Has Anyone Dealt With This?

[sjoh197]

I recently trapped a senior cat (10+ years) who had been living between a hospital and parking garage in our inner city. He wasn't doing well.

He was severely dehydrated when I picked him up, and also appeared very malnourished. He is FIV+, blind, has a 3/5 heart murmur, is extremely skinny, and has some thinned/lost fur. He also currently has a terrible URI which is being treated.

His bloodwork came back showing the typical signs of dehydration. His creatinine was slightly elevated, but not bad, all things considered. His ALT was high at 236. His thyroid levels came back normal, so not hyperthyroidism. He has burst blood vessels in his eyes, likely causing his blindness. But his blood pressure wasn't super high. It was mildly elevated, but not outside the range of a scared cat at the vet.

Has anyone else had the blindness, heart murmur, elevated ALT, and skinniness of a cat that doesn't have hyperthyroidism? We really thought that that was a shoo-in diagnosis, but now we're treating them as separate problems We're going to measure blood pressure again, and I'll have to do bloodwork again in the future when he isn't dehydrated, but not knowing what's wrong is frustrating.

 

[FeebysOwner]

Bless you for taking him in! He probably does have more than one issue going on. But, didn't the vet think his high ALT could be from his poor diet and dehydration? That would have been my guess.

I wish I had more to offer. But, he is sure a beauty!
I hope other members come along soon and have some insight to offer.
Please keep us posted.

 

[daftcat75]

I wouldn't worry about the ALT. That's not super high and certainly not the highest priority. Treat the URI and the dehydration first! Get him fluids and antibiotics. Get him B-12 and get him eating. Put down an ounce of food as often as he'll take it (every couple of hours when I was refeeding Krista after a 10 days of hospitalizaton with an ALT value of 1400!) In Krista's case, she had a broken tooth that turned into an IBD and pancreatitis flare-up as I was feeding her whatever she would eat until I could get her a dental appointment.

ALT is a tricky enzyme. It's sensitive to inflammation and damage in just about anywhere in the body. If he's eating and he's peeing and pooping okay (he has to eat to poop so it may take a few days to assess this), if his poops are brown and not gray, his liver is probably fine, all things considered. He's certainly under some physical stress and that will show up in the ALT value. Re-test the ALT after you've treated more immediate problems.

 

[sjoh197]

He's on antibiotics and had sub-q fluids and pedialyte. He's eating great and his poops seem normal. We're trying to tackle the URI first, and also the bleeding in his eyes.

I'm just hoping I can help him get better

 

[daftcat75]

If he’s eating great and his poops seem normal, I think you’re on the right track. Get him on B-12 replacement. He’s certainly got a lot going on but I also don’t think he’s so rough he won’t get through this.

 

[daftcat75]

My guess is the URI slowed him down and he maybe hasn’t been living well or eating right for a while. Treat the dehydration and refeed him as often as he wants and he should bounce back pretty quick.

 

[sjoh197]

I forgot that he does have 2 broken canines. He's eating the wet food well though.

 

[daftcat75]

Dental disease and dental injury is another thing that can ALT to elevate.

Why Are My Dog Or Cat's ALT Levels Abnormal?

But seriously, if he's eating well, the prognosis is always much better than if he isn't. I hope you can get the broken teeth removed but maybe it's not so important right now if he's still eating. I don't know if the vet thinks he'd be a good candidate for anesthesia just yet. I wouldn't let the ALT stop you but maybe the other things like dehydration or weight or heart murmur.