Fatty LIver disease plus

chuchitassick

TCS Member
Thread starter
Kitten
Joined
Dec 9, 2012
Messages
2
Purraise
0
Hello, My little 1.5 year old cat Chuchita has a very severe liver disease.  I took her to the vet and they did an x-ray and blood work.  And had me to take her to the vet hospital for an ultrasound.  Then she had to get a plasma transfusion because her clotting times were so abnormal in order to get an aspirates of her liver and spleen done.  The liver aspirates (Sp?) showed fatty liver and the spleen showed some inflammation.  But clinically she has not presented like a regular fatty liver patient.  Although we think its possible she went a few days without eating, after she got her rabies vaccine she came home from the vet and started acting weird within the next few days and seemed to not want to eat the wet food we were giving her, but I had never heard of fatty liver disease and thought the vaccine just needed to go through her system and she'd be fine.  We switched her back to the dry food she likes and she started eating again.  We don't know exactly how much cause we have a second cat too but she was definitely eating.  In fact the night before I finally brought her into the vet she ate almost a whole can of food.  Even still her liver enzymes were highly elevated she had hepatic encephalopathy,meaning neurological changes.  So anyway, two overnights at the vet hospital and $3K, where she got tons of meds and IV fluids, she started eating again.  The first few days she was home, Sunday, Monday and Tuesday morning she ate, she even cried for food and she seemed a little more alert.  Come Tuesday night I had to coax her but she still ate some Tuna.  Wednesday she also ate a good amount of tuna, I know this could possible be bad for cats, but better than nothing.  Anyway, come Thursday all she would eat was tuna juice.  I took her back to the vet Friday morning and she tried the feeding tube that went down her nose but Chuchita wouldn't tolerate it.  Because her clotting times were again abnormal they couldn't do the incision required for the E tube.  The vet suggested that I could take her to the hospital for a Peg tube, but 3-4K more later she might still be sick so couldn't justify that cost.  The vet thinks only a miracle could save her now but said we could try syringe feeding (after I read about it online and asked her about it). So that's what were doing now with the medicines.  But her liver is failing, even with all the treatment she received at the hospital and some food in her stomach.  When her blood work was done this past Friday, she also was anemic with red and white blood cell counts being abnormal.  She has absolutely no energy walks really slowly and does not make it to the litter box.  Basically they think something else is going on other than the fatty liver disease but can't tell anything else without a biopsy.  So, I'm just wondering if anyone else has seen a fatty liver cat who wasn't completely anorexic who was acting this abnormal she barely moves and has no control over her bowl/bladder.  The vet said we could try a steroid as a last ditch effort but it could make it worse.  I just don't know if she can be saved at this point and don't know if its fair to prolong her suffering.  She does tolerate the force feeding and hasn't vomited but she hates it and all the meds.  She's also still very jaundice. Thanks for any help!! 
 

white shadow

TCS Member
Top Cat
Joined
Nov 28, 2010
Messages
3,102
Purraise
2,985
Location
CA
Welcome to the forum, Chuchitassick! Having gone through critical illness with a cherished kitty, I can understand the need for info and support from experienced people.

Quote:
I'm just wondering if anyone else has seen a fatty liver cat who wasn't completely anorexic who was acting this abnormal
The best chance of finding someone like that is to be found here http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/

IF I were in your position, I know that I'd be putting all this in front of that specialized online group - that's where I'd be.

I have to run out, but a couple of extra thoughts:

- if you're assist-feeding regularly (and, of course that needs to be scheduled and frequent), then you'll know how much she's taking in

- if the above is not so (unscheduled/"sporadic"), then you'll need to separate her from the other cat in order to monitor food intake (you can still allow her some time for socialization, just keep the other cat away from her food dishes)

- you mentioned rabies vaccine, so I'll presume she goes outdoors...you should NOT allow her outside unsupervised while she's ill because sick cats are "hard-wired" to go off and hide as a defense mechanism...you won't want that

- because she's anemic, you need to keep her warm...a wrapped hot water bottle/a heated pet bed/covered in bed...these can help with that

- IF there's a Vet school nearby, I'd recommend having her seen there - Board-Certified specialists, latest technologies etc...plus, she will present "them" with a very challenging situation...that would be a valuable plus/incentive for them

Keep us posted...thinking of you in this most difficult time
 

denice

TCS Member
Veteran
Joined
Feb 7, 2006
Messages
18,838
Purraise
13,144
Location
Columbus OH
There is usually an underlying disease that causes fatty liver.  The underlying disease is why the cat quits eating which then causes the fatty liver.  I went through it with one of my cats.  In his case he has IBD with unusual symptoms which is why the other vets I took him to didn't diagnose the IBD.  IBD is usually food related but a cause was never found with Patches so he stays on a small daily dose of steroid.  
 

white shadow

TCS Member
Top Cat
Joined
Nov 28, 2010
Messages
3,102
Purraise
2,985
Location
CA
It just dawned on me that there is also a HL group online.....it seems that there is very little activity on there, BUT they have been around for 12 years, and it's very likely that the original members are still active, which means there's potentially more collective experience available from them. All that said, it's also likely that some people there will also be members of the assist-feeding group.

I would be joining up with them as well...right here http://pets.groups.yahoo.com/group/FelineHL/
 
 
  • Thread Starter Thread Starter
  • #5

chuchitassick

TCS Member
Thread starter
Kitten
Joined
Dec 9, 2012
Messages
2
Purraise
0
Okay thanks for the pointers and the links.  She is actually an indoor cat but they still told me to get the vaccine which I now regret since she was acting normal until then.

What were the symptoms of IBD in your cat and how was he diagnosed?
 
 

mrsgreenjeens

Every Life Should Have Nine Cats
Staff Member
Advisor
Joined
Aug 13, 2009
Messages
16,391
Purraise
7,131
Location
Arizona
It may be she barely moves because she is so weak from the anemia and just not having enough food in her to give her strength right now.  Are some of the meds you are giving her for the anemia?  Since she is tolerating the assist feeding, I would just continue that at regular intervals until she gains some strength and see if you see some improvement.  She will probably stay "yellow" for quite some time, even after she starts eating on her own again.  (And even when she does eat on her own again, you may need to continue assist feeding her for awhile to make sure she gets enough or this cycle may continue)

Are you feeding her a prescription food like Hills A/D?  Hopefully your Vet gave you some of that to use, as it makes a good slurry for the syringes,and has extra vitamins, etc. in it for her recovery.  Did you get some extra syringes?  Those syringes will start sticking after several uses which makes them hard to   s l o w l y  depress the plunger (which is necessary for a good assist feed) so it doesn't squirt all over. 

Many folks here at TCS have assist fed over the years, and had cats with HL, some have them right now, so feel free to ask specific questions. 

for your little girl
 

denice

TCS Member
Veteran
Joined
Feb 7, 2006
Messages
18,838
Purraise
13,144
Location
Columbus OH
Okay thanks for the pointers and the links.  She is actually an indoor cat but they still told me to get the vaccine which I now regret since she was acting normal until then.

What were the symptoms of IBD in your cat and how was he diagnosed?
 
Patches would have like dry heaves and vomit small amounts of stomach acid and be constipated.  Most cats with IBD have the problem that is opposite of constipation.  The only definitive way to diagnose IBD is with a biopsy which means surgery, Patches didn't have that done.  He had two ultrasounds and two needle biopsies done on his liver.  He actually had two forms of hepatitis the fatty liver and one caused by infection.  The infection is common with IBD because the digestive system is so close together physically.  Often cats will have something start in one part of their digestive system and end up with something called triaditis which includes the pancreas.  He didn't have the problem extend to his pancreas.  That can be determined with a blood test that is only done at Texas A&M University which was done for Patches.  The main reason she did the needle biopsy was to rule out lymphoma.  Without the surgery IBD is a diagnoses made by eliminating all other possibilities.
 

white shadow

TCS Member
Top Cat
Joined
Nov 28, 2010
Messages
3,102
Purraise
2,985
Location
CA
...Basically they think something else is going on other than the fatty liver disease
Churchitassick, read the following carefully to see if any of this corresponds to what you're seeing:
When a patient has been in a starvation state for a while and then begins to eat, some serious metabolic problems may occur in the first few days as metabolism changes. When food is delivered, the pancreas releases insulin in an attempt to store the calories. Unfortunately, insulin also drives circulating potassium inside cells and cats with hepatic lipidosis are often depleted of potassium to start out with. This sudden drop in potassium can make a cat very weak (causing drooping neck, listlessness, urine retention / inability to urinate normally, heart muscle depression and more). Similarly, insulin will drive phosphate into cells in a similar way leaving the bloodstream depleted. Red blood cells will not have enough phosphate to maintain their own structure; they burst causing severe anemia.

If the blood phosphate level drops below 2.2 mg/dl, an IV supplement will be needed. After the phosphate level has started to rise, an oral supplement of phosphate (usually lactose-free cow's milk works well). Expect the cat to be monitored in the hospital for the first 3 days following initiation of nutritional support.

Refeeding injury can be usually avoided by starting with half (or less) of the required amount of Calories at first and gradually working up to the full nutritional requirement over a few days
That comes from an excellent piece on HL.....there is much more, including the extra supports which should be provided apart from nutrition. It's right here http://www.marvistavet.com/html/body_hepatic_lipidosis.html The quote is from "Refeeding injury" at the bottom of that page.
 
Top