Kittie suspected of Liver problems or worse - advice on Buprenorphine for pain after procedure yeste

I am new here and we are having issues with our 14 year old tuxedo kittie named Patches.  She is a darling cat normally but we have had to take her to the vet three times in the last 2 weeks.  We are waiting for test results after an ultrasound and liver aspirate and lymph node aspirate(after having bile acid test showing liver function not working correctly).  It isn't looking great at this point but we don't have anything definitive yet.  They have mentioned things such as Pancreatitis, liver disease, lymphoma.

Today after the procedures yesterday (she was sedated but not anesthetized) she is still very tired and not herself yet. She just wants to sleep.  She has not eaten unless I take the food to her and I'm tempting her with tuna (I don't normally feed her that) and she will eat tiny bits at a time.  She is drinking a lot.

She decided to jump on my papazzan chair and pee on it instead of using the litterbox not far from her.  Last night after we got back she pooped outside the box.

I took her back to the vet today who said she is just recuperating and they weren't concerned about her. Two vets looked her over.  Do you think this behavior is because she is just angry at us!?

I also went back to the vet earlier today as she looked like she was in pain with her eyes half closed all the time and they gave me 0.1ml syringes of Buprenorphine to give to her twice a day.  After reading about it I only gave her half the dose as I'm not clear if this is a good thing for a cat suspected of anything wrong with their liver!

Do you have any advice on any of this for me please?

Thanks!

Mel

My kitty has IBD and has had fatty liver disease and the vet has given him buprenorphine twice for pain.  When it comes to medication she assumes that there is liver damage even though his numbers look good.  Once was after extractions for FORL the other time after I closed his tail in the hinge side of a door and scraped his tail.  Luckily he just lost a little skin with that one.  It is really the safest alternative for pain relieve in kitties because their livers can't process NSAIDS.

I really think the litter box issues are from being sick.  I really don't think that kitties eliminate inappropriately out of anger or spite.

I hope you get your kitties issues sorted out and it is something easily taken care of or easily controlled.

I agree with Denise.  While any medication will go through the liver, Bupe is a safe and very effective pain reliever if given as directed.  It will make her sleepy, but that's to be expected.  She has been through a lot, needs time to recuperate, and hopefully the diagnosis won't be bad

Hi "Me" and welcome to the forum !

You are absolutely right to be concerned about using buprenorphine with a cat who's is having liver issues.

Buprenorphine is processed - metabolized - by the liver and you don't want to be giving that organ any extra work....unless you're caught between a rock and a hard place - more on that later.

That said, the symptoms you observed suggesting she's experiencing pain sound more like she's just feeling "crappy"...as in a hangover type of feeling.

I suspect that if she were in pain, she'd be hiding or secluding herself in unusual places or somewhere where she might feel "safer". Cats seek out safe places when in pain - because they feel vulnerable.

Where it comes to having to control pain in liver patients, I would insist that my Vet consult with a competent Anesthesiologist - a skilled Anesthesiologist will use a combination of anesthetics to produce the safest effective "cocktail" of drugs. The usually-considered "safe" drugs for cats (Bup, Tramadol, Fenatyl) are all processed by the liver.

The only pain meds used in cats that are NOT processed by the liver are NSAIDs........but, because a cat's liver lacks the enzymes to process them,the job is left to the kidneys to excrete them......and they are known to destroy kidney cells. While some are licensed for cats, IMO no cat should receive them.

And, did she "go" outside the box because she was upset? It's not impossible - it's one of my neighbour's cats favourite behaviour when he is frustrated by her!  If those incidents were one-timers, I wouldn't worry - if she continues though, I'd be looking for a medical issue.

I hope you'll keep us updated - you didn't say much about her history and events leading up to her going in in the first place....if you need further opinion later on, that info would be important.

Thank you for your posts. We took her in for a routine checkup and her blood count showed elevated ALT then we went down the path of a bile acid test which showed the liver function not quite right which then lead to the ultrasound and liver and lymph node aspirates as the ultrasound indicated that was necessary.

Prior to all this she was her usual self, but has gone through picky stages with food for the last two years. About 1.5 yrs ago she really didn't want to eat anything. She did eat but was fussy. She lost weight during that time. She has gone from 9.2 lbs to 6.9 in 18 months. We had her thyroid checked back in March 2012 and that was fine and we did again recently. It's been a progressive weightloss throughout since Oct 2011 probably. This is the first time bloodwork showed problems.

She is an indoor kittie and we have been feeding her grain free wellness and natural balance wet food.

I did go ahead and give her half a dose of the syringe of Bupe and she's been sleeping on and off since. She did just eat tuna and drink again!

Thanks all
Melanie

Hopefully it isn't liver disease.  Pickiness is often associated with IBD.  A food upsets their stomach so they avoid that food.  My kitty had undiagnosed IBD for six years and he was incredibly picky.  He has gotten better about his food since the IBD is under control.  A lot of people think that IBD always means diarrhea but Patches never did have diarrhea.  When he would be feeling particularly bad he would actually be constipated.

Patches is doing a little better today I am happy to report.  Still sleeping mostly but her eyes tell me she's a little more herself and she's eating a bit more herself too. 

Yay!!!

I just found out there is a chance it could be cancer in the stomach but more likely to be the following: chronic pancreatitis, bacterial hepatitis in liver and possible IBD. We will get antibiotics (Clavamox) and hypo allergenic food (Hills SD z/d) . We are going to try another liver supplement which is a smaller pill. Denamarin. Any experience with this? After 30 days go for another blood checkup.

They did find loss of layering in stomach muscle wall which is a concern that could indicate cancer in the stomach. This could just mean IBD though. Inflammatory bowel disease. Only conclusive way to know is full surgery opening stomach for biopsy which we don't want to do.

Hopefully it won't be cancer and the other treatment will show good results! Any advice?

Thanks,

Melanie

My cat has been on denamarin and it works.  He also has serious IBD and had full surgical biopsy that was very helpful in the diagnosis.  If you're cat's issue is in the stomach then an endoscopic biopsy is a less invasive procedure.

Denice I noticed a post you commented on re Flagyl. Patches was put on Clavamox which is giving her diarrhea. Flagyl is now recommended to be given to her along with clavamox. Any advice? Read it may not be a good idea if liver disease?

My kitty has been on Flagyl with flares but now I am reading some things about other choices being better.  The main reason it is used is because it is an antibiotic with an anti-inflammatory effect.  You can go to LDG's post in this thread http://www.thecatsite.com/t/274582/long-term-ibd-meds.  She has several links in there as to the why and better alternatives.  This is geared towards IBD.

Often giving a probiotic with an antibiotic will help with the diarrhea caused by an antibiotic.  The s boulari mentioned in the above thread can be given with an antibiotic because it is yeast based.  Most probiotics would need to be given at least two hours apart from the antibiotic because the antibiotic will kill the good bacteria in the probiotic.

Thanks she did give me a probiotic to take but not helping with loose stools. Now wants to give Flagyl but only for 7 days.