Elevated liver enzyme question? Any advice would be helpful.

My 5 year old kitty, Miss, has been having an issue the past two weeks about being fussy with her food, where I've had to switch brands twice, and then rejecting any food but freeze dried treats and temptations. (Which I was giving her like crazy to try and get any kind of calories into her. She was also not pooping much, but then again, she wasn't eating much.

She is 19 pounds and currently under the care of the vet while she is losing weight safely. I took her to the vet immediately, because I didn't want her to get fatty liver with her having no appetite.

They ran a senior panel (gives more details though she isn't a senior) and she had elevated liver enzymes. He didn't say which ones, and I forgot to ask.

Miss has a history of IBS, and she is on Metronidazole (sp?). I normally give her 100 mg per day. I'm *supposed* to give her 200 due to her weight, but I hate having her on so much medicine. So in these past two weeks I've been trying to be diligent about giving her the accurate dose, since they kind of reprimanded me that she should be taking her full dose. That's around the time the trouble started.

I have said to my old vet in the past that when she takes the full dose, she backs off on eating. He didn't seem to be convinced. However, the new vet thinks that it is a possibility she is sensitive to it since she has been on metro for a while, and the upping of the dose possibly caused an elevation of the liver enzymes, which caused her appetite to drop.

The other things he said can cause it are infection or cancer. He didn't seem to think these were very likely, since she wasn't vomiting or acting sick for an infection, just losing her appetite. She had blood work about two months ago before this and her levels were good.

We have her on an appetite stimulant, and have discontinued the metronidazole. He wants to see if she will resume eating by herself without the stimulant on Sunday, and then get her levels tested again to see if they have dropped.

My question is, if it *is* the medication, how long would it take to clear and the enzyme levels to drop? I don't want to rush out and do this Monday if her levels are going to take a bit of time to drop down, as it seems it wouldn't be an accurate picture of what's going on if they don't clear that fast.

I'm also worried how I will manage her IBS without any medication. For the first time ever, she had normal stools on Hills I/D dry. She has *never* had that. Unfortunately, that's what caused her 5 pound weight gain, so we are trying to deal with as well. 

Thanks for any information you guys can offer.

Jen

Hi Jen, it's IBD, not IBS. IBS is rare in cats and can be easily controlled with diet change. Anyway, the answer is yes that the metronidazole can elevate liver enzymes, it caused my Alex to get fatty liver so you did the right thing. It will however take awhile for her enzymes to get back to normal. The liver needs to heal itself and it doesn't happen overnight so definitely it will take some time. Have you tried a grain free diet instead of a prescription diet? Grains turn to sugar which is just bad carbs and it seems like you're trying to get her to lose weight safely, not gain! Putting her on a grain free diet will safely take those pounds off and the higher protein will help heal her liver the healthy way. 

Thanks for the info.

How did metro cause fatty liver? I thought only not eating caused that?

Unfortunately, Missy did extremely bad on grain free, high protein diets. Both canned and dry. And I had her on the best foods, full of real ingredients. Evo, Wellness, etc.. I tried allergen free, limited diets, the entire works. I have tried natural fibres, pumpkin, etc. I know how grains and dry food cause inflammation...however, I tried them for a year, and she was constantly barfing, getting sick, and having diarrhea, even with a slow transition to try a new food. When I finally got down to the Duck and Pea formula, she was barfing after every meal.

She HATES canned food, so it's a terrible challenge to get her to eat canned other than a few licks. 

The only food that has ever stopped the issue is the dry I/D. She had formed stools on it. I was really reluctant to even put her on a food of that quality, but it helped. It's extremely frustrating, and I am at a total loss.

The last option I have is raw, and I don't know if she will go for that, as she hates canned, but since she can't take metro anymore, I need to do something to get this kid sorted out. 

I've spoken to the vet and I am wondering if an animal safe probiotic will help.

I guess I will wait a while for her test, so long as she continues eating. I'm really hoping that it is only the metro. I mean, it makes sense on paper, you know? And it is the first time I have been extremely strict about giving her the metro all the time.

Oh I see. Then you have to go with whatever she'll eat, I understand. The metro caused fatty liver in my Alex because she already had an inflamed liver. Metro is very strong and should be used with caution in kitties with inflamed livers. We were trying to find something to work and unfortunately this made her worse. I'm not putting it down, it helps a lot of cats. So if your kitty had inflammation in the liver prior, without you even knowing it, it could have elevated her enzymes. 

Trust me, I wish I could feed her the good stuff. I just don't know what else to do with feeding, I always, always give her wet food to try every day, at least three times. I usually get her to take a few licks of it, and that's about it. 

Why does your kitty have an inflamed liver? Do they know? The vet said most kitties can use it safely. Apparently not, like your kitty.

Is Alex still with you? If that is her in the pic, she is super cute.

Thanks for your insight.

I'm sorry, I went to your site and saw that Alex passed away. It's a good thing you are doing in her name. I will check it out for sure.

Thank you so much Jen, not a day goes by that I don't think of her and what she went through. If I can help you with anything don't be afraid to email me okay? Alex had IBD, it got very bad and she got an inflamed liver. Then the metro caused her to have a seizure and become jaundiced. Then she developed pancreatitis and then developed a pancreatic infection and died. It was horrible. 

That is so awful. I have tears in my eyes just reading that. In that case, I am happy Miss is off the metro. She was just given an appetite stimulant, the Mirzapanine(sp)  but she did ok with it, I think. It did make her more affectionate and meowy. Today is her third day since she has taken it.

I was reading your site, and the information is very helpful. Especially info about the different treatments you would have considered.

I would *love* Miss to be on a good diet, and I am thinking of getting her to try raw. I am encouraged because she hates regular cooked chicken, but she loves freeze dried chicken treats. She seems to prefer pate. I am just agonizing over every step I take with her. I think she is allergic or sensitive to peas, so it limits different dry food she can have as well, as pea protein is a big ingredient. When I made a list of all the foods she was on and had trouble with, the common ingredients were peas or pea protein.

It sounds like Alex was a huge part of your life, and I am glad she found her way to you. I'm sure she loved you very much, and knew how much you loved her. It shows.

I feel like that about my Miss. She is not only a cat, but my friend, and my family. I want what is best for her of course.

You are a wonderful mother to her Jen. My Alex was like my daughter. We are soulmates and I feel like her heart never leaves mine. A part of me died the night she died, I miss her still. 

Gosh I wish I could think of a food without pea protein! I think it's worth a try to do raw. You never know until you try it. 

I think raw would be the best option for Miss.

If you haven't already heard Bugsy's story, poke around in Carolina's posts for a thread named "the long raw journey' or something of the like. Basically Bugsy had bad food reactions every day for a whole year I think??? And on the first day of all raw he had his first solid poop!!! I think it'll be inspiring for you