elevated liver enzymes & cardiac enzymes in a 3-year old cat

Just got my cat's blood work results, and his liver enzymes are sky high, ALK phosphatase, ALT, and AST - all of them. His ALT is over 5 times the highest normal.  Cardiopet proBNP is also high, which indicates increased stretch and stress on the myocardium. This is also one of the (two) cats who have suffered with chronic diarrhea/loose stools from day one, though since switching them over to a frozen raw diet (recently) their stools have improved tremendously (knock on wood).

I lost two cats to heart failure, and honestly, the thought of this cat, Willow, suffering one down the road has me in tears. Isn't there something I can do to reverse this? Could 3.5 years of untreated loose stools have resulted in damage to his heart? Could an infection be causing all of this? From what I'm reading elevated liver enzymes can be caused by infections, and this would be logical since he has unexplained poop problems. The vet checked his blood pressure yesterday (it's fine) and is checking his thyroid in case he has hyperthyroidism, though I'm pretty confident that will come back normal as he's a fatty at 14.3 lbs. But if that comes back normal, she's basically pawning me off to both an internal medicine specialist and a cardiologist. Part of the reason she's pawning me off though is because I've been pretty adamant that some sort of infection triggered all of this, and her ego apparently can't accept challenge. The only antibiotics she will give me (he is positive for clostridium perfigens) are metronidazole and basic wormers. I really would like to try a different antibiotic since all of these have never really helped.

Apart from the cost of all these specialists, the stress on a cat who pants when in distress, what is the point of all this? She says the internal medicine specialist might want to look for 'masses'. This cat has had GI problems from day one. I honestly don't think he'd be alive if any masses were present. Plus my other cat shares his GI problems - do they both have masses? Hmmm?...not very likely or logical, but they both may have an infection. The cardiologist would do an echocardiogram and basically confirm what we already know - he has heart problems. And neither the internal medicine specialist nor the cardiologist is going to care what the other is doing - most likely they will treat these as if they are two independent diseases, unrelated to each other.

I'm desperate at this point. I don't just want them treating symptoms - I want to know the CAUSE, as I believe both of these things - the GI issues and the heart issues - ARE related.

What can I do to fix his heart and liver? Can this be reversed or is the damage already done? Watching 2 cats drop to the floor in my kitchen having heart attacks, a year apart, was extremely traumatic for me. I can't, I just can't go through this a third time.

Could it be a poison? Or genetics?

Livers have limited regeneration abilities, and the heart just replaces damaged tissue with scar tissue. Loose stools can result in hypokalemia which can stress the heart, but only a vet and preferably a cardiologist can properly diagnose that.

Maybe a second opinion would be best.

I do know that bacteria can go throughout the system and yes bacteria can affect the heart.  If the liver enzymes is due to the bacteria then you need to get your cat on different antibiotics.  Here is the recommendations I found for liver disease, at the vet clinic I work at we use Denamarin. 

Ask your vet about Denamarin "Denamarin includes SAMe, an antioxidant nutritional supplement which helps to reduce further damage to liver cells. It also has anti-inflammatory properties and promotes liver regeneration. It also may improve bile flow, protect from bile-induced injury and inhibit liver cell death. Denamarin also includes silybin, the most biologically active component of an extract from milk thistle. This is another antioxidant, as well as a free-radical scavenger that helps protect liver cells from toxins that build up in liver cells. It also helps to chelate (bind) iron and promotes the passing of harmful bile buildup into the urine."

Supplement L-Carnitine. This is an amino acid that helps to protect the liver against lipid and ammonia accumulation, which frequently occurs in cats with liver disease. The recommended dose is 250-500mg per day.

Vitamin E is given as an anti-oxidant to remove free radicals and prevent further oxidative injury to the liver. A water-soluble form of vitamin E is preferable since the absorption of fat-soluble vitamins may be decreased in some forms of liver disease.

peaches08, it's definitely not poison. And I'm not exactly sure if a cardiologist is going to be able to do too much for him if I can't afford bypass surgery.

cprcheetah, is Denamarin a prescription? If it is, we can count that out because my vet appears to be abandoning us. But if I can supplement these myself, I'd definitely be interested in that. Can I?

Thanks for your replies. Just to give you an idea of how bad his liver is doing, a normal ALT is 28-100. His is 574. His Alk.Phos is 125 - normal is 0-62. His AST is 170 - normal is 5-55.

I've been doing searches on this site, and cats with ALTs of 300 or 400 have been jaundiced. Not this guy.

Does he need a bypass too?

I have no idea what is going on with your little guy, but maybe a holistic vet might be able to help? Many vibes for him and hugs for you. I know it must be so hard to have an ailing pet and not know what's wrong or how to help.

Denamarin is not a prescription item so you should be able to find it yourself.  I googled it and found several sources of it.  If you give it, it has to be given on an empty stomach 1 hour before meal time.  His numbers are high, poor little guy.  Hopefully his liver will be able to regenerate and heal itself.

I don't honest know about the liver OR the heart at this point.  BUT, I recalled reading another very interesting thread about the clostridium, so am attaching it here:  http://www.thecatsite.com/t/259419/kittens-raw-and-clostridium-safety   From what I understand from additional reading, it is imperative that you get your guy on a really good probiotic, or else the clostridium may come never completely be gone.  And, of course, you need to space out the antibiotic with the probiotic, giving a few hours in between each one.  That thread that I provided discusses specific probiotics for your reading pleasure

I would certainly give the Denamarin a try...everything I've heard about it is good.  But one has to wonder WHY his liver values are so out of whack.  Has his appetite changed at all? 

Regarding his heart, is this the same breed cat as the other two who had heart attacks?  Is this a breed that is prone to heart attacks?  If not, this just seems way too coincidental.  So, as Peaches asked, could it be genetics?  Are you 100% certain they are not getting into something poisonous that you are possibly unaware of.  Do you have your house sprayed for bugs, or do they ever go outside? 

If I were you, I would at least have a discussion with a cardiologist with the test results of the BNP and see what they have to say, and tell them about the elevated liver panel as well, and how stressful it is to take your guy to the Vet.  Ask their advise.  Maybe they have  facility that has more than one specialist in it so one appointment can resolve both issues if you can get it timed just right.

My problem with specialists (besides cost) is that they'd be quite a drive away. This guy can't handle the stress, and I don't think I could afford bypass? How much would that cost? And would I be making repeated trips back and forth to have this done? Could I try baby aspirin?

I'm definitely sure his elevated liver enzymes aren't related to poison. No bug sprays or anything. In fact, I use mostly natural products because I have chemical sensitivities myself. He's 100% indoors and just your basic grey/white domestic short hair, with a little tabby in him because I can see it faintly in his tail. He's not related to the other two I lost.

I think I'll probably try the Denamarin, and mrsgreenjeens, thanks for the link! I'll check it out.

I ordered some Denamarin for Willow, but it won't get here until Tuesday, and I'm consequently a wreck. He's been listless the last 2 days, though he is eating. He also sighs a lot while he's laying there, and his ears feel warm to the touch. I've been scanning the web for posts about elevated liver enzymes in cats, especially ALT levels, and the highest I've found were levels around 400...his ALT is 574. I do have a milk thistle supplement that I was taking a while back that is still good. I was wondering if I could give him a little bit of this until his Denamarin arrives, but I'm not sure how much? The bottle reads:

Standardized Milk Thistle Extract (seed) - (total flavonoids including silymarin 80mg/80%) - 100mg

Milk Thistle Powder (aerial, seed) - 350mg

I'm also not sure if the vegetable cellulose and vegetable magnesium stearate are okay to give cats? Does anybody know?

I wish I knew what was bothering him - his liver? his heart? or both. I've been calling around trying to find internal medicine specialists and cardiologists, but they're an hour away - I'm so scared to put him through this. I also noticed that he seems to go downhill whenever he's static-y. Anybody know why this might be? I could give you my theory on this (maybe eventually), but you'd think I was crazy.

You can give up to 200mg for a 10# cat. Those other ingresients are fine.

Thank you so much - at least he won't have to wait until Tuesday now :-)