My cat has been diagnosed with Cholangitis/Cholangiohepatitis

Hi recently my 5 year old cat Bella has been siagnosed with Cholangitis/Cholangiohepatitis. her blood tests resulted in high ATL AZT liver enzymes she has been lethargic was vomiting has weight loss etc. We have been back anf forth to her doctor he put her on clavamox, ursidoil(actgall), fortiflora all liquid meds she was not responding to meds still vomiting not eating took her back to doc she had 104.7 fever was congested he gave her antibiotic injection sub-q injection. I have been syringe feeding her water and wet food. She was still vomiting took her back this past Sat he gave her anti vomit injection and is trying her on liquid metronzidole. So far so good she seems to be doing a little better but my fear is this can come back it has been an emotional rollacoaster seeing her suffer like this I am trying to do all that i can to help my beloved friend. My concern is her weight she is typically a small cat normal weight has been 9 lbs but she is down to 7.9 over 2 weeks. What i have read was this disease causes anerotic issues because nutrition is not processed normally in the liver. Doc said next step if she does not respond to meds is hospitilization, feeding tube and liver biopsy. Please does anyone have experience with this disease, any suggestions or advice would be so appreciated.

I'm so very sorry you and your baby have to deal with this terrible, potentially life-threatening disease. I have one good article with information that might be helpful to you

http://www.vin.com/proceedings/Proceedings.plx?CID=WALTHAMTNAVC2003&PID=3671

I would also like to urge you to call the vet school nearest you for additional help

http://vetmedicine.about.com/od/veterinaryschools/Veterinary_Schools_and_Universities.htm

Plus. please be sure to find a very good holistic vet in your area who has experience with treating this disease

http://www.holisticvetlist.com/

Hopefully another member (finnlacey) who has experience with very serious diseases involving the digestive system will also be along very soon to help you with more advice.

I'd just like to add that this disease requires aggressive, long-term treatment and very close monitoring to make sure treatment is working.

Dear Violet thank you so very much for the links and suggestions I greatly appreciate it! Lisa

I would be very careful giving metronidazole with liver disease, it states on one of the websites that it shouldn't be and with my Alex that actually made her jaundice when before the met, she only had an inflamed liver.

Metronidazole should be avoided in animals with liver disease

http://www.petplace.com/drug-library/metronidazole-flagyl/page1.aspx

P.S. thank you Violet!!!

(((((HUGS)))))

Thank you for the linki will read into this further as well. Based upon what my vet suggested metronizdoile is one of many broad spectrum antibiotics he believes she has supperative acending infection in the bile duct and from her ultra sound she has small gallstones. In addition she has had surgery prior when she was around 2 yrs old had a congential growth removed from her stomach duoedom area recovered well and now 3 ys later has a bacterical infection. She was throwing up from clavamox and actgall which are used to treat thenliver inflamation so instead he gave her a shot of convenia and metronizdole. I am using fortiflora as a good bacteria support so she does not get loose stools what are your thoughts on convenia and fortiflora? Thanks for your insight i also like your website to so important for people to know about IBD thanks for all the great information

Oh thank you so much. I'm glad my site is helping, that's my goal. Covenia is usually overused but in this instance I'd have to say it was needed. I think that you should mention Cerenia to your vet though. Cerenia is a very good anti-nausea med and is being used a lot more for IBD: http://thelearningvet.wordpress.com/2011/02/05/what-i-couldnt-live-without-cerenia/#comment-115.

It's safer than Covenia which is normally only supposed to be used for severe skin infections. I'm so sorry your baby is throwing up so much. Believe me I know what that's like to see that happen. If Bella does end up needing a feeding tube, don't be scared. It saves lives!!! It's not as hard to do as people think and it's only for a little while. Fortiflora is not my personal choice for probiotics because of the animal digest in it. Animal digest frankly could be adding to the nausea but that's for you to decide. I prefer Prozyme myself.

One of my cats was on a feeding tube for a few weeks and I found it much less stressful for both he and I. He tolerated it well and it was easy to give him feedings through it. I think if it is needed the sooner the better. Anesthetic isn't easy on a healthy liver. Your cat will be in better shape for the anesthetic the sooner it is done. My cat had IBD that went into two types of hepatitis, one being what your cat has and the other being fatty liver disease. He came through it and has felt well since and this was at Christmas time in 2010.

@finnlacey thanks again fornthe insight i just read the adverse side effects of convenia omg i hope that does not affect bella this way it could be fatal....jeese now i am very worried and will be calling the doc tomorrow...yes she had a shot of cerenia and thank god it helped her. She is acting a bit anxious today though but has been active looking out the windows and staying on her cat bed on the windowsil I have been feeding her small meals and water through out the day. I actually took the day off to make sure she was ok today. I am worried very worried. I will try prozyme instead i do not like the thought of animal digest in the probiotic. Thank you again for everything :-)

I think if she hasn't yet, she'll be okay. I just would not use it again personally unless she really needs it. But sometimes you have to take a chance when they are really bad. When you say anxious, does she look uncomfortable at all? Is she eating those small meals? I also suggest getting her B12 injections weekly!!! This is very important in the healing process as her nutrients are not being absorbed right now. I'm sure she's got malabsorption if she's losing weight. That B12 helps her to absorb vitamins and nutrients but also a positive side effect is it makes them hungry and gives them energy.

Hi Finnlacey! Thanks for the response. She has been pacing the floors of the apartment back and forth i have all the windows open so i guess she is curious but i can sense that she is not as calm as she usually will be. However her appetite is returning she scoffed down her food last night cleaned the entire bowl this morning she jumped on my bed like she would do normally to wake me up at 5 am cat time. Our routine every morning is to go downstairs sit and bird watch by the feeder as she sits in my lap. So with that said she has interest again which is very positive i am hopeful and grateful we have another day to share together

Is she taking Mirtazapine for her appetite? Watch that reaction if she is. That pacing and uneasiness may get worse. That drug is not my favorite at all, I prefer cyproheptadine. Mirtazapine gave Alex seratonin syndrome and it has that same reaction of pacing and constant uneasiness on a lot of kitties, more so than it should be.

Hi again yes the doc did prescribe that apetite stimulant however i have not given it to her and probably wont justbbased on the fact that she is starting to regain her appetite. I think the cerenia worked well in combination with me giving her liquid fortiflora and wheat grass is helping to settle her acidic stomach.. Somi am going to hold off on that appetite stimulant for now. I am so thankful and grateful to have such wonderful informative feedback and support for you and everyone on this blog!!! What an amazing group of kind people you are!!!! All the best to you and your beloved companions too!!! Hugs Lisa

Thank you Denice !! All the best to you and your kitties too! Thanks for the encouragement Lisa

Ok now we are back to bella being lethargic again yesterday and this morning she was seeming a little better wide eyed responsive i came home from work at 7 pm Today and now her eyes are droopy she has a slight fever applied a cool damp cloth to her belly and head she is resting comfortably but is just so lethargic... I guess i can expect good days bad days good hours and bad hours my poor little friend is just not well. She is getting more thin with each day even though she is eating a bit now this is just so sad i just wish i could turn back the hands of time for my beloved companion. I am lost and dont know what else to do call the vet, do i give her meds tonight even though she is lethargic... I guess i should let her rest this breaks my heart to see her suffer

I know how you feel, just heart-sick that you can't do something right now that will make a real difference. All I can tell you is that sometimes you have to keep on track, giving the medications, providing the support, until you see the turn-around.  A year ago, my most special cat, foster Sam (CRF since 7/2009) really crashed. She'd caught an extremely nasty virus from the others, we never knew where it came from, and wasn't responding to treatment as the others were. I'd see her laying on her side on the first level of the cat tree, with her head lolling over the side, completely exhausted and unresponsive. It turned out she'd become anemic from the CRF. It took a blood transfusion, treatment with epogen, antibiotics, etc. etc. and a few months to bring her back to reasonable health but now she's literally racing around the house. I can't count the number of times last year that I made an appointment to euthanize her because I couldn't bear to see her so sick.

I really hope you can bring back your Bella back to reasonable health.

In regard to the Mirtazapine, I did see an extreme reaction in one cat (17 years old and a sedate old soul), but for others it's proved to be invaluable. Sam gets it every three days and does very well on it. She just gets a little more affectionate after the dose. I've tried Cypro on her but it didn't work as well. Every cat is different, just like humans, so I'd never give it to Raven again, but I wouldn't be without it for Sam.

You're right, just like people every cat is different. So glad your kitty is doing well on Mirtaz! Hey, more affectionate is not a bad thing, although they can get pushy about it sometimes.

I'm so sorry about Bella. I wish I knew what to tell you but I too know how you feel, believe me. I cried and cried and cried so many days and nights when Alex was sick. We're here for you when you need us. That's all I know to say right now.

MyLittleBella, I would like you to know we are not giving up on trying to help you.

I spent a sleepless night thinking about everything I know about cholangiohepatitis and possible treatments that can be helpful in treating this disease. Definitely, there are additional options that might be helpful to you..

So....... first of all I'd like to say that, web sites that claim this is an easy to treat disease, are misleading, to say the least. Cholangiohepatitis can be a devastating, very difficult to treat disease. All conventional and holistic options must be explored and put to use to try to get the liver to respond. Diet can be an important factor, so depending on what you are feeding, a holistic vet could make some very important and helpful recommendations to you.

This article

http://www.marvistavet.com/html/body_feline_cholangiohepatitis.html

mentions two additional treatment options, SAMe and silymarin, that can be very important and actually helpful in treating this disease, so please ask your vet about trying them and also look for a holistic vet for additional help and advice regarding the use of these treatments.

Based on my experiences I have to tell you that when it comes to such supplements, some cats have to start with a teeny tiny amount that has to be built up slowly and carefully over time to a higher amount. Some cats just can't tolerate large amounts of these supplements at first, even though they are vitally important for them.

Also, please please please keep a very careful eye on the liver enzymes while you are using metronidazole. This medication, even though very important in treating bacterial infections involved in liver diseases, can cause liver failure, so I would have to say, you can't be careful enough when it comes to making sure this medication is not doing any harm. Please check liver enzymes frequently while your baby is on this medication.  (It can also cause severe depression/lethargy and loss of appetite.)

Finnlacey violet denice simka thank you all so very much from my heart sincerely for all of your encouragement and support i so appreciate every word of kindness and compassion boy if everyone in the world were like you it would sure be a better place! if there is anything i can do for you please reach out !! I am here for you too! Lisa