Well,keep the Red Sea split open Dear Lord so little BH can pass through !!! Love you Feral❤
LOL Yes it absolutely helps as it's keeps you stable and not going into panic mode.

Love you too Kwik ❤

This is absolutely the best group of people I've ever come across. It's truly a blessing for everyone.
 
Last edited:
  • Thread Starter Thread Starter
  • #18

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
Sorry about all the typos - I'm pretty exhausted.

Looked through her detailed invoice and no pred was used at this point.

I don't have the reports yet. Hopefully tomorrow. I'm very curious about her GI panel.
 

silent meowlook

TCS Member
Staff Member
Forum Helper
Joined
Nov 10, 2014
Messages
4,717
Purraise
8,954
If they are considering a biopsy, they shouldn’t use Prednisolone prior as it will alter the results. It also might not be the best for the liver.
 
  • Thread Starter Thread Starter
  • #20

FeralHearts

TCS Member
Thread starter
Top Cat
Joined
Jul 4, 2018
Messages
1,868
Purraise
3,663
Location
Canada
If they are considering a biopsy, they shouldn’t use Prednisolone prior as it will alter the results. It also might not be the best for the liver.
Also while SCL is on the table, even as a differential. I was glad to see none was used.
 
Status
Not open for further replies.
Top