Portosystemic Shunts - Aka Liver Shunt

kleigh300

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SOLUTION THAT WORKS FOR ME & SOPHIA
1/2 Can of Blue Wilderness Turkey (twice a day) mixed with
1mL of Enulose (Lactulose Solution, USP) 10g/15ml and
.1mL of Metronidazole 100mg/ml (Refrigerated)

She is fed twice a day with her medicines mixed into her food. Once in the morning and once at night with about 10-12 hours in-between feedings. Most times she finishes her food and for those times she doesn't, I put the left over food covered in the refrigerator and mix it into her next meal along with the exact measurements of food and medicine I mentioned above or I try to get her to eat what she did not finish in-between each meal so I can start with fresh food at the next feeding. If she doesn't eat the left over food in-between meals, then I just add it to the next meal like I mentioned above or if there is a lot left over, then I just give her the left over food from the previous meal (that already has medicine in it) for her next meal. DO NOT ADD ADDITIONAL MEDICINE TO LEFT OVER FOOD IF ALL YOU ARE GIVING IS LEFT OVER FOOD TO EAT AS THEIR NEXT MEAL. She eats in a 1/2 bath off my kitchen separate from my other cats in order to keep her from eating their food. The other cats, of course, do not have medicines in their food and they eat a higher protein food. If she had access to eat their food, that would bring on an episode.* I feed all my cats at the same time every day as Sophia eats. I mix Sophia's food first and place her in a separate room before fixing the other cats food (she actually follows me on her own into the other room and none of the other cats do because they have gotten used to the routine). NO FOOD is ever left out for Sophia to gain access to during the day or night. My other cats have adapted well to this arrangement and on a positive note, every one of them is a healthy weight because they are on measured meals twice a day and are not over eating because food is NEVER left out. She will be on this regimen for the rest of her life. I also feel compelled to mention, that I keep Sophia's stress level as low as possible. I spend equal amount of time with all my cats but Sophia is usually kept close to me. I find that brushing her with a silicone cat brush, rubbing her belly (yes, she loves her belly rubbed), giving her lots of love and allowing her to sleep in my lap keeps her stress levels low. Also, I DO NOT give my cats treats or cat nip. It is on a rare and I really do mean rare occasion that I will give them including Sophia a few small pieces of cooked chicken. Of course, Sophia does not get as much as my other cats because of her condition and she has never had a negative Central Nervous System reaction to the cooked chicken. But again, I stress that she does not get a lot and this is an extremely rare occasion for her. I am only mentioning this because I know that some people will want to give their liver shunted cat treats and I am trying to offer an alternative. If anyone else has a better alternative, I would love to hear it.


*See MY STORY below where I define what an episode for Sophia consisted of.
**Doing nothing is NOT an option and neither is euthanizing. My cat is very happy and healthy and it takes very little effort once you figure out the correct Food/Medicine ratio

RESULTS
Sophia is now over 4 years old and weighs an astounding 9.1 lbs. She is smaller than a regular sized cat and always will be but for a cat with her condition, she is at a very healthy weight. She has not suffered from an episode* to her Central Nervous System since I have found the proper balance between food, medication, feedings and of course love.

*See MY STORY below where I define what an episode for Sophia consisted of.

MY STORY
I had trapped a pregnant feral stray cat and decided to house her indoors (it was winter outside) for the remaining part of her pregnancy. My plan was to allow her to give birth inside in an extremely large caged in area in my finished basement and after she had successfully nursed them to the proper age, I would have her spayed, recovered and released back outdoors. She was to feral to domesticate. I would also adjust the kittens into domestic kittens to be adopted out. Well, you know what they say, we make plans and God laughs. It's true. The mother became ill after two weeks of nursing her 4 kittens and she had to be on medication to get better. So, she could no longer nurse the kittens and I became the surrogate mother feeding the 4 kittens around the clock. At first, they all appeared healthy and normal but @ 3 months old, Sophia had copper colored eyes, was only 1.5 lbs - 2 lbs & not gaining weight and often suffered from what appeared to be a catatonic state after she ate. Her tongue would hang out of her mouth, she always drooled and stared at the wall because of intermittent blindness. She also suffered from mental dullness, lethargy, listlessness, slight ataxia and could also become aggressive to my other cats. I would refer to them as episodes and they could last sometimes 8-10 hours at a time. I did not know that these symptoms were typical of a liver shunted cat and I had never heard of a Portosystemic shunt before. The first time it occurred, I was heartbroken and slightly panicked because it is an upsetting sight. I immediately took her to a Vet Emergency Hospital because it happened over a holiday weekend and my Vet was closed. She had a full line of blood work done but they were unable to diagnosis her at that time and placed her in an oxygen tank with fluids where she eventually recovered and was released after the weekend. I immediately took her to my regular Vet with hopes that they would have more answers. My Vet was unsure of her diagnosis but I was persistent enough to continue pursuing an answer within my Vet's practice when another Vet colleague of his suggested to have the acid bile test done and sure enough it came back positive. Most Vets will not suspect a liver shunt for a cat because they claim that it is an unusual or unlikely condition in cats but I have found through my research on the internet that many cat owners have cats with this condition and are not able to figure out what their cat is suffering from or what to do about it. This is why I am posting my story along with my solution and results in hopes that this may help others who's cats are suffering from this condition. Anyway, the moment I found out that she had a Portosystemic Shunt, I diligently did my research online. It wasn't easy. I didn't find anyone posting their exact regimen that they had used to get their cat back to good health. I suspect that most people who have a cat suffering from this condition either have not figured out what to do for their cat or their Vet is also not that familiar with a course of action that would work best for cats. My Vet was suggesting the usual solutions:
  1. Surgery - I would have opted for this recommendation if the success rate was higher after one surgery and if Sophia would NOT have been at great risk going under Anesthesia. However, from what I was learning, the surgery sometimes needs to be done more than once to be successful and the cost can run up to $5,000 for each surgery. More importantly, my Vet had mentioned to me that Sophia would have been at risk going under Anesthesia with the possibility of her dying on the table while in surgery. That was all I needed to hear, so needless to say, it no longer was an option for me.
  2. Food & Medicine Management - Obviously, this is the option I chose. It took me a while to configure the correct amount of food to medicine ratio. Originally, my Vet had issued me a prescription for Sophia to be put on Hill's Prescription Diet k/d Feline wet food along with the Enulose & Metronidazole medicines. I was told that the level of Crude Protein in the food needs to be between 6%-9% to minimize the level of toxins in the blood and that the Enulose (Lactulose) is a colonic acidifier that works by decreasing the amount of ammonia in the blood (It is a man-made sugar solution) and Metronidazole is capable of crossing the patient's blood/brain barrier, so it can stop infections affecting the Central Nervous System. It's also rapidly absorbed by your cats body, getting to work right away.
Before I had perfected the balanced Food to Medicine ratio, I was also administering Subcutaneous Fluids under the skin to ensure proper hydration because she was not drinking or eating enough due to the condition she was suffering from. Dehydration can lead to cat bladder problems and urinary diseases, including kidney disease and feline lower urinary tract disease. Other common conditions from dehydration are bladder inflammation (cystitis), tumors, ruptured bladder, and stones. Bladder stones can lead to life-threatening urethral blockages, particularly in male cats. There are a few ways you can tell if your cat is dehydrated. One of the best tests is to pinch your cat’s skin at the back of the neck and gently pull upward. If her/his skin does not return to its normal position quickly, she/he is probably dehydrated. Also pay attention to signs of panting, depression, lack of appetite, sunken eyes, dry mouth, increased lethargy, and increased heart rate. However, since finding the proper balance with her food & medicine management, I no longer have to administer the Subcutaneous Fluids. She properly hydrates herself at the water bowl daily and her food intake is wet canned food only.

IMPORTANT NOTES & COMMENTS
  1. Always consult your Vet first and foremost before ever trying any other course of action for your cat that the Vet is not aware of. Your Vet knows your cat best and should always be consulted. Review the regimen that I have Sophia on with your Vet to get the most accurate and professional advice with the proper course of action to help the quality of life for your cat.
  2. Do your research & be diligent. Learn as much as you can about this condition. The internet as well as careful trial & errors have been vital tools for me figuring out the best course of action for Sophia.
  3. I have chosen to feed Sophia Blue Wilderness Turkey in lieu of the Hill's Prescription Diet k/d Feline because I was not noticing enough weight gain in the beginning and I feel that the Blue Wilderness Turkey recipe is overall a healthier food for her. PLEASE NOTE: Blue Wilderness Turkey has a Crude Protein of 10%min which is higher than the Hill's Prescription Diet k/d Feline which has a Crude Protein of 6%min. After many trials, I have found the correct level of medicines to combine with the correct amount of Blue Wilderness Turkey for each feeding that works for Sophia.
  4. Make sure you check with your Vet that all the medications that your cat is on (if any) are all okay to be taken together before ever administering them. As I'm sure you already know, mixing medications can sometimes be fatal.
  5. DO NOT EVER OVERDOSE THE MEDICATIONS. If Metronidazole is given in too high a dose, the reaction to the medication can look exactly like the symptoms that your cat already showed due to the Portosystemic Shunt. It was confusing at first because my Vet did not mention that and unfortunately in the beginning they had prescribed her too high a dose of Metronidazole and I did not think the drug was working. I was cautious and smart enough to not try and give her more. I called my Vet and discovered that they had prescribed too high a dose so we cut back on the amount until I found the amount that she no longer had a negative reaction to.
  6. I know that this is a lot of information to take in and you still have a lot of research on the internet to do, but I promise you, you are your cats best advocate and it is well worth it. Sophia has been a happy little girl since. You can see for yourself in the pictures I have included.
  7. Lastly, I would like to mention again that NO FOOD should ever be left out where your liver shunted cat can eat it. It is detrimental to them. And, please be diligent in administering the correct amount of medications. Your cat baby will love you forever for it.
 

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FeebysOwner

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Thank you for sharing! This will be a searchable thread down the road for others, which is great! Btw, Sophia looks wonderful in those pics!!
 
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kleigh300

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Thank you for sharing! This will be a searchable thread down the road for others, which is great! Btw, Sophia looks wonderful in those pics!!
Thanks Feebys Owner. I know the thread was long but I tried to include everything I had experienced so others could relate. I only hope it helps other cat owners who have cats with similar symptoms to contact their Vet for a Bile Acid test ASAP to conclude if their cat is suffering from a liver shunt. The sooner the condition is diagnosed the better the chances the cat has for survival and there is less time that the cat has to suffer trying to diagnose their symptoms. I forgot to mention that Sophia is strictly an indoor cat.
 
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kleigh300

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SOLUTION THAT WORKS FOR ME & SOPHIA
1/2 Can of Blue Wilderness Turkey (twice a day) mixed with
1mL of Enulose (Lactulose Solution, USP) 10g/15ml and
.1mL of Metronidazole 100mg/ml (Refrigerated)

She is fed twice a day with her medicines mixed into her food. Once in the morning and once at night with about 10-12 hours in-between feedings. Most times she finishes her food and for those times she doesn't, I put the left over food covered in the refrigerator and mix it into her next meal along with the exact measurements of food and medicine I mentioned above or I try to get her to eat what she did not finish in-between each meal so I can start with fresh food at the next feeding. If she doesn't eat the left over food in-between meals, then I just add it to the next meal like I mentioned above or if there is a lot left over, then I just give her the left over food from the previous meal (that already has medicine in it) for her next meal. DO NOT ADD ADDITIONAL MEDICINE TO LEFT OVER FOOD IF ALL YOU ARE GIVING IS LEFT OVER FOOD TO EAT AS THEIR NEXT MEAL. She eats in a 1/2 bath off my kitchen separate from my other cats in order to keep her from eating their food. The other cats, of course, do not have medicines in their food and they eat a higher protein food. If she had access to eat their food, that would bring on an episode.* I feed all my cats at the same time every day as Sophia eats. I mix Sophia's food first and place her in a separate room before fixing the other cats food (she actually follows me on her own into the other room and none of the other cats do because they have gotten used to the routine). NO FOOD is ever left out for Sophia to gain access to during the day or night. My other cats have adapted well to this arrangement and on a positive note, every one of them is a healthy weight because they are on measured meals twice a day and are not over eating because food is NEVER left out. She will be on this regimen for the rest of her life. I also feel compelled to mention, that I keep Sophia's stress level as low as possible. I spend equal amount of time with all my cats but Sophia is usually kept close to me. I find that brushing her with a silicone cat brush, rubbing her belly (yes, she loves her belly rubbed), giving her lots of love and allowing her to sleep in my lap keeps her stress levels low. Also, I DO NOT give my cats treats or cat nip. It is on a rare and I really do mean rare occasion that I will give them including Sophia a few small pieces of cooked chicken. Of course, Sophia does not get as much as my other cats because of her condition and she has never had a negative Central Nervous System reaction to the cooked chicken. But again, I stress that she does not get a lot and this is an extremely rare occasion for her. I am only mentioning this because I know that some people will want to give their liver shunted cat treats and I am trying to offer an alternative. If anyone else has a better alternative, I would love to hear it.


*See MY STORY below where I define what an episode for Sophia consisted of.
**Doing nothing is NOT an option and neither is euthanizing. My cat is very happy and healthy and it takes very little effort once you figure out the correct Food/Medicine ratio


RESULTS
Sophia is now over 4 years old and weighs an astounding 9.1 lbs. She is smaller than a regular sized cat and always will be but for a cat with her condition, she is at a very healthy weight. She has not suffered from an episode* to her Central Nervous System since I have found the proper balance between food, medication, feedings and of course love.

*See MY STORY below where I define what an episode for Sophia consisted of.

MY STORY
I had trapped a pregnant feral stray cat and decided to house her indoors (it was winter outside) for the remaining part of her pregnancy. My plan was to allow her to give birth inside in an extremely large caged in area in my finished basement and after she had successfully nursed them to the proper age, I would have her spayed, recovered and released back outdoors. She was to feral to domesticate. I would also adjust the kittens into domestic kittens to be adopted out. Well, you know what they say, we make plans and God laughs. It's true. The mother became ill after two weeks of nursing her 4 kittens and she had to be on medication to get better. So, she could no longer nurse the kittens and I became the surrogate mother feeding the 4 kittens around the clock. At first, they all appeared healthy and normal but @ 3 months old, Sophia had copper colored eyes, was only 1.5 lbs - 2 lbs & not gaining weight and often suffered from what appeared to be a catatonic state after she ate. Her tongue would hang out of her mouth, she always drooled and stared at the wall because of intermittent blindness. She also suffered from mental dullness, lethargy, listlessness, slight ataxia and could also become aggressive to my other cats. I would refer to them as episodes and they could last sometimes 8-10 hours at a time. I did not know that these symptoms were typical of a liver shunted cat and I had never heard of a Portosystemic shunt before. The first time it occurred, I was heartbroken and slightly panicked because it is an upsetting sight. I immediately took her to a Vet Emergency Hospital because it happened over a holiday weekend and my Vet was closed. She had a full line of blood work done but they were unable to diagnosis her at that time and placed her in an oxygen tank with fluids where she eventually recovered and was released after the weekend. I immediately took her to my regular Vet with hopes that they would have more answers. My Vet was unsure of her diagnosis but I was persistent enough to continue pursuing an answer within my Vet's practice when another Vet colleague of his suggested to have the acid bile test done and sure enough it came back positive. Most Vets will not suspect a liver shunt for a cat because they claim that it is an unusual or unlikely condition in cats but I have found through my research on the internet that many cat owners have cats with this condition and are not able to figure out what their cat is suffering from or what to do about it. This is why I am posting my story along with my solution and results in hopes that this may help others who's cats are suffering from this condition. Anyway, the moment I found out that she had a Portosystemic Shunt, I diligently did my research online. It wasn't easy. I didn't find anyone posting their exact regimen that they had used to get their cat back to good health. I suspect that most people who have a cat suffering from this condition either have not figured out what to do for their cat or their Vet is also not that familiar with a course of action that would work best for cats. My Vet was suggesting the usual solutions:

  1. Surgery - I would have opted for this recommendation if the success rate was higher after one surgery and if Sophia would NOT have been at great risk going under Anesthesia. However, from what I was learning, the surgery sometimes needs to be done more than once to be successful and the cost can run up to $5,000 for each surgery. More importantly, my Vet had mentioned to me that Sophia would have been at risk going under Anesthesia with the possibility of her dying on the table while in surgery. That was all I needed to hear, so needless to say, it no longer was an option for me.
  2. Food & Medicine Management - Obviously, this is the option I chose. It took me a while to configure the correct amount of food to medicine ratio. Originally, my Vet had issued me a prescription for Sophia to be put on Hill's Prescription Diet k/d Feline wet food along with the Enulose & Metronidazole medicines. I was told that the level of Crude Protein in the food needs to be between 6%-9% to minimize the level of toxins in the blood and that the Enulose (Lactulose) is a colonic acidifier that works by decreasing the amount of ammonia in the blood (It is a man-made sugar solution) and Metronidazole is capable of crossing the patient's blood/brain barrier, so it can stop infections affecting the Central Nervous System. It's also rapidly absorbed by your cats body, getting to work right away.
Before I had perfected the balanced Food to Medicine ratio, I was also administering Subcutaneous Fluids under the skin to ensure proper hydration because she was not drinking or eating enough due to the condition she was suffering from. Dehydration can lead to cat bladder problems and urinary diseases, including kidney disease and feline lower urinary tract disease. Other common conditions from dehydration are bladder inflammation (cystitis), tumors, ruptured bladder, and stones. Bladder stones can lead to life-threatening urethral blockages, particularly in male cats. There are a few ways you can tell if your cat is dehydrated. One of the best tests is to pinch your cat’s skin at the back of the neck and gently pull upward. If her/his skin does not return to its normal position quickly, she/he is probably dehydrated. Also pay attention to signs of panting, depression, lack of appetite, sunken eyes, dry mouth, increased lethargy, and increased heart rate. However, since finding the proper balance with her food & medicine management, I no longer have to administer the Subcutaneous Fluids. She properly hydrates herself at the water bowl daily and her food intake is wet canned food only.

IMPORTANT NOTES & COMMENTS

  1. Always consult your Vet first and foremost before ever trying any other course of action for your cat that the Vet is not aware of. Your Vet knows your cat best and should always be consulted. Review the regimen that I have Sophia on with your Vet to get the most accurate and professional advice with the proper course of action to help the quality of life for your cat.
  2. Do your research & be diligent. Learn as much as you can about this condition. The internet as well as careful trial & errors have been vital tools for me figuring out the best course of action for Sophia.
  3. I have chosen to feed Sophia Blue Wilderness Turkey in lieu of the Hill's Prescription Diet k/d Feline because I was not noticing enough weight gain in the beginning and I feel that the Blue Wilderness Turkey recipe is overall a healthier food for her. PLEASE NOTE: Blue Wilderness Turkey has a Crude Protein of 10%min which is higher than the Hill's Prescription Diet k/d Feline which has a Crude Protein of 6%min. After many trials, I have found the correct level of medicines to combine with the correct amount of Blue Wilderness Turkey for each feeding that works for Sophia.
  4. Make sure you check with your Vet that all the medications that your cat is on (if any) are all okay to be taken together before ever administering them. As I'm sure you already know, mixing medications can sometimes be fatal.
  5. DO NOT EVER OVERDOSE THE MEDICATIONS. If Metronidazole is given in too high a dose, the reaction to the medication can look exactly like the symptoms that your cat already showed due to the Portosystemic Shunt. It was confusing at first because my Vet did not mention that and unfortunately in the beginning they had prescribed her too high a dose of Metronidazole and I did not think the drug was working. I was cautious and smart enough to not try and give her more. I called my Vet and discovered that they had prescribed too high a dose so we cut back on the amount until I found the amount that she no longer had a negative reaction to.
  6. I know that this is a lot of information to take in and you still have a lot of research on the internet to do, but I promise you, you are your cats best advocate and it is well worth it. Sophia has been a happy little girl since. You can see for yourself in the pictures I have included.
  7. Lastly, I would like to mention again that NO FOOD should ever be left out where your liver shunted cat can eat it. It is detrimental to them. And, please be diligent in administering the correct amount of medications. Your cat baby will love you forever for it.
1-YEAR UPDATE
I'd like to mention a few things:
  1. I neglected to state in my original post that Sophia is strictly an indoor cat as well as my 5 other cats.
  2. I've been switching back and forth every month between Blue Wilderness Turkey and Dave's Naturally Healthy Food (Turkey or Chicken Formula). I still feed her 1/2 of a 5.5oz can twice a day. I have NOT changed the amount of Enulose or Metronidazole in each feeding. The food to medicine ratio has remained the same because the Crude Protein is still at 10%min with the Dave's Naturally Healthy Food. *If you are looking for your cat to gain weight, I would suggest sticking with the Blue Wilderness Turkey because it has a 1,485 Kcals/kg, 231 Kcals/can (5.5oz) which is higher than Dave's Naturally Healthy Food that has 1,243 Kcals/kg, 194 Kcals/can (5.5oz) Turkey & 1,150 Kcals/kg, 185 Kcals/can (5.5oz) Chicken.
  3. In the last year, she has also been diagnosed with Cardiomyopathy & Asthma. On top of her Liver Shunt medications, she now takes Diltiazem 30mg - 1/2 Tablet (Twice a day after both meals), Furosemide Syrup 1% (10 mg/mL) - .4mL (Twice a day after both meals) & Baby Low Dose Aspirin 81mg - 1 Pill (Every 3 days) for the Cardiomyopathy and Flovent HFA 110 mcg - 2-Puffs/day for the Asthma (1/Puff Morning & 1/Puff Evening). *The puff is released into a AeroKat Chamber that covers Sophia's nose which she breaths in/out 10 full breaths or 20 short breaths depending on how well she can breath at the time of admission. I do this to ensure she breaths in all the medicine in the chamber. Also, it is important to clean the chamber at the end of every day.
  4. Recently, my Vet has also added in Pet-Tinic to her daily regimen of medications. I give her 1/4 teaspoon (1/2 mL or .5 mL) once a day. It is a palatable liquid Vitamin-Mineral Supplement.
 

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