High ALT levels, treatment is not helping, what to do?

denice

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I am so sorry.  We all hope our kitties will live to be 20 but unfortunately it doesn't happen very often.
 
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mak17f

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Hi All,

just wanted to give everybody an update. We have been diligently giving our kitty all the prescribed meds. It's been a few months now. We took her to a vet yesterday for a blood check and the results were great! Her ALT levels came down a lot! Her latest reading is a bit over 300, compared to 1700+ from before. It  seems like all the liver related metrics have improved. She is still above the range on everything liver related but not as bad as before. We are hopeful! It just took the meds a few months to work, I guess.

It was really reassuring to read about everybody else's experience, so I thought I'd give you an update as well. We are on the same meds regimen for the next 3 months and then will do another blood test.

Thank you all!
 
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moes dad

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Hi, New here, I've been going through this with Moe for about a year now and the Vet's in the beginning wanted me to put him down which was not an option. I brought him in to help/cure him not destroy him. I noticed none of you mentioned if your cats had Jaundice also with the high ALT levels. I have had him on Ursodiol 50mg. Denamarin, Denosyl, S-Adenosyl-100. I feed him through a syringe extra nutrition Hills Prescription with a mixture of a/d and l/d for the hepatic. I also give him 100 ML's of I/V's of Lactated Ringers Solution every other day. His ALT levels were 700 the last time we checked, when he first had this his jaundice actually went away and has come back. Yellow in the ears and behind the eyes. He has maintained his weight of 13 pounds does have an appetite and at times is very playful and he just turned 8 on Aug. 28th. He has a twin brother (Larry) who is fine. Since none of the Vets (Banfield) at Petsmart have the knowledge to help Moe I am taking him to a VCA Hospital that has pet internist. The only thing is that they charge an arm and a leg because they have advanced training as specialist's. I had just paid off the title loan I took out on my Van to pay for his previous Vet bills plus I was giving blood/plasma to help off-set the costs. I collect SSD so money is tight but I will do it all over again if I have to just to save my little boy! I saw some people say that the ALT level's dropped dramatically but didn't pinpoint what it was that did it and there were no follow-up's saying if their babies were still ok or not. I had tried prednisone but it didn't work and his levels got worst and I understand prednisone is hit or miss so it was a miss. ANY helpful and proven suggestions of any kind would be great in the meantime before I get to the VCA specialist.

Thanks,

Moe's Dad
 

denice

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I think the supplements like the Denamarin is the most help.  I think the majority of the times you see high ALT here it is because of fatty liver which isn't what's going on here.  With fatty liver, getting enough calories in through a feeding tube or syringe feeding stops the process in the liver and the ALT comes down.  This sounds like some kind of primary liver disease and you are doing all you can until you see the specialist.
 

moes dad

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I took my Little Moe to the VCA Vet Hospital in Albuquerque, NM on Montgomery st. to a specialist/internist (Phil Ries) and had an ultrasound done and a consult, he said that his gallbladder was super enlarged and stretched out he told me it might not be anything serious and that in surgery they could take the gallbladder out and could take his bile duct and reroute the bile direct so the bilirubin would be eliminated, made it sound like a route operation. Then he brought in a surgeon specialist named Collin Wolfe who assured me he could do the operation easily. So I agreed and had to go to a part of town and get yet another title loan on my Van and I used my life saving to pay for everything beforehand. Before I left to drive back to Truth or Consequences, NM which is almost 200 miles I visited with Moe, I had to leave after 10 minutes as a shift change was going on. The last sight and memory of Moe was him going nuts standing up against the cage meow and yelling and I could swear in my head I heard him says "daddy, don't leave, Daddy Please don't leave me!" I had that picture in my head the whole drive home and to this day. I called through-out the night as it's a 24 hour clinic for updates and they were all good. I received a call in the morning of Wed. Oct 8th saying he was being prepared for surgery and I lay on my bed praying with Moes brother Larry and my older boy Shemp. Sometime after 12 noon I received a call from the Surgeon Dr. Wolfe saying that when he opened Moe he found a huge tumor that involved his bile duct, gallbladder and possibly liver he said he could remove the tumor which they believed was benign. I said well I brought him in here to cure him so go ahead and remove it. I received another call soon after from him and he said that he removed 80% of the tumor but said that there was nothing left to be able to route the bile, he said that the tumor was still in the liver nodes and no gallbladder and no bile duct left, so he wanted to put Moe down at this point. I asked about transplant or anyway to save him and he seemed to be in a rush to get this over with. Moe had been so alert and alive and amazed the doctors and staff that he was even sick at all. I couldn't bring myself to give permission to euthanize him and of course broke down, they had to overly convince me to say yes especially after they were so confident beforehand that they could easily fix him. So since they couldn't bring him out of the anesthesia and him being alive I had to agree. It was the hardest thing I ever had to do as I loved him with all my heart. I just feel that when I brought him to my vet in Las Vegas, NV back in Nov. of 2013 and had an ultrasound and biopsy that if it has been properly diagnosed and if I was told then he needed to go to a specialist and have surgery that the tumor might have been small enough to be removed successfully. So I lost my little baby/friend on Oct. 8th, 2014 at the young age of 8. He was so special and was loved by everyone and I feel like my heart was torn out. Moe was born Aug. 28th 2006 and Passed on Oct. 8th, 2014. Before this I had given my job up so I could do the feedings every 3 to 4 hours. So now, I have no job, am out thousands of dollars and most importantly I lost my Lil Moe! It would have been all worth it had Moe survived.
 

catwoman707

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I took my Little Moe to the VCA Vet Hospital in Albuquerque, NM on Montgomery st. to a specialist/internist (Phil Ries) and had an ultrasound done and a consult, he said that his gallbladder was super enlarged and stretched out he told me it might not be anything serious and that in surgery they could take the gallbladder out and could take his bile duct and reroute the bile direct so the bilirubin would be eliminated, made it sound like a route operation. Then he brought in a surgeon specialist named Collin Wolfe who assured me he could do the operation easily. So I agreed and had to go to a part of town and get yet another title loan on my Van and I used my life saving to pay for everything beforehand. Before I left to drive back to Truth or Consequences, NM which is almost 200 miles I visited with Moe, I had to leave after 10 minutes as a shift change was going on. The last sight and memory of Moe was him going nuts standing up against the cage meow and yelling and I could swear in my head I heard him says "daddy, don't leave, Daddy Please don't leave me!" I had that picture in my head the whole drive home and to this day. I called through-out the night as it's a 24 hour clinic for updates and they were all good. I received a call in the morning of Wed. Oct 8th saying he was being prepared for surgery and I lay on my bed praying with Moes brother Larry and my older boy Shemp. Sometime after 12 noon I received a call from the Surgeon Dr. Wolfe saying that when he opened Moe he found a huge tumor that involved his bile duct, gallbladder and possibly liver he said he could remove the tumor which they believed was benign. I said well I brought him in here to cure him so go ahead and remove it. I received another call soon after from him and he said that he removed 80% of the tumor but said that there was nothing left to be able to route the bile, he said that the tumor was still in the liver nodes and no gallbladder and no bile duct left, so he wanted to put Moe down at this point. I asked about transplant or anyway to save him and he seemed to be in a rush to get this over with. Moe had been so alert and alive and amazed the doctors and staff that he was even sick at all. I couldn't bring myself to give permission to euthanize him and of course broke down, they had to overly convince me to say yes especially after they were so confident beforehand that they could easily fix him. So since they couldn't bring him out of the anesthesia and him being alive I had to agree. It was the hardest thing I ever had to do as I loved him with all my heart. I just feel that when I brought him to my vet in Las Vegas, NV back in Nov. of 2013 and had an ultrasound and biopsy that if it has been properly diagnosed and if I was told then he needed to go to a specialist and have surgery that the tumor might have been small enough to be removed successfully. So I lost my little baby/friend on Oct. 8th, 2014 at the young age of 8. He was so special and was loved by everyone and I feel like my heart was torn out. Moe was born Aug. 28th 2006 and Passed on Oct. 8th, 2014. Before this I had given my job up so I could do the feedings every 3 to 4 hours. So now, I have no job, am out thousands of dollars and most importantly I lost my Lil Moe! It would have been all worth it had Moe survived.
Oh, I'm so sorry you lost your boy. How sad, gosh. NOT what you were expecting it sounds like.

As @Denice  advised, post a tribute to Moe, and we will all be there to help support you and get you through this hard time.

So very sorry.
 

jillync

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How long did it take for the ALT to come down with the prednisone and supplements?
 

denice

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It really depends on what is causing the elevated levels.  My kitty had fatty liver which is why his was high and it was the main number that the vet was watching.  It took probably a good 2 months for it to return to normal but fatty liver is notorious for having a long recovery period.
 

princess 2011

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My ca t is 5 years old I noticed she had lost weight I contacted my vet he was concerned I brought her in she had lost 2 pounds in 3 months they did blood work and found that all of her liver enzymes were high at that point he put her on an antibiotic to treat an infection it could be it came back even higher than he did an ultrasound to rule out any math she had no mass then he referred me to an internal medicine doctor they did another ultrasound they did more blood work put her on a series of three different antibiotics brought it back for bloodwork her alt was even higher at this point 3 weeks ago her alt was 469 but all of her other liver enzymes are down she is eating her weight is up she is playing acting normal so I am going through the same thing they want to do a liver biopsy to find out what is causing her enzymes to be high the alt I mean at this point I don't want to put her through a biopsy I watched a video of a liver biopsy on a cat it is very invasive and very dangerous but I do know with a cat with liver problems cant get any steroids
 

denice

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My kitty was started on prednisolone when he had fatty liver and cholangiohepatitis.  The steroids were to get previously undiagnosed IBD under control.  An IBD flare was the root cause of his liver issues.  
 
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