Cat with raised liver disease, treatment and diet advice?

Hi there,

I'm looking for any advice or guidance on dealing with liver issues in a senior cat. Our cat, Phoenix is a 21 year old female, of slim build, and in excellent health considering her age, most vets have thought she looks and appears around 11 on examination.

She had a check up in December and her weight noted,I took her in 2 months later to have her nails trimmed and also to be reweighed, as in December they thought she was underweight somewhat, and wanted to follow up.

December weight was 2.89kg, February weight 2.80kg... April weight 2.70kg

She has always been a small eater, and there seems to have been no real change in that department. I was advised to bring her back for a weigh in, which I did this week. Her weight was 2.70kg on Wednesday. The vet was concerned and ran a blood test, showing high liver count - 330, they asked me to bring her back today.

She was given a B12 injection, and an anabolic steroid injection to reduce inflammation and liver scarring. I was also given a daily dose of denamarin to start her on, as well as advised to put her on a prescription diet for liver disease. We've ordered her new food, a mixture of hills and royal canin prescription diets, which should be here by the beginning of the week.

I will be trying her with the denamarin tomorrow morning, I'm concerned about giving her pills, I forsee her being very difficult with it, the tablets look FAR too large imo, for a cat, and of course, cannot be broken or split.

I've done some reading on denamarin and it seems it can cause some vomiting and/or diahorrea, which is a concern, because basically we were told she has to gain or at least maintain her weight, by our next scheduled visit in 6 weeks. I've read a little about milk thistle, and wondering how many people have found that a viable option to denamarin? I'm just looking to have options for her in case we need to go down that road.

I'm also concerned that the lack of variety and limited range of foods on the prescription diet are going to make her life miserable. She is old, I know that, she has a good quality of life, and has pleasure in the range of foods she enjoys, I don't want to make her miserable. I've looked into some recipes for making homemade cat foods for liver conditions, and wondering if any one has experiences of this, or any advice too?

She is to have another anabolic steroid injection in 6 weeks when she returns for her weigh in, I'm anxious in the knowledge that she HAS to put some weight on, otherwise they were saying she'll be so underweight that euthanasia will be a likely outcome. It breaks my heart because she appears and acts in good health, I just want to give her the best fighting chance I can, to ease the pressure on her liver.

Denamarin is basically a combination of SAM-e and milk thistle

http://www.drugs.com/vet/denamarin.html

Good grief, what a nightmare trying to give her this tablet, she threw up within 10 mins, was anxious and suspicious. At 21 years old I am really struggling with the prospect of making her upset each day. The tablet is SO large I can't hide it in anything, she eats by licking her food, always has, the tablet has no chance!


I'm seeing the vet on Monday so they can access how she handles the administering of pills, but I'm going to ask about the milk thistle or other alternatives, frankly she has been off her food since the drama with the pill this morning. I've had to coax her for an hour to get her calm and eating again.... Weight loss is the immediate issue, it seems crazy to me to risk her not eating...

Success with alternatives? Suggestions or the likes? Thanks

do you have the smallest tablet? 90 mg + 9 mg? 

you can get the 2 supplements separately. Denosyl, which is the SAM-e and Marin, which is the extract from milk thistle. 

http://www.nutramaxlabs.com/cat/cat-liver-health/denosyl-for-cats

http://www.nutramaxlabs.com/cat/cat-liver-health/marin-for-cats

http://www.nutramaxlabs.com/cat/cat-liver-health/denamarin-for-cats

I do have the smallest yes, not that I think it's an acceptable size for a cat! At least not my small girl!

I'm going to ask the vet on Monday about the alternative you mention, as long as I can obtain something in liquid or powder form, I seriously do not want to stress her out with these tablets. She's been off her game all day, because of the tablet episode this morning, we couldn't even get it in her. I'm not prepared to make her suffer for a supplement, essentially, and not if I could adopt some alternative, she has never had tablets in her 21 years, and she is not reacting well to it, at all!

The irony is since she got diagnosed, and her injection the other day, and with these tablets today, she's far more anxious and upset than she's ever been... Repeated vet visits wouldn't be helping, I can't help but feel she's too old to be causing this type of trauma, essentially.

Why can't the pills be split? It looks like it comes in a chewable version for dogs, so I don't see why you couldn't break open or smash a capsule and put it in food.

They can't be split, they have an enteric coating that must stay intact to not damage a cats throat, the larger chewable ones are dog specific, as far as I've been informed, and not at her dosage regardless.

Liquid meds make life so much easier in this kind of situation. IMO, that's definitely the way forward. Until then, have you tried buttering the pill to make it slip down more easily? I agree that the size of some pills is just ridiculous. I don't know why manufacturers can't take size and ease of swallowing into account when they make them in the first place.

My heart goes out to you. Its awful trying to medicate and animal only to find the process causes them so much stress. Really hope you can find a way forward soon.

well, the Marin for cats is a capsule that you open and sprinkle over food. 

Thanks for the advice guys... I've only just now got her back to eating and settling down a bit. I think all the vet visits, and changing circumstances have put her on edge too. I did try butter, along with a meat paste she gets, in a little food etc, was a no go. I'll mention the Marin too, which was suggested...

Thanks again, I'll certainly be telling the vet on Monday that these pills are a no, and I'm looking for an alternative..

I had to give my kitty a supplement when he had fatty  liver and they are a nightmare.  I was always afraid I would choke Patches with that pill.  If you can't get the pill down I would ask about using just the milk thistle.  That by itself doesn't have to be swallowed whole the way the Denamarin does. 

You can't get anything comparable to Denamarin in liquid form because of the need for the protective coating.  My kitty had a feeding tube when he was sick and I would crush up his other pills mix it in his food and put it through the feeding tube but that supplement was a pill that needed to be swallowed whole.

Thanks Denice,
We just couldn't get her close to taking it, and the anxiety and stress was just ridiculous, I know our vet will be recommendinga pill stick or something similar.. I just seriously don't know if it's a route worth going down with her. I'm hoping that maybe the prescription liver disease diets, the anabolic steroids and vitamin injections, and some milk thistle or equivalent, will give her a fair shot. I just don't want her to be unsettled and uncomfortable in her own home, if she doesn't gain weight, it will be the inevitable in a few months.... I don't see why I should make her suffer on a daily basis, at her age...