High Liver Enzymes, light Pancreatitis inflamation and Fatty Liver

Hi there

I found this blog online as I was doing some research about liver illnesses in cats. My 16.5 years of Himalayan cat Maggie became very ill. I now understand more of what has been going on for a bit, but last Sunday night was the tip and I decided to go to the vet. After a blood test and Xrays were done, the vet came up with the above diagnosis. I was sent home with her with nausea medication and painkillers until our Ultrasound examination today. her appointment is at 2 pm today, but I dropped her off as agreed at 8 am, so she can get some IV fluids into her. I had to force feed her this week, and of course it was challenging to get enough food into her. how do you get a cat to eat enough? and you are already using a syringe. I also gave her the pain killers and nausea meds. It seemed to help. Day-before yesterday morning, she seemed much better, she wanted food, her own, and I let her have it, as I was already happy that she wanted it. I did not give her the nausea meds as I thought, if she wants to eat, she can't be naucious, but when I got home, I found a different story. She didn't want to come out from under the blanket, was crying ...heartbreaking. I had no choice, she needed her pain killer, which I was supposed to give her in the evening. I mixed it with the liquified food and forced fed her. Within hours she felt better. She had discovered the treats I normally give her here and there on the table and took a bit whiff, signaling that she wanted some of them. Since the vet asked me to let her fast before the ultrasound today to get clear pictures, I resisted giving her any.

She has lost 170 g more than we had on Monday, today is Friday...I know the food I gave her couldn't have been enough, but as I said, how can I make eat, if she had enough after already using the syringe feeding her through the mouth.

I just hope she will recover. As we all know very well, they grow close to our hearts, are family members so-to-speak, and she is such a cutie. Not ready yet to let her go. One thing more, the doctor was surprised how well she looked on the Xrays given that she is 16.5 years old. Well, she is a strict indoor cat, which might have something to do with it and I normally do take care of her very well.

Hi and welcome to TCS. So sorry to hear that Maggie is sick. Is the ultrasound to diagnose the pancreatitis or something else? Was the special fPl blood test done?

Unfortunately, fatty liver is often a concurrent issue with many diseases. When cats don't feel well, they don't eat, and they can't metabolize fat stores well at all.

In terms of syringe feeding, multiple feedings of small amounts are best. You want to aim to get a 5.5 or 6 ounce can of a good food into her. A food like Hill's a/d is good for that as it's high calorie and a perfect texture for syringe feeding, but you can use most other smooth pates well blended with water as well.

Many vibes for Maggie to recover quickly and lots of hugs for you. I know it's so hard when our beloved pets are sick.

Sometimes vets will put a feeding tube in to syringe feed easier with cats with Fatty Liver as sometimes it can take weeks for them to start eating again.  There are appetite stimulants that can be given.  May I ask what the name of the pain medication was?  If it's Metacam, you do not want to use it as it can cause kidney failure after just a couple of doses.  It is important that you syringe feed enough calories for your cat each day, you can do multiple feedings spread out to make it easier.

First of all, thank you to those who have responded to my cry for info yesterday. Much appreciated. I am Maggie's owner, Patricia, and I live in Vancouver, Canada.

Well, the results from the ultrasound came back yesterday. It looks like her Gallbladder is infected and her bile duct walls are really thick, which could be the result of her high liver enzymes. The vet said she has a light pancreatitis, also a side effect, but because the walls of the bile duct are so thick unlike the vet has seen before, there is the possibility of cancer. I so hope it is the infection and it can be treated.

She is still at the vet, will pick her up this afternoon, and has received IV Fluids to flush out her system. She was doing well, has received pain medication. She wanted to eat but was also fed in addition, as she had lost weight again this week (from Monday) before we came back to the vet on Friday morning. My poor little Maggie. I tried to get as much food into her as possible. The challenge I naturally have is also that I am working full-time, so I can feed her in the morning and a couple of times at night. During the night if need be. It was challenging to get that into her. She has never been a great eater, was always on the small side. she is at normal weight for her at 5.4 pounds/2.5 kg.

Just a a few weeks ago, she was eating normally, loved her food and all, and out of nowhere she ate less and less. I noticed it but waited for it to improve as she goes through patches. 3.5 weeks ago, she had done the same and I was able to feed her her favorite foods, and she gained the weight back, but only a week and half later, we were back where we started and this time, she did not eat at all, so it was off to the vet without delay.

During the first visit, Maggie received water treatment, to replenish her, as she must have been dehydrated. Her ears were yellow but that has gone. She is responding well to the antibiotics and painkiller/nausea medication that she is getting.

Any comments are appreciated. Many thanks in advance.

Sympathies to you and your kitty. I have a kitty with some similar issues, although her liver is functioning well.

My kitty has distension and all sorts of things going wrong in her bile duct too (with mild liver inflammation and mild pancreas inflammation). She never had an acute attack and surprisingly her liver values were all close to normal so any blockage etc. was not complete. They think the thickening in one area (papilla?) is due to inflammatory disease and is the source of issues - but they raised the possibility of a neoplasia (cancer) but they did not seem to focus on this.

She is on prednisolone now to control this inflammation, and several months post-ultrasound, she is doing reasonably well all things considered.

Thank you for your comments. There are so many things that are affected in her internal life right now, it seems like a chain reaction to me. What worried me the most is the fact that the specialist said that she had never seen thick bile duct walls such as hers...but of course it could be BECAUSE they are inflamed and it is not necessarily cancer. She is the cutest cat ever and she has not had anything much, but now all is coming at once. Thank you again for coming through. Good luck to your kiddy as well.

All of this is connected and is a chain reaction.  Because of the way the kitties digestive system is arranged inflammation and or infection in one area can lead to the same in other areas.  My kitty had undiagnosed IBD for six years, not due to my not trying to get a diagnosis, I went to several vets.  The last really big flare that he had I took him to a feline specialist and he had cholangiohepatitis which is a fancy word for liver inflammation.  When all three, the intestines, liver and pancreas are involved it's called triaditis.  My kitty is on a low steroid dose to control inflammation but many kitties condition can be controlled with diet.

The possibility of cancer is always there with this.  It's very difficult to know where the line is between inflammation and lymphoma.  I chose not to get a biopsy done but to just have the inflammation treated.  The bad thing with a biopsy, other than it is so invasive, the kitty has to be off the steroid for a period of time before the biopsy is done to get a good result.  My kitty would get very sick without the steroid and the whole chain reaction would begin again.  He has been on the steroid for a little over three years.  I don't think it's lymphoma for my kitty because a low dose of steroid would not keep it in check this long.

Denice said:

 
The possibility of cancer is always there with this.  It's very difficult to know where the line is between inflammation and lymphoma.  I chose not to get a biopsy done but to just have the inflammation treated.  The bad thing with a biopsy, other than it is so invasive, the kitty has to be off the steroid for a period of time before the biopsy is done to get a good result.  My kitty would get very sick without the steroid and the whole chain reaction would begin again.  He has been on the steroid for a little over three years.  I don't think it's lymphoma for my kitty because a low dose of steroid would not keep it in check this long.

Click to expand...

Similar to my thoughts for my kitty as to how I am approaching things.

Hi Denise

Thank you so much for your comments. I agree with you, I also feel it is a chain reaction being new to this and what I have read up on on the internet. They did the biopsy yesterday, final results next week. There is much open right now and one is wondering about what ifs and what it is. I am picking her up in 2 hours. Can't wait to get her back home, but of course it comes with ray of concerns and what I will be able to do for her. I love my kiddy, she is like family to me, so naturally, I am worried.

Thanks a lot for coming back with your comments. Every bit of info helps.

Warmest

Just to give you an update: I just returned from the vet this afternoon to pick Maggie back up. Contrary to what the vet was expecting, she already had a preliminary report back from the Specialist with the final one to come next week and it is NOT CANCER. The relief I felt, I cannot tell you. How far her liver has taken a beating remains to be seen. She is on antibiotics and is responding well. She was alert, and quite herself when I got her back, so the IV Fluids, meds and having eating, which is the most important part has helped a lot. I still have to feed her with the tube in addition to her eating on her own without jeopardizing the relationship with my cat for the time being until she gained some weight and monitor carefully. The vet told me that she wants to research giving steroids, as some cats respond well, other don't but for now she things antibiotics will help as mentioned, she seems to respond well to it.

Let's keep our fingers crossed that the trend continous. Thank you all for your support. I will definitely stay in touch now that I found this blog with likeminded people who care about their little pets.

Warmest

Best news that you could have had given the situation. You must feel a huge sense of relief.

Most definitely, not completely over the hump yet but I am hopeful that with care and meds, we can manage. How far liver damage has occurred, not sure, but i will watch for any signs of change in her. Thanks again for the support. Very helpful.

That is great.  My kitty also had fatty liver with the inflammation the last time he was really sick and he has done well.  He does go to the vet every six months and gets a liver panel done each time.   Even though his number are normal, when it comes to things like vaccinations which he no longer gets and medications the vet assumes that there is liver damage.

Hi Denice,

How damaged Maggie's liver is we don't know yet. She is responding well to anitbiotics for now and also still gets some painkillers. I hadn't given mine any vaccinations since she didn't react well six years ago, so I didn't want to put her through it. She is a strict indoor cat, and doesn't normally come in contact with other cats or dogs. I was thinking along the same lines, checkup every few months, to be safe.