Mitzi has fatty liver, what to expect?

[Maggsy]

So, Mitzi stopped eating on Thursday evening, I got her to eat tiny bits of food over the weekend and yesterday (public holiday here) gave a tube treat approx. every hour just to get something inside her,
After blood tests and ultrasound the vet told me that Mitzi has fatty liver and is keeping her overnight to administer rehydration, nausea and pain meds ...

I'm devastated, as apart from not eating she seems bright, alert and no different than normal behaviour, even the vet said she appears fine but must be feeling unwell inside and she said I'd done the right thing by feeding her the hourly treats ..
first visit this morning when they just did blood tests was $390, hospitalisation + meds will be $1500, I can mange this (just) and vet will let me pay off subsequent visits but what can I expect?
I'm 75, have no family since hubby passed in 2014 and quite honestly, I believe that she's been the only thing that's kept me going, if anything happens to her I reckon I'll just give up, what to do!!!

 

[silent meowlook]

Hi. I am sorry you and your cat are going through this.

If she still isn’t eating well, you might do best for her by having an esophageal feeding tube placed, provided the vet is knowledgeable with these and how to place them. That way you can easily get her food and medication into her. If she is eating, then it isn’t necessary.

Denmarin is a liver supplement. You may want to ask your vet about this.

There is almost always an underlying cause of hepatic lipidosis. Often times you never find out what it is.

I have seen many cats recover from hepatic lipidosis just fine.

 

[Maggsy]

I'll find out more tomorrow when vet rings me, this is first time since I got her at 6 weeks old that we've been apart and I know it sounds silly but I truly hope that she isn't fretting as much as I am

 

[di and bob]

There are many more cats, and humans, out there that have fatty livers and are doing fine. My own husband has had a fatty liver for years, at least twenty. once in a while you will have flareups like what happened, my cats have leukemia and have flareups once in a while. They completely stop eating and I encourage them to take a few bites of lickable treats like you did. Ask your vet first,then I would start her on supplements such as DMG, to keep her immune system in good standing, and a liver supplement to help the liver. Making sure they are not overweight, and get some exercise helps too. Unless her labs are completely out of wack, just take one day at a time and continue to love and care for her!

 

[silent meowlook]

Hepatic lipidosis is different in people than in cats.

In people it progresses much more slowly and can be caused by many different things. It can often be controlled in people by lifestyle and diet, excersize choices.

In cats it is almost always caused by a significant reduction in food leading to fat stores being rapidly moved to the liver. In cats hepatic lipidosis is a rapid moving disease process that becomes critical quickly.

This is a good article that explains it.

Hepatic Lipidosis (Fatty Liver Disease) in Cats

The liver failure cat is jaundiced, inappetent, frequently nauseated, and generally an obviously ill animal.

veterinarypartner.vin.com

 

[Maggsy]

thanks, I'm reading thru' posts of others who have cats with similar problems and hoping that my Mitzi hasn't progressed too far along with this disease, she isn't jaundiced at all , hasn't lost any weight, still 7.8kg and didn't seem depressed, altho' maybe she was and I just didn't recognise it ...
she was ill in February with a 'suspected allergy', only symptom was a discolouration under her nose, bw was normal etc and after a round of steroids she recovered well ( so I thought)
It's 8am here (Wed) I'm expecting to hear from vet at about 11am so will be back later

 

[Maggsy]

Vet just rang and apparently Mitzi is doing well and ate some roast chicken
(something I never dreamed of offering)
Vet will assess her thru' the day and make a plan so I can bring her home,
I mentioned Denamarin but she said that there's no call for it at this stage,
I also mentioned milkthistle which vet said wouldn't hurt ...
she's willing to give me scripts if it means I can buy her meds cheaper at an online pharmacy.

Are there any other helpful medications that I should ask her about?
I feel that unless I'd mentioned Denamarin, she may not have mentioned it,
My experience earlier this year with same vet disappointed me as there was no helpful diagnosis
other than a 'suspected allergy' which cost me $1000 for tests

 

[Maggsy]

She's home, vet gave me anti biotics and 4 appetite pills but hopes she won't need them as she's been eating roast chook and ate half a pouch of RC chicken, will have to see how she goes ...
she's happy to be home

 

[Maggsy]

This is so hard, vet said not to give Mitzi treats and to make sure that she eats every 4 hrs but the only way I can get her to take the antibiotics is to crush them (2 pills Amoxyclav 50, twice a day) mix them with a bit of a treat and flaked chicken breast and hand feed her, it's just too difficult trying to force dry pills down her throat, she just spits them out, I've got a pill popper but it greatly offends her and I don't want her any more stressed at this stage
I've ordered forte flora and Denamarin from Petchemist for later when she's eating more and will appreciate any advice from experienced cat owners who have dealt with similar circumstance,
she ate some chicken last night as well as a third of a can of pro plan beef& carrots ...
today she's had a tblsp of chicken and maybe same of Hills 11+ dry food,

 

[neely]

it's just too difficult trying to force dry pills down her throat, she just spits them out

I had a similar problem with Carleton. What worked for me was putting the pill in his throat and having a syringe partly filled with warm water to squirt in his mouth right afterwards so he'd swallow the pill.

Glad Mitzi is home and eating. Please keep us posted on her progress.

 

[Maggsy]

thanks, I'm hoping that I'm doing the right thing here, Mitzi loves head scratches etc but the minute I try to hold her head, she panics and fights me, I hate to stress her out more when she's unwell, I feel that as long as I can get her to eat as well as get the pills into her anyway I can, that she'll be okay, I don't use a full treat, just enough to blend with the pills as a dip, then hand feed her the pill coated chicken bits, she takes them willingly,
I'm also worried about possibly forcing water into her the wrong way and making her choke,
I'm such a coward, lol

 

[silent meowlook]

First off, is there a catheter in the bandages leg? If not, remove that wrap right away. They should have told you to take it off when you got home. It should be easy to just find the end and unwrap it.

Hi. Denmarin and milk thistle are similar. Denmarin has a few other things in it but it contains milk thistle.

If you have to use treats to get the meds in he then do that.

With the Denmarin, it is best given 1 hour before or 2 hours after a meal. You aren’t supposed to give with food, but it won’t hurt her if you do. It just wont be as effective.

Why is she on antibiotics?

With my cat, I pill her directly. I hate the pill poppers and so do cats. I just wait until my cat is not paying attention and get the pill and give it and walk away.

You can also try pill pockets.

 

[Maggsy]

First off, is there a catheter in the bandages leg? If not, remove that wrap right away. They should have told you to take it off when you got home. It should be easy to just find the end and unwrap it.

Thanks for advice, I took the bandage off shortly after the photo, I was told to leave it for an hour...
Vet didn't say why she was on antibiotics, she explained a feeding plan for future to get Mitzi's weight down and she only gave 1 pill (divided into 4) for appetite stimulation every 48hrs, I'm going to ask her for a script in case we need it in future as it's cheaper to buy direct ...
( vet charges $140 for 30 Denamarin, I ordered it for $67 at Petchemist, I know they need to make a profit but geez!)
she didn't give me any anti nausea pills either, said she didn't need them as she got an injection while in hospital overnight,
I have no idea what I paid $1200 for as bill isn't itemised, I rang and asked for a proper invoice today in case I may need info' for an emergency vet in coming days (god forbid!)
I honestly have no idea how I would have coped without the information from other cat owners here,
maybe it's because I'm old but I felt that the vet thought I was silly for asking about Denamarin or milk thistle /nausea meds etc, she just said that there was no need for it, maybe she's right but jus seems that Mitzi's treatment is not as complete as those I've been reading here
She's eaten a little chicken and some dry food this am and I just went and bought her some pet steak mince, she had 30gr of that, vet said to feed low fat foods

 

[silent meowlook]

Hi. So, if I understand this right, the vet wants your cat on a restricted fat diet due to her weight. And she is recovering from hepatic lipidosis.

I am not a veterinarian. I have worked decades in small animal hospitals including a specialty for nine years with both internal medicine and the surgery department. I worked six years recently at a feline only hospital. Do, I have seen allot of cats. But I do not have the schooling a veterinarian has and even a veterinarian cannot offer sound advice on a cat they have not physically examined. Do any advice or suggestions her are not medical advice. Just my opinion or what I would do if Mitzi was my cat.

Here is an article on the nursing care of hepatic lipidosis cats. It is written for technicians, but I think you will be able to benefit from reading it.

07 | How to treat and care for cats with hepatic lipidosis

At this stage in your cat’s recovery, I wouldn’t be worried about restricting fat. Cats need some fat.I would be more concerned about your cat eating, and wouldn’t limit food to a schedule. Once the hee we patio lipidosis is fully resolved you can worry about the cat losing weight.

I would certainly look into anti nausea medications and supplemental support of the liver etc with the vitamins mentioned and Denmarin.

Carbohydrates are bad for cats. Some more than others. All dry food is high in carbohydrates. Canned food is a much better option for cats. Provided, of course they will eat enough canned. I have seen many cats lose weight just by stopping the dry food, and giving all the canned food they want.

 

[Maggsy]

Thank you so much for this, much more helpful than my vet,
I've only been in my present address for 4 yrs and have taken Mitzi to this new vet 3 times, each time I've had unclear diagnosis ..On my visit on Tuesday morning, vet hinted that it may be diabetes, then when she rang with bw results said it may be pancreatitus, then after ultrasound said it was fatty liver but I was shown no results so haven't a clue, just trusting what they tell me ...
I'm trying my best to do what's best as far as feeding goes, she's had a variety of food today in small portions as vet said to only feed her little and often, over past 2 days she's had just 1/4 cup of Hills senior 11+ dry food but isn't looking for more, she's very lethargic compared to before she had treatment ...
I'm worried that she'll stop eating again when I run out of the mirtazapine, do they usually need to take it for awhile?

I'll ask vet about the need for antibiotics when they ring me tomorrow, she has 28 pills so 14 days of them to get thru'
are there any otc nausea meds I can get for her, vet said she didn't need them?

 

[silent meowlook]

Hi. If she is lethargic, I would look for another vet. Preferably a cat only hospital if there is one near you.

Lethargy in a cat is concerning. But I think this vet won’t be much help.

You can ask the vet that your cats records and bloodwork be sent to you.

 

[FeebysOwner]

Whether Mitzi has pancreatitis and/or fatty liver disease, the 'treatment' is pretty much the same - food, food, food (but, yes small amounts frequently), appetite stimulant, and anti-nausea meds as the primary things. Pain meds, fluids, and antibiotics are sometimes given as well, at least with pancreatitis - I don't know about fatty liver disease.

The appetite stimulant and anti-nausea meds need to be given for as long as they are needed to get Mitzi to continue to eat. A lot of vets feel that Mirtazapine can take care of nausea since it is supposed to have an anti-emetic effect, but often it is not enough. OTC possibilities are slippery elm bark, famotidine/Pepcid, meclizine - which is actually an antihistamine. But, I wouldn't give any of these to Mitzi without talking to the vet. Maybe if you bring them up, they will relent and give you Cerenia or ondansetron, two of the more common anti-nausea meds given to cats. Nausea can cause lethargy too; what cat - or human for that matter - wants to move around much if they are feeling sick.

 

[Maggsy]

No cat hospitals or specialists here, in fact most animal treatments need scripts and many which I see on Amazon.com can't be shipped here, it's very frustrating,
Xmas holidays will be here soon and I'm dreading another incident as local vets are mostly closed/limited hrs and the only emergency clinic is miles away, I'll ask for bw/records so that they can see her history if I do need to take her in
(I'm just afraid that this may happen again)
She ate 1/2 a can of FF this morning and a tbsp of dry, I feed her every 4/5 hrs

I really miss my old vet, known him for 35yrs and I trusted him with my pets, he retired and the old practice changed to a mini supermarket for animal accessories/feed etc, I know that all vets must be qualified but the new ppl didn't seem to have the same caring attitude ( maybe I'm just biased) anyhow, I moved away so not close now

 

[Maggsy]

OTC possibilities are slippery elm bark, famotidine/Pepcid, meclizine - which is actually an antihistamine. But, I wouldn't give any of these to Mitzi without talking to the vet. Maybe if you bring them up, they will relent and give you Cerenia or ondansetron, two of the more common anti-nausea meds given to cats. Nausea can cause lethargy too; what cat - or human for that matter - wants to move around much if they are feeling sick.

what is best way to dose slippery elm bark? I viewed it on Amazon and there are powders/capsules/tinctures etc,
I appreciate any and all advice, I'm waiting for vet to call but she didn't mention Denamarin to me until I brought it up and vet medicine is atrociously priced
(I ordered Denamarin from Petchemist without a script at $67/30 pills, it's $140 from vet)
I can buy Famotidine from normal chemist but would need dosage, will ask vet when I hear from her

 

[FeebysOwner]

what is best way to dose slippery elm bark? I viewed it on Amazon and there are powders/capsules/tinctures etc,

I have never used it. I only know of it from this site. So, hopefully, those who have used it before can answer your question.