Support needed for a cat with enlarged liver - please

[diesse]

Has anyone had a similar experience as this please?

My little 10 year old cat had a limp from her shoulder in July so took to vet.  They did blood works as one of their normal procedures for a cat of that age which showed that her liver, heart and kidneys were A1 - perfect levels.  She was then given Metacam for her limp.  She was on this for a couple of weeks and when her limp went, I stopped the drug as I had heard it could have an affect on her kidneys.  The vet wanted me to carry on on a lower dose but I refused.

I suppose that looking back, her behaviours changed.  She would sometimes go behind the sofa or insist on going out and sit underneath the patio furniture.  However, whenever I put food down, she appeared to be eating so no alarm bells there.  I then thought that she was losing weight but there again, I had taken my cats off a cereal based diet and given them Applaws dry which is 80% meat and they also got wet food morning and night which is Butchers which doesn't have any cereal.  So I thought that everything was ok.

I then noticed that she wasn't eating and throwing up.  I looked in her mouth and saw that her one and only tooth was badly swollen at the gums.  I thought that this was why she wasn't eating properly.

I took her to the vet who put her on antibiotics but I rang 3 days later and told them that I wanted the tooth out.

I received a call to say that the op had gone well but that she was very very jaundiced and they asked if they could do more blood works and an ultra sound.

The blood works showed elevated levels in her liver and the ultrasound showed that her liver and gall bladder were enlarged.  However, they couldn't find any sign of tumours.  

She was sent away with further antibiotics, a tablet for the flow of bile and a supplement to support the liver.

At this point she was eating to a certain extent and in fact, I was able to give her her meds in food.

However, the next few days saw her becoming more lethargic and stop eating all together.  She started vomiting.

I too her back.  They didn't want to do a biopsy as they felt that this would put more pressure on the liver and she was weak.  We agreed a needle aspiration.  This hasn't shown anything other than she has a liver problem.

She was given steroids and at the moment she is on antibiotics, liver supplement, sterioids and a tablet to help the flow of bile including a tablet every 3 days to try and get her to eat.  In the meantime, I am feeding her a/d through a syringe and managing to get a tin down her.  The label suggests

1-11/4 cans of a/d per day.

Her urine is a strong yellow colour but not as orange or as smelly as it was.  Although she doesn't have much in the way of stools, they are firm.

She does seem a little brighter today and is coming to lay on the couch.  She doesn't look in pain.  She has had a go at eating but only either licks the food or picks up a couple of pieces.  I am taking her back to the vet today.  They are wanting me to give her the fluid myself as she is such a nervous cat and the shock could have adverse effects on her.

So really, I don't know what we are treating.  My vet has ruled out fatty liver as they say that it isn't common and were looking more on a bacterial infection or inflammation.  Two of the vets have wanted to put her to sleep but my favourite vet does not see her as a cancer cat and as she has said, she  is still interacting and isn't flat.

Has anyone had a similar experience.  Just don't know which way to turn with this. 

 

[miss mew]

I really wish I had some insight for you on this, but I haven't dealt with this type of issue.  Just wanted to pass along my prayers for her. 

 

[catwoman707]

Hi there and welcome to the cat site.

Yes, this is not uncommon, and here is a link by Dr. Ron Hines, who writes clearly and easy to understand.

http://www.2ndchance.info/triad.htm

I think you will find this info very helpful!

 

[Anne]

We have an article about liver disease right here - 

http://www.thecatsite.com/a/liver-disease-in-cats

Sounds to me like you have several vets looking after her, which is a good thing. Cats can sometimes have unexplained episodes like this and they certainly can bounce back. I've had that happen with my cat once, and while the vets could never fully diagnose, the supportive care helped him make full recovery, eventually.

I hope the same happens with your cat. I think that as long as you have the support of your vet and the cat is not in pain or discomfort, she should be given a chance. Ten is not young, but it's not that old either, and she could have quite a few more years of quality life ahead of her.

Please let us know how she's doing. I know this is a very stressful situation for you, so sending you lots of support and good health vibes for your cat 

 

[diesse]

Thank you to everyone who has replied and sent links.  She seemed marginally better yesterday.  The vet actually said that if she didn't know that she had jaundice and her problems, due to her clear eyes and glossy coat, she would have said that she was a healthy cat.  She said that if she had just been presented to her for the first time for vaccinations, she would have said that she was in good condition.  The vet said that if it was her cat she would continue with her treatment.  I asked the vet if she knew exactly what was happening and she said that the ultrasound was showing an enlarged liver and gall bladder and some obstruction in the biliary system.  She said that the latter could be due to a tumour or inflammation.  Unfortunately, the ultrasound and needle aspiration did not confirm her condition.  Last night she actually managed a couple of drinks of water and again this morning.  This is the first time in the last 2 weeks that she has been seen to drink on her own.  The vet also thought that her gums may not look quite as jaundiced.  This morning she did seem much quieter again but did drink on her own and had a few bites of cat food.  She has been syringe fed and is now lying at the side of me purring.  This is the most weird condition that I have ever come across.  I am a little worried as I have just recently changed my cat food to one that is 80% meat and no cereal.  The fat content looks high which is something that isn't needed in cats with liver problems.  I know that some of the cheaper brands have rubbish in them but just wonder if we are now feeding too rich a food for cats.  Maybe they fayre better on a poorer diet.  

 

[mrsgreenjeens]

I've had a cat with Fatty Liver, and read about MANY cats with it.  What your little one is suffering from currently sounds an awful lot like it, and I beg to differ that is a rare thing. As I was reading your story, it screamed at me"fatty liver" 

  That being said, I would certainly keep fighting.  I just want you to know that even though she is starting to drink and eat a little bit doesn't mean you can ease up on syringe feeding her the A/D.  I think you will need to continue that for quite some time still.  Is Denamarin one of the pills you are giving her?  My own cat was just on a round of that and it did wonders for her numbers.  She wasn't as bad as your little girl, but in just 30 days her numbers vastly improved  (she wasn't my cat with Fatty liver...that was a LONG time ago for me)  With our girl, we don't know what caused her liver values to skyrocket either...all we know is that, for the moment, the values have gone back down.  We did NOT do an ultrasound since they dropped after just 14 days on Denamarin (that's as long as she would permit us to pill her

)

As to the Applaws, is that now 100% nutritionally complete?  Used to be a wasn't - at least the canned Applaws wasn't. 

 

 

[goholistic]

I agree with @mrsgreenjeens that this could be fatty liver. I certainly wouldn't describe fatty liver as rare. Any cat can get it and it can come on pretty quickly. I have read more cases of it than I would like. Even if a cat is eating, if they are not eating enough over an extended period of time, they can get fatty liver. Of course, it could be something like cancer, too.  

  I also agree to continue with the full amount of syringe feeding. If you think she might be interested in eating on her own, you could put down a small amount of food (not the A/D). If she doesn't go for it, then syringe feed.

I had to syringe feed my Sebastian for two weeks. When he started feeling better, he would only eat a small amount on his own. But it wasn't enough, so I finished off what he needed with syringe feedings.

I will echo the suggestion to check the Applaws and make sure it is a complete food.

 

[diesse]

Thank you for replying.  I am shocked that 3 vets at my practice have said that this is not fatty liver and that it isn't a common condition as I can see from the internet that there appears to be a lot of cats that have or had this disease and that some of the cats have managed to get through it.

I was delighted this morning as she was waiting for me to get up, had a drink and tried to eat something.  She seemed a lot stronger and was interacting with me.  However, she only managed a small amount of food and then seemed to feel sick again and went into a corner. She has now gone quiet again.

The drugs that she is on are -

Kesium - twice a day - antibiotics

Mirtazapine - third every 3 days  - to help with her appetitie

Hepatosyl Plus  - 1 per day -  liver support/supplement

Destolit - quarter per day - for bile flow

Prednidale - half twice a day - steroid

Previously she has had steroid injections and an injection to help with her nausea.

I am managing to get a tin of a/d down her by syringe which I am having to water down but I am using Liquivite for this and not water.

I am finding it really weird that in July she had blood works which showed all her organs as normal including her liver.

She was then prescribed Meloxdyl for a strained shoulder although she was only on this for 2 weeks.

It was 2 weeks ago that I noticed that she wasn't eating properly  but not sure how long this had been going on for.  I noticed that her one and only tooth was inflamed at the gum and took her for this out when the vet noticed that she was jaundiced.

I have been syringe feeding now for 2 weeks.

On Wednesday night she started to drink on her own and has kept trying to eat but without much success.

Just not sure what to expect. 

 

[goholistic]

The fact that she attempted to eat something on her own is a good sign, but then she likely got nauseous shortly after. Despite the Mirtazapine, if she's nauseous, she will likely still not want to eat.  Perhaps you may want to speak with the vet about adding an anti-nausea medication. In the U.S., Cerenia seems to be a popular choice. It comes in tablet and injectable form, although my vet has only ever sent me home with the tablet. @Denice also has a cat that had fatty liver and I learned from her that cats with fatty liver just won't eat until the liver starts improving.

Are you happy with the practice you go to? Are any of the three vets you saw internal medicine specialists? If not, perhaps you may want to pursue another opinion with an internal medicine specialist at another practice or specialty center? When my vet is stumped, she refers me to a specialist.

I know a lot of vets still use Meloxidyl/Metacam and sometimes it is for good reason, but it does not come without risks. The potential side effects can be really serious. I have it on my vet's list of things never to give to my cats. While we can't say for sure that it is what caused your cat's liver problems, the timing does seem suspect. But what's done is done, unfortunately, and the only thing you can do now is focus on trying to heal her liver.

 

[diesse]

Thank you for your support.  I am really annoyed with myself over the Metacam as I have only used it for the odd day if my cats have had a problem but I have never been happy about it.  She was on it for 14 days in July and the vet who I have known for years has said that I would gave seen an adverse effect much earlier had it been the metacam.  She said that the symptoms would have shown quickly and that once off it, the liver would have sorted itself out.  Whereas, she seems to have gone progressively worse.

I am wondering if it is inflammation as had it been cancer, which didn't show up on the needle aspiration and ulrasound, she would have become much more ill over the last 2 weeks and I wouldn't have expected her to start drinking on her own which she did on Wednesday and so far, is still continuing to do so.  I can see where the other member is coming from and it makes a lot of sense that until the inflammation and fattty liver starts to improve, she will continue to feel sick.  I guess it is just a matter of waiting and hoping.  I am hoping that she will start to eat on her own next week as after that, I will be at work for 3 days per week and this is full time.  I don't have anyone else to syringe feed her so I am starting to panic. 

I understand that she has had an anti sickness injection which lasts for a couple of weeks but I am back at the vets on Monday and will query this with the vet who is dealing with her at the moment.

With regard to trusting these vets, they have taken care of my cats for years but I have always had an open mind and questioned them if necessary.  They have dealt with my 17 year old moggie for many years who has asthma, thyroidism and collapsed throat muscles and she is still going strong.  However, I believe that the best vet is the one who looks after my rabbits and I believe that she has some sort of certificate to do with specialising in cats.  I have spoken with her previously about her taking care of my cats but she only works a couple of days a week and is a number of miles away.  Her main surgery (which she doesn't work from) is several miles away and we felt that it would be too far in the case of an emergency.  The surgery that she works from is only very small.  Having 7 cats, I just thought that a vet nearer to where I live would be much better.   The vets that I use for my cats are only 3 miles away.   I am however trying to speak with my rabbit vet and see about seeking a second opinion from her.  Not sure though how this will sit with my normal cat vets for the future.  

The biggest problem is that we don't know what is exactly wrong with her as the tests have not shown anything positive and it is felt that a biopsy is too much of a risk for her.  So basically, the vet has put her on antibiotics in case of a bacterial infection and then steriods for an inflammation.  I did agree with the vet that even if we put Minnie at risk with a biopsy, other than it being something nasty like cancer,  the treatment would be the same as she is receiving. 

 

[catwoman707]

The main thing is to keep those calories going in, fatty liver happens when a cat takes in under 50% of their normal caloric intake daily.

So a full can of A/D diluted per day will be fine.

Don't beat yourself up about the metacam, we trust our vets advice, just as our human doctors. 

If it had anything to do with what's going on, perhaps it's like a delayed effect from having it for 2 weeks, which IS  a long time.

 

[diesse]

I rang my other vet up who told me to get her to the present vets for admittance and fluids.  I have done this.  Whilst there they took some more bloods which has shown that all levels have increased but the most increase is with regard to the bile which the ultrasound did show as having an obstruction albeit it did not show as a tumour but could have been due to inflammation for which she was being treated along with the antibiotics.  They are keeping her in over the weekend.  I hate putting animals through things like this but the problem is that I can't have her pts as I don't know what the cause is.  The other vet has said that she will accept her as a referral once she has been stabilised and obviously will need her records.  Just hoping she pulls through.  She has become very weak.

 

[catwoman707]

I completely agree and support your decision not to put her to sleep, as it is too unidentified as to what's going on.

Maybe it's no obstruction but merely inflammation causing this, and the steroid will help get that down, she will let you know if/when it really is time.

Don't give up if there is hope, you would never forgive yourself and live with the "what if's", making you feel lots of guilt.

Hang in there and see this through, there is always hope!   

    

  

 

[diesse]

I have spoken to the other vets who deal with my rabbits.  I didn't realise but they are the leading animal hospital in yorkshire and have vets dealing in specialist areas so take on an enormous amount of referrals from other vets.  I am just waiting for my vet to open and am asking for a referral today.  Just hope that it won't be too late for her.  

 

[mrsgreenjeens]

 
I have spoken to the other vets who deal with my rabbits.  I didn't realise but they are the leading animal hospital in yorkshire and have vets dealing in specialist areas so take on an enormous amount of referrals from other vets.  I am just waiting for my vet to open and am asking for a referral today.  Just hope that it won't be too late for her.  

Can they do everything via phone by just looking at her faxed records, or are you going to have to drive her way over there?  Hopefully they can just do everything via the phone

Continued vibes for your little one

 

[diesse]

I have picked her up and driven her over to the other vets.  From the examination they noted that the liver felt quite hard.  They have taken their own blood tests which are not showing anything other than increased levels.  They have scanned which has shown an abnormal shape in part of the liver and dilated blood vessels.  They are going to scan to get a closer look at the abnormal shape and blood vessels and also the rest of her body.  They are taking tests for an immune deficiency and are looking to do a biopsy.  In the meantime, she is quite bright and taking syringe feeds plus trying to feed on her own.  They have spoken to me about the Metacam which he has said is highly unlikely that it has caused the problems but that she appears to have had something happening for quite a while.  However, I guess that the Metacam won't have helped with any pre existing conditions.  In the meantime, I am speaking with our Royal Vet Assoc tomorrow as I want to see where I stand before I go and complain to my previous vet.  I want to know why they haven't told me that this new vet can do a biopsy which is so much less invasive as he has all the upto date equipment.  They have left my cat for 2 weeks when they knew that they could have referred her at the beginning.  So, getting all the information I need as I also want to refer all my cats away from them and I am going in to have it out with them.     

 

[diesse]

Sad news.  The vets did an exploratory which found that she had a nasty pancreatic tumour.  They were surprised that she hadn't gone downhill or shown worse symptoms.  In fact, they had reported in the morning that she was quite bright and had eaten quite a lot the evening before.  The vet had been investigating the fact that the liver was enlarged with dilated blood vessels although he said that the bile was flowing ok and therefore there wasn't an obstruction which the first vets had said she had.  He said that when he operated, the liver was the wrong colour with dilated blood vessels.  This wasn't the problem though, it was the tumour which he said was inoperable.  I decided to let her go on the operating table.  Just so upset.  Loved her so much.

 

[di and bob]

My heart goes out to you, but you did the right thing by not allowing her to suffer. It was something that could not be made better and in fact would have gotten nothing but worse. I know that doesn't help your broken heart but I pray you will feel the comfort and love we all send your way. Only time will help you now, the grief is overwhelming at first and threatens to overcome you. You need to surround yourself with people who understand what you are going through and let them share your sorrow. I cry for your loss, and will keep you both in my thoughts and prayers, take care of yourself, try not to dwell on the passing, but remember the happy times and the love you two shared. She will never be forgotten and will always have a place in your heart. RIP little girl, you were greatly loved!

 

[catwoman707]

Oh my gosh, when I just read this update my heart dropped.................I am SO, SO sorry!  

  ugh...

This is where I sit here at my computer just thinking, what can I possibly say that can help, that we are all saddened, and feel your heart aching, and we are here to talk about it, and be supportive, but only time and knowing you gave so much love and care, plus the fact that cats do not fear death as we do, which in some small way seems to help me, and she did not suffer as she went downhill will get you through this and leave tons of sweet memories of life with her.

   

 

[mrsgreenjeens]

I'm so sorry it ended up this way

.  She is at peace now.