My kitty and Hepatic Lipidosis

[epona]

Oh she is extremely pretty!
I'm very glad to hear that she seems to have perked up a bit, I hope she continues to improve.

 

[mrsgreenjeens]

This was her today.

She looks good! Hoping she is now on the mend.

 

[Catlover0188]

Izzys bilirubin is slightly worse today, but her other liver markers are coming down. I have to remember that her bilirubin last time got way worse before better. They said her liver biopsy is consistent with fatty liver disease. They started her on ursodiol. They also said her feeding tube site looked infected, so they've been cleaning it and started her on an antibiotic.

I get to pick her up in a hour and then take her in for labs tomorrow!

 

[Catlover0188]

Izzy had lab work yesterday and they added on an additional antibiotic for a possible tube site infection that would also help a potential kidney infection. Shes on Verafox and Clavamox. Her bilirubin is worse and her kidney levels are starting to go up again. Her anemia is worse, as well. However, her other liver enzymes are coming down. Her urine culture came back today as no growth, but we are continuing her antibiotics as scheduled.

The one day I visited her; she was very perky. She hasn't been so perky at home. Sleeps a lot and lethargic.

The vet said her hematocrit is 21% and they wouldn't want it to get much worse without readmitting. She follows up with her primary on Monday for labs and I asked the ER vet if I should bring up steroids. Izzy had to be on a low dose steroid last time for anemia, as well. She said that while steroids can help, they can also be harmful to the liver so she wouldn't recommend that just yet.

Her last hospitalization was $5800. And her other overnight stay at another vet $3500. And another bill from an urgent care was $1500.

I hate to say it, but I simply can't fork out anymore money for hospitalizations for her. I'm willing to spend money to take her for lab work, medications, and food. But it is just way too expensive.

I hate seeing her so ill, too. And how is it that I got her feeding tube in so early and we still are at this point? It's frustrating and just goes to show you can do everything right and still things don't go right.

The vet keeps saying give it time that she has seen labs get worse before before better. The kidney thing however with what they saw on ultrasound. I'm worried that this is a chronic kidney issue.

 

[FeebysOwner]

I am sorry things are not improving faster.

What 'kidney thing' that was seen on the ultrasound? You shared the x-rays and the information in the report did not suggest any issues besides stones. So, what was on the ultrasound? Are the vets echoing your concerns about something to do with the kidneys?

 

[Catlover0188]

Oh I'm sorry I don't remember if I included this in a post or not. But she had an ultrasound when she was hospitalized last week. They said one of her kidneys was bigger then the other which could be an infection or a chronic issue.

The vet said it very well could be chronic or an infection. Her urine culture had no growth, but she also had an antibiotic injection at the last ER vet due to a fever.

She also had a fever at her check up yesterday.

 

[Catlover0188]

Try the Gastro Elm I posted a link to above. I'm trying it with my pancreatitis kitty.

I just bought this!

 

[FeebysOwner]

They said one of her kidneys was bigger then the other which could be an infection or a chronic issue.

Or, it could be neither, and merely an anatomical anomaly. Tbh, I have never heard of a urinalysis/urine culture coming back clean with either a kidney infection or a bladder infection. I suppose it is possible to mask the infection if she was already taking antibiotics at the time the urine was collected. But, if there is a kidney infection, antibiotics are generally needed long term, at least 2, more like 6, weeks - if not longer. They aren't usually resolved quickly, so I doubt a few rounds of antibiotics would mask it. The fever could be from the possible tube site infection.

Gastro Elm is some proprietary blend of herbs - slippery elm, milk thistle seed, marshmallow root, and dandelion root. Given it is more of a holistic treatment it probably can't hurt anything, but I would definitely run it by your vet first.

Did the vet ever mention SAMe (S-adenosylmethionine)?

 

[Catlover0188]

Or, it could be neither, and merely an anatomical anomaly. Tbh, I have never heard of a urinalysis/urine culture coming back clean with either a kidney infection or a bladder infection. I suppose it is possible to mask the infection if she was already taking antibiotics at the time the urine was collected. But, if there is a kidney infection, antibiotics are generally needed long term, at least 2, more like 6, weeks - if not longer. They aren't usually resolved quickly, so I doubt a few rounds of antibiotics would mask it. The fever could be from the possible tube site infection.

Gastro Elm is some proprietary blend of herbs - slippery elm, milk thistle seed, marshmallow root, and dandelion root. Given it is more of a holistic treatment it probably can't hurt anything, but I would definitely run it by your vet first.

Did the vet ever mention SAMe (S-adenosylmethionine)?

She's already on Denamarin. This one is tricky because it can't be crushed. The past 2 days just when I think she's swallowed it, she coughs it back up.

2 years ago she had multiple ultrasounds for fatty liver disease and nothing was ever mentioned about her kidneys. That worries me a bit.

 

[Catlover0188]

Izzy is back in hospital overnight after starting not to tolerate tube feeds. Her hematocrit and kidney values are worse.

They said her one kidney value was so high it didn't register.

They did a point of care ultrasound and saw some fluid on her belly. They started her on Reglan and they told me even after that she was dry heaving. She'll have an ultrasound to reevaluate things.

I do think depending on the news that we are at the point of no return or at least very close to it. I'm okay with this and have started to accept this. The vet worked out a deal with me to keep her overnight so it wasn't as expensive.

 

[Catlover0188]

Today on an ultrasound they found a stone obstructing my kitty's right kidney. They said she would need some sort of bypass surgery? I've decided to put her to sleep in the home tomorrow.

I feel guilty that there's more I can do, but the vet agreed there's too much going on.

 

[fionasmom]

There is a great deal going on and if you feel that it is time, then it is the right thing to do. The attitude of many of the specialist vets out here, bless their hearts for trying, is that something else can always be done. That does not mean that it should be done.

 

[Catlover0188]

You would not guess she was sick by how she's acting at home now. I know it's the adrenaline of her first getting home, though. She has the same adrenaline when I take her into the vet.

A part of me feels like I'm giving up just because she looks so good now. They said I'd have to go to another state for the surgery she needs. There's no way I can do that. The vet said she believes what I'm doing is reasonable as there's so much going on. She said if it were just the liver thing, she'd push me to keep going. But she said this kidney thing gives her pause.

 

[fionasmom]

You don't need to do anything that you are not ready to do. This can be watched on a day to day basis and you can make a decision when you feel that it is the right time. Were you given information about the stone in the kidney? Is this an imminent problem?

I completely understand not going out of state which would have a lot of complications.

Would the house call vet be able to come on a fairly short notice if you felt that the time had come? If so, you might consider not doing anything tomorrow.

 

[Catlover0188]

The vet feels like she wouldn't have a week left. I just can't fork out anymore money for procedures. I feel guilty that I didn't notice sooner, but it wouldn't have changed anything I don't think.

I'm a little annoyed that they didn't send me home with any sort of pain medication.

 

[fionasmom]

I just can't fork out anymore money for procedures.

Don't feel that way. More money does not mean success or a cure. I have a friend who is still paying off a vet bill for a dog who died on the operating table. I don't mean to be so dismal, but you have done a huge amount. We all start to think this way at a time like this. I refused surgery for my 15 year old GSD who had an anal adenocarcinoma. How much time was it going to buy him vs stress of surgery and recovery?

I feel guilty that I didn't notice sooner, but it wouldn't have changed anything I don't think.

You have been on top of this and very sadly it has probably run its course.

I'm a little annoyed that they didn't send me home with any sort of pain medication.

Call back and ask for pain meds or a good reason why they were not offered.

 

[Catlover0188]

Don't feel that way. More money does not mean success or a cure. I have a friend who is still paying off a vet bill for a dog who died on the operating table. I don't mean to be so dismal, but you have done a huge amount. We all start to think this way at a time like this. I refused surgery for my 15 year old GSD who had an anal adenocarcinoma. How much time was it going to buy him vs stress of surgery and recovery?

You have been on top of this and very sadly it has probably run its course.


Call back and ask for pain meds or a good reason why they were not offered.

Yeah. I have a friend who is very well off who said they wouldn't have even forked out more then $2K. I think her bladder stones are what led to the fatty liver issue. The vet thinks that as well. Cats just are so good at hiding when they're sick!

 

[FeralHearts]

Not much to add to this... but will be thinking of you. It's a tough call - and I agree - you were on top of this. It may not feel like it - but you were and like fionasmom said - more money doesn't mean a cure or even a long good quality of life.

I know all to well how they are masters of hiding things. It's enough to make you insane and question yourself and you probably will for a long time... but you've done right by her in every way you can. I hope you hold onto that.

XOXOXOXOXOX

 

[Catlover0188]

I called her primary vet who said Izzy would need something called a SUB procedure and only certain centers do it in the U.S. She also said success rates are hit or miss. Her primary vet agreed there's too much going on and I've done so much for her already. She said she thinks I'm making the right call.

 

[FeralHearts]

I think you'll be glad that you made that call to her primary and asked questions. I hope that things brings you some peace of mind. I know it's not easy.

My heart goes out to you.