Our adored moggy became unwell about a year ago, lots of tests, ended up with the diagnosis of idiopathic hepatitis. After O-tube feeding, he gained weight and made a good recovery (although has remained jaundiced). He has started to dip again, and we are absolutely desperate to help him - currently using mirtazapine for appetite support, he doesn't seem to be in pain, saw vet yesterday, no ascites and all obs OK but ongoing jaundice, awaiting blood results. Has anyone had any experience of this condition? We obviously have his best interests at heart, but at the moment he still has good quality of life.
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Idiopathic hepatitis
- Thread starter KK300
- Start Date
FelineLiverDisease groups.io Group
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Other Illnesses
Welcome to The Cat Site. I am sorry that your baby's condition is what brought you here. I do not have any experience in this condition in cats. Hopefully a member who has some advice will post.
The first link is a support group that you can join. I am entirely unfamiliar with them so cannot comment but there are some specialized support groups for conditions like diabetes and hyperthyroidism in cats which are very knowledgeable. The second is to Tanya's Comprehensive Guide which is referred to here on TCS frequently. This page on other illnesses talks about some liver issues.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Other Illnesses
Welcome to The Cat Site. I am sorry that your baby's condition is what brought you here. I do not have any experience in this condition in cats. Hopefully a member who has some advice will post.
The first link is a support group that you can join. I am entirely unfamiliar with them so cannot comment but there are some specialized support groups for conditions like diabetes and hyperthyroidism in cats which are very knowledgeable. The second is to Tanya's Comprehensive Guide which is referred to here on TCS frequently. This page on other illnesses talks about some liver issues.
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- #3
So he's been jaundiced for an entire year? Am I reading that correctly? I had a cat once with Hepatic Lipidosis and he was oh so yellow, but it went away once the condition improved. While he was on the feeding tube, was he getting liver supplements? I don't really know much about hepatitis in cats, but do know about it in humans, and it doesn't really go away without a LOT of drug intervention. And not sure if they offer the same type of drugs for cats. I'll be interested in what your Vet says once the blood tests come back.
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- #5
Thank you for your reply.
Yes, he has been jaundiced to varying extent for a year. Whilst he had the tube, and afterwards for several months, he had destolit, ventoquil, steroids and initially antibiotics. He was investigated for all the usual culprits, lymphoma, cholangiohepatitis, viral illnesses, copper deposition, USS liver biopsies, with the eventual label of 'idiopathic'. He's been off all meds for a few months now - his LFT results just didn't correlate with medication and doses, there was no rhyme or reason to it, and he's very difficult to medicate.
At the moment, we're giving him transdermal mirtazapine every couple of days, and have just started prevomax - will look into ondansetron when we speak to his vet regarding his latest LFTs (waiting on the results).
It's just awful. He's such a special little guy. It's all the more upsetting because both my partner and I are doctors, and are used to being able to 'fix things', we feel so useless.
Yes, he has been jaundiced to varying extent for a year. Whilst he had the tube, and afterwards for several months, he had destolit, ventoquil, steroids and initially antibiotics. He was investigated for all the usual culprits, lymphoma, cholangiohepatitis, viral illnesses, copper deposition, USS liver biopsies, with the eventual label of 'idiopathic'. He's been off all meds for a few months now - his LFT results just didn't correlate with medication and doses, there was no rhyme or reason to it, and he's very difficult to medicate.
At the moment, we're giving him transdermal mirtazapine every couple of days, and have just started prevomax - will look into ondansetron when we speak to his vet regarding his latest LFTs (waiting on the results).
It's just awful. He's such a special little guy. It's all the more upsetting because both my partner and I are doctors, and are used to being able to 'fix things', we feel so useless.
I see. So it appears that this new "dip" is vomiting and loss of appetite, per the medications he is currently on. I really don't know what to tell you, especially since you are in the medical field, except to let you know that there is another appetite stimulant out there quite similar to Mirtazapine called Mirataz, also transdermal, which seems to work better. It gets applied daily for 14 straight days, and then, per my Vet, you can continue it's use as needed. Really worked for one of mine, who has loss of appetite for unknown reason.
Also, since you are in the field, perhaps there is something in this article that you could discuss with your Vet? I'm not sure what articles you get when you google and what you don't as I don't think you are in the U.S. Disorders of the Liver and Gallbladder in Cats - Cat Owners - Merck Veterinary Manual
Oh, and are you giving the Prevomax as an injection? I found with our kidney cat that giving pills simply didn't work, so we did everything as either transdermal or injection. Worked great that way. She never even realized she was getting the shots as we would sneak them in during the middle of a petting session
Keep us posted as more results come back
Also, since you are in the field, perhaps there is something in this article that you could discuss with your Vet? I'm not sure what articles you get when you google and what you don't as I don't think you are in the U.S. Disorders of the Liver and Gallbladder in Cats - Cat Owners - Merck Veterinary Manual
Oh, and are you giving the Prevomax as an injection? I found with our kidney cat that giving pills simply didn't work, so we did everything as either transdermal or injection. Worked great that way. She never even realized she was getting the shots as we would sneak them in during the middle of a petting session
Keep us posted as more results come back
- Thread Starter Thread Starter
- #7
Hi
He's not vomiting, but just not eating as much as he needs to, he's lost 0.8kg over the past few weeks. He's having Mirataz via the ear and Prevomax injections. We can't tell if he is quiet because of the Mirataz or not. I hate this.
He's not vomiting, but just not eating as much as he needs to, he's lost 0.8kg over the past few weeks. He's having Mirataz via the ear and Prevomax injections. We can't tell if he is quiet because of the Mirataz or not. I hate this.
Depending on where you are, is he seeing a specialist? This may not be possible, I realize, but just a suggestion.
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- #9
Yes, we started off at our local vet, then went to a referral centre, then he was discussed with Bristol Vet School, who have a professor of Gastroenterology. At this point, I'm hoping for a miracle.
Thank you for your continued replies, and to those who have messaged me privately. I really appreciate your suggestions and support, it means a lot that people, literally thousands of miles away, are taking the time to read and respond to this thread.
Thank you for your continued replies, and to those who have messaged me privately. I really appreciate your suggestions and support, it means a lot that people, literally thousands of miles away, are taking the time to read and respond to this thread.
Everyone hopes for the best for your cat and family.
Absolutely
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- #12
We have his blood results back, his Hb, lymphocyte count and platelets have gradually dropped over the past year, but still within normal range. His bilirubin is 150 (gone up since last test) but other liver function tests are better (but still v high). His T4 is slightly low. So, some things are better, others worse. Waiting to discuss with the vet now.
This is my handsome boy, just before he dipped.
This is my handsome boy, just before he dipped.
He certainly is handsome!
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- #14
Well, he, thankfully, seems to have rallied a bit, eating more and generally engaging more with us. Still waiting to speak to the vet.
I am wondering whether we are doing the right thing with his Mirataz and Prevomax - he had it two consecutive nights, and became less and less interactive, just looked miserable. This morning at around 1am, he started shouting, guzzled a load of food, then curled up on my lap. He has eaten pretty well all day today. I don't know whether we should give him mirataz on alternate days, or whether this was completely unrelated to his meds.
I am wondering whether we are doing the right thing with his Mirataz and Prevomax - he had it two consecutive nights, and became less and less interactive, just looked miserable. This morning at around 1am, he started shouting, guzzled a load of food, then curled up on my lap. He has eaten pretty well all day today. I don't know whether we should give him mirataz on alternate days, or whether this was completely unrelated to his meds.
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- #15
Just when we thought things were getting better, Sammy has just had an episode of being startled, yowling, drooling and being incontinent of urine. Just afterwards, the vet happened to phone, he doesn't think it is likely to be hepatic encephalopathy. To me, it looks like a seizure. We're getting him to the emergency clinic asap.
Please let us know what happens. You and your poor baby have had to face so much. All I can add is that I had a dog years ago who did have hepatic encephalopathy and it did not manifest itself in seizures, but as a cognitive disorder.
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- #17
Hi
We took him to the emergency vet, who admitted him to the hospital for further bloods, ammonia (to prove / refute encephalopathy), and repeat imaging. He had an episode in the car of just screaming, it was awful. He's going to have fluids, antibiotics and pain relief overnight. The vet is 90 mins away from where we live, I hate the idea of him being there on his own, so far from home.
We took him to the emergency vet, who admitted him to the hospital for further bloods, ammonia (to prove / refute encephalopathy), and repeat imaging. He had an episode in the car of just screaming, it was awful. He's going to have fluids, antibiotics and pain relief overnight. The vet is 90 mins away from where we live, I hate the idea of him being there on his own, so far from home.
Sorry, I've seen your thread only now.
My cat, now at the Bridge, had a hepatitis for a long time and despite the number of tests, visits, scans, therapies, nothing seemed to help her.
There were times when it seemed things were going better, then we were back to square one. Her liver levels were high, especially the bilirubines. She was hospitalized at the vet university for a week, they inserted a nose tube for feeding her, but it didn't work.
On the day they discharged her, she peed on the vet table at the university and her pee was so yellow it could have been used for road signage!
They told me nothing more could be done and they sent her home.
Out of desperation, I kept looking and found a vet clinic where they ran all the scans, tests and everything from scratch and they found something that all other vets (many vets in different places) didn't find. There was a malformation of the bile duct, from her gall bladder to the intestine. This malformation was slowing the bile flow down and the bile was accumulating in her liver.
They said that with a surgery they could fix it, but the cat was very weak and they told me the risks were high. They even told me off for being late in taking her in, they said "If you came here 3 months ago things would have been much different".
Well, the surgery went fine, but 5 days later my beloved furball went to the Rainbow Bridge...
I would ask your vet if such a thing has occurred to your Sammy.
My cat, now at the Bridge, had a hepatitis for a long time and despite the number of tests, visits, scans, therapies, nothing seemed to help her.
There were times when it seemed things were going better, then we were back to square one. Her liver levels were high, especially the bilirubines. She was hospitalized at the vet university for a week, they inserted a nose tube for feeding her, but it didn't work.
On the day they discharged her, she peed on the vet table at the university and her pee was so yellow it could have been used for road signage!
They told me nothing more could be done and they sent her home.
Out of desperation, I kept looking and found a vet clinic where they ran all the scans, tests and everything from scratch and they found something that all other vets (many vets in different places) didn't find. There was a malformation of the bile duct, from her gall bladder to the intestine. This malformation was slowing the bile flow down and the bile was accumulating in her liver.
They said that with a surgery they could fix it, but the cat was very weak and they told me the risks were high. They even told me off for being late in taking her in, they said "If you came here 3 months ago things would have been much different".
Well, the surgery went fine, but 5 days later my beloved furball went to the Rainbow Bridge...
I would ask your vet if such a thing has occurred to your Sammy.
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- #19
Thank you for your post about your little one, I'm so sorry you lost her.
I will definitely mention this possibility to our vet when they phone back.
We had an update early this morning from the night vet, his ammonium love was normal, he had one more episode, so he's now on midazolam and apparently settled.
Again, thank you all for your help, I really appreciate it.
I will definitely mention this possibility to our vet when they phone back.
We had an update early this morning from the night vet, his ammonium love was normal, he had one more episode, so he's now on midazolam and apparently settled.
Again, thank you all for your help, I really appreciate it.
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- #20
Latest update.
He continued to have episodes as I described. The vet gave midazolam, and later phoned back for permission to give keppra. Symptoms were precipitated by eating, which makes it much more likely we're dealing with encephalopathy.
He's due to have imaging tomorrow, but I can't imagine it will be good news, ie they suddenly find a reversible cause. I am utterly heartbroken, he's my soulmate. How do I find the courage to make the inevitable decision? It hurts to breathe.
He continued to have episodes as I described. The vet gave midazolam, and later phoned back for permission to give keppra. Symptoms were precipitated by eating, which makes it much more likely we're dealing with encephalopathy.
He's due to have imaging tomorrow, but I can't imagine it will be good news, ie they suddenly find a reversible cause. I am utterly heartbroken, he's my soulmate. How do I find the courage to make the inevitable decision? It hurts to breathe.
