Liver failure :(

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
We got Musiakas bloodwork done today and the news are pretty bad. While his blood glucose, kidney parameters and other things, like creatinine look so much better, his liver is failing... ALP is 291 IU/ when it should be below 123, and GPT is over 1000! When it should be below 105...

Musiaka will have to get medicine with the drip for at least three days in a row, we will go back on Monday. Also, he got some Epato supplements and they want him to eat Royal Canin Hepatic food, but am I not sure if I should give it, cause maybe eating kibble only made it so much worse for him? The vet also thinks that that's why Musiaka vomits - because of his liver.

Any advice?
 
  • Thread Starter Thread Starter
  • #2

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
I dont understand why it got so much worse since January. In January his GPT was 115, so only slightly higher, and now its 10 times higher? How could it be? Can it be that this kibble-only diet caused this?
 
  • Thread Starter Thread Starter
  • #3

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
By the way GPT is probably same as ALT
 
  • Thread Starter Thread Starter
  • #4

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
Could someone please advise, if Musiaka has to eat the RC Hepatic food? Lately he has totally lost his appetite for kibble, so I started re-introducing wet food to his diet, that he eats way more willingly. He drinks loads of water and looks like he misses moisture in his food. He started ignoring kibble, so I'm not sure if it's worth ordering the Hepatic sort. Maybe he doesn't have to be on it if he gets liver supplement and will get an iv drip?
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
Does the Hepatic food come in wet? Most vet foods have a canned version.
 
  • Thread Starter Thread Starter
  • #6

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
Does the Hepatic food come in wet? Most vet foods have a canned version.
No, this one doesn't come in wet, only the renal one. Musiaka probably has IBD, so I was planning on starting an IBD friendly diet with a high protein good quality wet food. Can his liver enzymes be elevated due to an IBD flareup? He's been throwing up a lot of hairballs lately and drinking more water than usual. Lots of dandruff. I don't see a reason why it could have gotten so much worse in only 4 months other than kibble diet and ibd getting worse :/ he also took a supplement for the liver for 1 month. I just don't understand why would his liver get this bad so fast
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
I found this article

Inflammatory Bowel Disease | Manhattan Cat Specialists

But one point specifically did say this.....

"In cases of IBD, routine laboratory tests tend to be normal. Protein levels in the bloodstream may be either high or low. Increased liver enzymes are occasionally reported in cases of feline IBD and may be important given the recent studies that reveal that many cats with IBD have concurrent inflammation of the liver and bile ducts (cholangiohepatitis) and/or pancreatitis. In one published case series, a low cholesterol level was the most common biochemical abnormality reported."
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
I also found this...

Feline Inflammatory Bowel Disease and Inflammatory Liver Disease - TUFTSBG2009 - VIN

What stood out to me was this.....

"In the neutrophilic form of inflammatory liver disease the infiltration of the liver and biliary tree is primarily neutrophilic. It has been described as suppurative although this term may be misleading. The cause is uncertain but may be related to ascending infection of the bile duct from the gut. There is sometimes a link with pancreatitis and IBD-if all three features are present this is referred to as "triaditis".

There are no well recognized predispositions for neutrophilic cholangitis. Most affected cats are presented with jaundice, often as markedly depressed, sick cats with a relatively acute illness. Aggressive antibiotic therapy is usually successful in treating the disease."
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
You may need to call the vet and ask them specifically why the hepatic food.
I went to the RC site and looked up why hepatic food would be prescribed....
This was on their site - talking about the hepatic food.

RECOMMENDED FOR CASES OF • Cholangitis/Cholangiohepatitis associated with liver dysfunction • Portosystemic shunt • Hepatic encephalopathy • Copper storage disease
NOT RECOMMENDED IN CASE OF • Hepatic lipidosis without hepatic encephalopathy* • Acute hepatitis without hepatic encephalopathy* • Growth, gestation/lactation
*In these cases the recommended diets are Gastrointestinal or Recovery.
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
This is an article I found that explains the many different forms of liver issues.
Disorders of the Liver and Gallbladder in Cats - Cat Owners - Merck Veterinary Manual

In one section when talking about hepatic lipidosis it states this.

" Your veterinarian will recommend an appropriate food, usually a high-protein, calorie-dense, balanced diet. Initially, feedings are small and given frequently."

The hepatic food your vet prescribed is just that...high protein and energy/calorie dense with low copper....so I don't know what else to tell you except to call the vet and ask them what type of liver issue they suspect...
But if kitty wont eat it...then perhaps the recovery food (canned) would be appropriate..it comes in a really mushy consistency that is helpful for syringe feeding when a kitty doesn't eat.
 
  • Thread Starter Thread Starter
  • #11

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
Thank you for finding this info, Jem!

The vet (and her assistant) seem to think in these terms here: liver issue = RC Hepatic. High glucose = RC Diabetic. Hairballs = RC Anti-hairball. Not going in deeper than that...
 
  • Thread Starter Thread Starter
  • #12

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
They mentioned fatty liver, although I read that it develops if a cat refuses to eat. Also, the assistant said "the liver is in metastases" which makes me think they don't know what they're talking about. Isn't metastases like spreading of a tumor/cancer?
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
The vet (and her assistant) seem to think in these terms here: liver issue = RC Hepatic. High glucose = RC Diabetic. Hairballs = RC Anti-hairball. Not going in deeper than that...
I'm sorry...I don't know if I should laugh or just roll my eyes...maybe both.
Many vets are actually not very good "nutritionists", so yes, many will simply prescribe the foods if it "matches" symptoms.

They mentioned fatty liver, although I read that it develops if a cat refuses to eat
Read the last article I put. The liver could be affected with decreased eating as well and change in diet....so if his liver is "damaged" due to the IBD perhaps the changes and the fact that he has been eating less was enough to "put him over the edge". I'm only speculating here....

Also, the assistant said "the liver is in metastases" which makes me think they don't know what they're talking about. Isn't metastases like spreading of a tumor/cancer?
Uh...yeah? I think so...for the most part. But maybe she was referring to some "leakage" (aka "spreading") from damaged liver cells or something and decided to use a "fancy" word? IDK...I don't know what to tell you there either. Perhaps someone else knows if metastases is a term used for other forms of "spreading" other than cancer.

At this point all I can say is call your vet for clarification......and only speak to the vet.
 

FeebysOwner

TCS Member
Top Cat
Joined
Jun 13, 2018
Messages
12,888
Purraise
17,048
Location
Central FL (Born in OH)
Hi. I can't offer much, but wanted to at least suggest you try the RC Hepatic dry by mixing it with water to make it more like wet food. Maybe he will eat it that way while you continue to sort all of this out. But, Jem Jem is right in that you need more clarification from the vet.

Fatty liver disease commonly thought to be caused by a lack of eating, but there are other situations/conditions that can prompt it. Diabetes, obesity to name a couple. I have read of cases that were deemed idiopathic (unknown cause). While you should also ask for clarification about this, as well as the vet's use of the word metastases, I do know that metastases is also used to denote the spread of bacteria and/or other type cells from one location in the body to another. It can also mean a change in location of a disease from one body part to another. Hopefully that is what they are referring to, but admittedly it is a poor choice of words if they are not talking cancer.

Are you considering a second opinion? All of Musiakas' records should be available to you for free, to help reduce redundant testing/costs if you do choose to get another opinion. If you do, please seek out one that is within an entirely different practice in order to avoid colleague bias.
 

Jem

TCS Member
Top Cat
Joined
Aug 6, 2018
Messages
4,131
Purraise
7,799
I'm sorry...I don't know if I should laugh or just roll my eyes...maybe both.
Many vets are actually not very good "nutritionists", so yes, many will simply prescribe the foods if it "matches" symptoms.
Just wanted to clarify though...I have used prescription foods for my cats with success, so they do work, but kitty still needs a proper diagnosis and clarification from your vet.

Thanks FeebysOwner FeebysOwner for clarifying about the use of metastases. I thought it MAY be used for other forms of "spreading"...but I agree a very poor choice of word here considering everyone tends to think "cancer" with is use.
 
  • Thread Starter Thread Starter
  • #16

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
I'm sorry...I don't know if I should laugh or just roll my eyes...maybe both.
Many vets are actually not very good "nutritionists", so yes, many will simply prescribe the foods if it "matches" symptoms.



Read the last article I put. The liver could be affected with decreased eating as well and change in diet....so if his liver is "damaged" due to the IBD perhaps the changes and the fact that he has been eating less was enough to "put him over the edge". I'm only speculating here....



Uh...yeah? I think so...for the most part. But maybe she was referring to some "leakage" (aka "spreading") from damaged liver cells or something and decided to use a "fancy" word? IDK...I don't know what to tell you there either. Perhaps someone else knows if metastases is a term used for other forms of "spreading" other than cancer.

At this point all I can say is call your vet for clarification......and only speak to the vet.
Maybe the 12 hour fasting prior to going to the vet put him over the edge? Or re-introducing wet food... But otherwise his appetite was really poor this week.
I will ask for clarification about the use of the word "metastases" when we go back there on Monday morning for the drip. When I heard it today I was just too taken aback to ask them
 
  • Thread Starter Thread Starter
  • #17

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
Hi. I can't offer much, but wanted to at least suggest you try the RC Hepatic dry by mixing it with water to make it more like wet food. Maybe he will eat it that way while you continue to sort all of this out. But, Jem Jem is right in that you need more clarification from the vet.

Fatty liver disease commonly thought to be caused by a lack of eating, but there are other situations/conditions that can prompt it. Diabetes, obesity to name a couple. I have read of cases that were deemed idiopathic (unknown cause). While you should also ask for clarification about this, as well as the vet's use of the word metastases, I do know that metastases is also used to denote the spread of bacteria and/or other type cells from one location in the body to another. It can also mean a change in location of a disease from one body part to another. Hopefully that is what they are referring to, but admittedly it is a poor choice of words if they are not talking cancer.

Are you considering a second opinion? All of Musiakas' records should be available to you for free, to help reduce redundant testing/costs if you do choose to get another opinion. If you do, please seek out one that is within an entirely different practice in order to avoid colleague bias.
Fortunately, diabetes is no longer a threat, his glucose and actually all other parametres came back normal, much better than in January. Probably they were referring to spreading of the disease/backteria, because it's not like they have any way of knowing if Musiaka has cancer - I think more extensive testing is needed for that...

I have tried to wet the other kibble he was on, but it probably messes with the tastes, as he doesn't eat it at all. But it's not only his sudden distaste for kibble that is bothering me - RC Hepatic includes both chicken ans wheat, two things I'd like to try and avoid from now on... RC Diabetic, that he was told to eat before, also includes tapioca, which can also aggrevate IBD. So both are not IBD friendly at all - the vet doesn't take it into the consideration apparently. Musiaka has an itchy head as well (he scratches so hard his skin bleeds, there's dandruff too) so maybe there's even an allergic reaction. So if the same effect can be achieved with an IBD friendly food I'd opt for that.

Probably we will be getting a second opinion. I have his blood results printed out, so that's not an issue
 
  • Thread Starter Thread Starter
  • #18

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
He threw up all undigested food tonight and is refusing to eat at all :( hasn't touched anything during the night or now. Isn't lethargic, climbing on stuff and miaowing (i took him outside on a leash yesterday on the way to the vet), wanting to go out. I'm suggesting all kinds of food to him, but he only ate a couple of bites if any...
 
  • Thread Starter Thread Starter
  • #19

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
What should we do? :(
 
  • Thread Starter Thread Starter
  • #20

Musiaka

TCS Member
Thread starter
Adult Cat
Joined
Dec 3, 2018
Messages
265
Purraise
156
We went to another vet in town today. Musiaka got some hepatic medicine and Cerenia, also a dose for tomorrow.
This vet, however, doesn't think Musiaka needs the iv drip as he doesn't look dehydrated from the touch of his skin and that if he drinks water, the drip won't do much. Also, that Musiaka looks restless and probably won't stay put for 1,5 hours. Sedating him with weak liver is not an option and putting him into a restraining bag is just too cruel imo. So I probably won't be taking him and use the medicine instead. The new vet also had some daily medicine in mind that we will discuss on tuesday
 
Top