Liver problems/abdominal fluid

[sharonwitch]

Hi, I haven’t been on this forum in awhile, but I remember how helpful it was with my cats previously. I recently lost my 17-1/2 year old tortie, Squeak, who spent 2 nights at an emergency hospital & ultimately passed away there the morning after Christmas – her lab numbers were suddenly all over the place and I unfortunately never really had a definitive answer as to what happened to her.

At the beginning of January, my 16-1/2 year old kitty (Bootsie) went for an ultrasound due to her liver numbers being elevated on a routine blood test. The specialist said that her blood vessels in her liver looked enlarged and she had some free fluid in her abdomen. He suggested getting a liver biopsy done; however, she has a history of heart issues/murmur which she is on medication for, and after just losing Squeak literally a week before, I was very scared to put her under anesthesia, so I didn’t have it done. At the time, Bootsie was not acting sick at all and my regular vet and I decided to monitor her and re-do blood work, etc. Her next blood work check still showed elevated liver numbers, so we did a bile acid function test, which did show she had decreased function. She still was eating fairly well and not really acting any differently.

I took her back for a re-check about 2 weeks ago – her eating wasn’t as good and she was getting pickier with the food. I also felt like the fluid had increased in her abdomen, which it did. Sometimes she would sit funny and looked uncomfortable. My vet drained quite a bit of fluid and she started her on a diuretic and appetite meds when her eating was off. Yesterday (a week later), she went in for a re-check and some fluid did come back. This time we are sending the fluid out to be tested, and I should have the results back next week. I know it’s not as detailed as a biopsy, but it may show some things and/or rule some things out. My vet is leaning towards this being some kind of cancer, and the fluid is obviously a bad sign. She agrees with my decision to not risk the anesthesia for the liver biopsy at her age and because of her heart, but at the same time we both wish we had a definitive answer as to why this is happening.

Does anyone have any experience with liver issues/abdominal fluid? Most of my cats dealt with kidney issues and I was usually giving them fluids, not removing it! I wrestle with my decision not to get the biopsy because I feel like maybe I could help her more; however, I couldn’t bear losing her to get a test done when maybe it is cancer and what would I really do differently if I knew? If she were younger and stronger, I would definitely do it, but she’s literally 5 pounds soaking wet and I don’t think she would be able to overcome any adverse effects. I’m hoping the testing of the fluid will give me some answers. Right now, I’m just trying to keep her eating and comfortable – so far she has been doing pretty well.

Unfortunately, the financial considerations are a factor with me as well. Since November, I have spent (mostly charged – thank you Care Credit) thousands of dollars on tests and hospitalizations. Squeak’s brief stay at the emergency hospital over Christmas added up to over $3,000.00 and Bootsie’s bills are close to that now. I love my cats and will do anything for them, but it was really a blow to spend all that for Squeak and there was nothing they could do for her. I was hoping she could make it through to the day after Christmas when the internal medicine doctor would be in, but sadly she went downhill very early that morning and I got the dreaded call as to whether they should let her go, which devastated me. I just wanted answers as to what was happening with her, and I never got them. And now I am mad at myself for putting her through all that for two days. But it's also hard to put your cat down when you don't really know why they're so sick. . . Sorry, I just needed to vent a little!

I appreciate any help and/or suggestions as to anyone’s cats having liver problems or abdominal fluid.

Thanks!

Sharon

 

[FeebysOwner]

Hi. So sorry for your loss with Squeak, and now dealing with Bootsie. I don't have any experience with cats and liver disease, but I do know from my father (who had Hepatitis C) the abdominal fluids are a matter of her liver not being able to function properly and it wards/throws off excess liquid into the belly cavity to help it process the remaining fluid/blood. So, as you obviously already know, the liver is having difficulty functioning at optimum level. This could be liver cancer, or a bile duct blockage/function issue, or probably a bunch of other issues as well.

I am not quite clear on what the bile acid test will show/not show. But, if the liver isn't functioning properly, as it apparently isn't, lactulose might help with her eating, as it lower levels of ammonia in the bloodstream, which can affect her eating. It is worth asking about anyway.

You've been on this site for a while, so I gather you have searched for other threads on liver issues? I wish I had something more than just my support and best wishes for Bootsie and you.

 

[mrsgreenjeens]

First off, my sympathies on losing Squeak . You gave her the greatest gift of all by letting her go, and please don't be mad at yourself for not doing it sooner...how could you know she was so near the end?

Now for Bootsie. I too have had kidney cats, and one of them also had liver issues. Her liver values would rise for unknown reasons, but we opted NOT to even do an ultrasound and definitely no biopsy, because, honestly, with her already having CKD, what were we going to do if they found anything? So our Vet would give her antibiotics, and her liver values would fall back in line for awhile, and then they'd rise again, and we'd do it again. We also gave her supplements for her liver. There are prescription ones out there, and OTC ones as well. We tried both but our old gal was impossible to pill so it was difficult to say the least. We finally ended up giving her the tiniest bit of Vit E mixed in with her food and called it a day. Our Vet told us exactly which kind and how much but it's been too long ago now for me to recall, sorry.

Anyway, not sure if what our Callie had was similar to what might be wrong with Bootsie, but it didn't get her in the end. Neither did the CKD. Oh, but the only time Callie had fluid built up was after we gave her sub-q fluids, so I'm guessing Bootsie has a different issue.

 

[sharonwitch]

Hi. So sorry for your loss with Squeak, and now dealing with Bootsie. I don't have any experience with cats and liver disease, but I do know from my father (who had Hepatitis C) the abdominal fluids are a matter of her liver not being able to function properly and it wards/throws off excess liquid into the belly cavity to help it process the remaining fluid/blood. So, as you obviously already know, the liver is having difficulty functioning at optimum level. This could be liver cancer, or a bile duct blockage/function issue, or probably a bunch of other issues as well.

I am not quite clear on what the bile acid test will show/not show. But, if the liver isn't functioning properly, as it apparently isn't, lactulose might help with her eating, as it lower levels of ammonia in the bloodstream, which can affect her eating. It is worth asking about anyway.

You've been on this site for a while, so I gather you have searched for other threads on liver issues? I wish I had something more than just my support and best wishes for Bootsie and you.

Thank you for your response. Yes, I have searched for similar issues & found some info. I am actually giving her lactulose because she of course also has constipation issues, so that’s supposed to help both issues.

It’s interesting how a lot of diseases are very similar in humans & pets...

I appreciate the support & best wishes!

 

[sharonwitch]

First off, my sympathies on losing Squeak . You gave her the greatest gift of all by letting her go, and please don't be mad at yourself for not doing it sooner...how could you know she was so near the end?

Now for Bootsie. I too have had kidney cats, and one of them also had liver issues. Her liver values would rise for unknown reasons, but we opted NOT to even do an ultrasound and definitely no biopsy, because, honestly, with her already having CKD, what were we going to do if they found anything? So our Vet would give her antibiotics, and her liver values would fall back in line for awhile, and then they'd rise again, and we'd do it again. We also gave her supplements for her liver. There are prescription ones out there, and OTC ones as well. We tried both but our old gal was impossible to pill so it was difficult to say the least. We finally ended up giving her the tiniest bit of Vit E mixed in with her food and called it a day. Our Vet told us exactly which kind and how much but it's been too long ago now for me to recall, sorry.

Anyway, not sure if what our Callie had was similar to what might be wrong with Bootsie, but it didn't get her in the end. Neither did the CKD. Oh, but the only time Callie had fluid built up was after we gave her sub-q fluids, so I'm guessing Bootsie has a different issue.

Hi, thanks for your response! I have tried the liver supplements-both otc & prescription. I feel the same way - if I find something on a biopsy, what can I do really. I’m going to see what the fluid test says & maybe it’ll give me some direction.

 

[MissClouseau]

I feel the same way - if I find something on a biopsy, what can I do really. I’m going to see what the fluid test says & maybe it’ll give me some direction.

I'm sorry you are going through all this. If I were you I would ask the vet if there is anything they might find in the ultrasound that they can treat realistically considering her age and make a pros-cons calculation that way. I also opted out some tests that way as there wasn't even anything to do that wasn't too risky.

Also discuss with the vet but I believe smaller meals is the ideal way for them to eat to not go heavy on the liver and gallbladder. Also diet makes a difference for the better or worse.

 

[di and bob]

I'm so sorry you are going through this. Being 16 1/2 years old and having a heart problem presents a big problem when trying to diagnose a problem. I hope the fluid can give you some kind of answers, it is so hard not knowing. I would think that xrays, tests, etc. would tell you if it was a blocked duct, etc. They can't do a needle biopsy with just light sedation? It would be much easier on her then heavy sedation. If it was me, i would continue supplements, have her drained when she becomes uncomfortable, and keep her comfortable. Just love her as hard and as much as you can, that is what she wants.
My heart goes out to you, I will pray for your little girl........

 

[sharonwitch]

I'm sorry you are going through all this. If I were you I would ask the vet if there is anything they might find in the ultrasound that they can treat realistically considering her age and make a pros-cons calculation that way. I also opted out some tests that way as there wasn't even anything to do that wasn't too risky.

Also discuss with the vet but I believe smaller meals is the ideal way for them to eat to not go heavy on the liver and gallbladder. Also diet makes a difference for the better or worse.

Thanks. We’re keeping her on the kidney diet, but when she’s fussy I sometimes give her other food to get her eating. I think smaller meals are better too. She doesn’t usually wolf down her food, but will go back to it during the day. During the week I always leave food out since I’m not here until noon for lunch & then not home til 5, so I feel like she’s having more little meals.

 

[sharonwitch]

I'm so sorry you are going through this. Being 16 1/2 years old and having a heart problem presents a big problem when trying to diagnose a problem. I hope the fluid can give you some kind of answers, it is so hard not knowing. I would think that xrays, tests, etc. would tell you if it was a blocked duct, etc. They can't do a needle biopsy with just light sedation? It would be much easier on her then heavy sedation. If it was me, i would continue supplements, have her drained when she becomes uncomfortable, and keep her comfortable. Just love her as hard and as much as you can, that is what she wants.
My heart goes out to you, I will pray for your little girl........

Thanks so much for the prayers. I’m hoping the fluid analysis gives me something to work with. Like if it’s cancer, then I know. I was told the needle biopsy isn’t very accurate compared to a regular biopsy, and even then it might be inconclusive. She’s had xrays, blood work & tests so I’m just doing what you said - keeping her comfy & loving up on her. Fortunately, she is very affectionate, sleeps with me & gives me kisses all the time so I treasure all those moments. Although I try not to think about what an empty space there will be when the day comes that she’s not here with me. At one point I had 5 cats & now only 2 - and my boy Sylvester is not a snuggler lol.