Liver Problems and Feeding Issues

[reba]

Just returned from the vet with my sister’s cat. Blood work showed pretty severe liver values. Cat has no appetite and had lost about 2lbs and had been hiding under the bed for a few days. Vet sent us home with fluids and some prescription diet, but said his prognosis was very poor. We followed the suggestion on here about making a slurry from the food and feeding it with a syringe slowly over time. He’s perked up some after the food/fluids, but still won’t eat on own. Also tried something called Goat Milk, from PetSmart. Any and all suggestions would be much appreciated.

 

[Kris107]

When my girl had gall stones and wasn't eating, I had a buffet of foods. It was trial and error on textures, flavors, etc. She just about never ate her old food again. Mirataz (mirtazapine) also helped a lot. Started with smaller doses every couple days but she also had a plethora of things going on.

 

[neely]

When one of our cats was diagnosed with liver problems, (hepatic lipidosis), it was 32 years ago and there has been more research and medical treatment since then. I look back and wish we had known more about this disease even though we took him to the vet immediately and followed through with their instructions. This is an excellent article from the Cornell Feline Health Center. It states that In 90% of cases, hepatic lipidosis is a secondary consequence of some other underlying condition, such as obesity, diabetes, cancer hyperthyroidism, pancreatitis, kidney disease or another type of liver problem. Please read this article particularly the last two paragraphs. Hepatic Lipidosis

Sending healing vibes and special thoughts for your sister's cat.

 

[reba]

Thanks, we have been getting a small syringe worth of Hills A/D into every few hours. If I put it in his mouth he does swallow it without a problem.

 

[silent meowlook]

Hi. You really cannot sustain a cat with syringe feedings. The best chance for a good outcome is to get an esophageal feeding tube placed and feed that way. The good thing about the feeding tube it also makes it very easy to give medications and liver support supplements that way.
Is your cat jaundiced? (Yellow skin and eyes?)

 

[reba]

Well I don’t think that’s an option for them. Update is we are doing well with making the slurry and giving it to him every hour now. He’s giving us no problems once we get the food into his mouth. He’s had most of his teeth extracted so it’s not that hard.

Speaking of the later as I read further I see dental issues can lead to this. Wondering if his remaining teeth are/were giving him trouble and we just didn’t realize it, so he stopped eating.

 

[reba]

Hi. You really cannot sustain a cat with syringe feedings. The best chance for a good outcome is to get an esophageal feeding tube placed and feed that way. The good thing about the feeding tube it also makes it very easy to give medications and liver support supplements that way.
Is your cat jaundiced? (Yellow skin and eyes?)

To ask a difficult question, if we cannot get enough food into him, is it better to just say goodbye rather than let him (I would think) starve to death. I just don’t think they are up for the feeding tube route as the cat is 15 y.o.

He’s not severely jaundiced from what i can tell.

 

[mrsgreenjeens]

WAS he diagnosed with Hepatic Lipidosis? You didn't say that, but it sounds like it, and you said the Vet did say his prognosis is poor. I would say chances are not that good for recovery if they do not have that feeding tube installed. Do you know if the Vet suggested it? I'm pretty sure it's not a very invasive surgery, but of course it would require anesthesia.

With a feedng tube you can get more food in, and food is key to recovery. One single small syringe of food every hour is probably not enough. Of course, we don't know the size of the syringe! Also, are they giving any liver supplements. That is key also. And how is the cat seeming to act now? I don't mean if he is trying eat on his own, because I wouldn't expect to see that for a long time yet, but overall, is he hiding away, lethargic, acting like an extremely sick cat, etc?

Just as a side note, when my cat had H/L, he was on a feeding tube for FOUR months! It can take a very long time to recover from this, so they need to be prepared to spend hours and hours working with him to help him recover. But with a tube, you don't have to feed them every hour at least.

We can't make the decision for them as to what the best thing to do is, but they can talk to their Vet and get their honest opinion on whether or not there is a real chance for recovery. Have them ask the Vet what they would do if it were their cat.

 

[reba]

History. In 2019 he had most of his teeth pulled. In October 2022 he wasn’t eating and his test values were terrible for the liver/kidney tests, but they improved and so he wasn’t treated for anything on a long-term basis.

2024: He early last week and she took him in for tests. The liver results were horrible ALT- 298, BUN 28, GGT 20, TBIL 6.6 (those are the most severe from what I can tell). The vet gave him an antibiotic shot and sent her home with fluids and an appetite stimulant. He didn’t eat for a few days after that and her plan was to say goodbye, but then he rallies and jumps up on the window starts using his scratcher. So we go back to the vet and she gives us the Hills A/D and says to try that for a few days. At that point we figured out we could get some food into him via syringe.

Anyway, this morning I decided to calculate just how much food we had to get into him. I got 1/2 - 3/4 of a 5.5 ounce can which is A LOT of small syringes. And if it’s not enough that’s not a solution, it’s just delaying the inevitable at best and starving him at worst.

I was really hoping, you know the bargaining that you do, that maybe his remaining teeth had gone bad and that was what caused him to stop eating, as opposed to liver or kidney disease. But after analyzing the historical blood work, IDK.

I know I feel helpless again after having some hope.

 

[mrsgreenjeens]

That bloodwork doesn't really mean too much without knowing what the "norms" are for that specific lab. But we aren't Vets here anyway, so not sure it matters. Guessing the Vet did not give a diagnosis either way. I am familiar with BUN, which is a kidney value, and 28 seems good, at least when I look at MY cats paperwork (again, it depends on the lab, and even in what part of the world you are located)

As far as how much food you are getting into him, that could be enough, depending on his size and how active he is, but probably not. Did the Vet not give any instructions as to how much to feed, how often, etc. Is he on any liver supplements? What instructions did the Vet give, what medications? Anything other than fluids and the food? Surely he told your sister how much to feed him, or are you the one who took him to the Vet? (I can't tell from your original post, not that it matters. What really matters is you need some direction from the Vet here)

 

[Furballsmom]

Hi
What happened? How are things?

 

[Antonio65]

Did your vet investigate your cat's gall bladder, if he doesn't have an obstruction? That TBIL is weird, looks like my cat's levels when she had an issue with her bile duct.
Did you vet run an US scan to her gall bladder and bile duct?
My cat starting eating less, but I think she was feeling nauseous because of her live issues.
Unfortunately, my cat was diagnosed too late to fix the issue, despite I took her to any clinic I could find. When a vet eventually noticed that bile duct problem it was too late to save her. Had a vet found it earlier it would have been a different story.

 

[kbstarfish]

Hi. You really cannot sustain a cat with syringe feedings. The best chance for a good outcome is to get an esophageal feeding tube placed and feed that way. The good thing about the feeding tube it also makes it very easy to give medications and liver support supplements that way.
Is your cat jaundiced? (Yellow skin and eyes?)

My Manx had a PEG TUBE placed, much less daunting! He wore a little t-shirt to keep him from messing with the port. He had it for 4 months. He survived & lived another 9 years. PEG tube is the only way to go.