Puddy with Hepatic Lipidosis (fatty liver)

Looking to get feedback on what worked for you. I have read several sites. I feel we can pull though this but I want to make sure there isn't  something else I could be trying. I just got back from picking Puddy up from being at the vet for 3 days and I asked for copies of her bloodwork.

I took Puddy (pronounced how Tweety says , "I thought I saw a puddy cat") to the vet on 6/5/16. They diagnosed her with hepatic lipidosis. They did bloodwork, her ALT was 462, AST 133, ALP 802, bilirubin was 3.1.  He gave me Denamarin, amoxicillin,  mirtazapine, 1000 ml bag of fluid and sent us home. He was very vague on how to take care of her. I have never been through this or heard of this before. So, I just figured give her the meds and everything will be okay. Well not the case.

I gave Puddy her meds as described, and several days later she was very yellow, walking seemed to be difficult for her and I noticed she wasn't really eating or using the litterbox. I googled some and saw that a feeding tube could be beneficial.  So, I called the vet and spoke with him about what else I could do, maybe get a feeding tube in since she wasn't eating. He said, he can't do it but the other vet that will be coming in could possibly put one in and he has given me everything they could do for her. I made an appt for the following day to see the other vet.

On 6/16/16 Puddy had an appt with the other vet. She said the prognosis didn't look very good, after examining Puddy, she wanted to run new blood work. She came back and Puddy's bloodwork, her ALT was 117, ALP 424, bilirubin 12.5. She seemed more hopeful and told me what I had done helped some. She said, she thinks Puddy would benefit from being hospitalized for 3 days. She told me she wanted me to pick up a prescription from the vet pharmacy to help protect her brain, Urosodiol. Well we left to get her other meds from home and pick up the new med.  I received a phone call before getting home and she said, she needs to do an x-ray, she thinks Puddy has cancer because her blood wasn't clotting. Since I read about it some on the internet, I mentioned a vitamin K shot and she said you are one step ahead of me and she would give her that and another medicine that helps with blood clotting. She said, if she does have cancer, then there is no reason to continue treatment. I was devastated. I was crying until I received the results from the x-ray. She called, I wasn't ready to hear that she had cancer and she was going to die but I answered any way. I needed to know. She said, good news, she doesn't have cancer but she does a kidney stone and she didn't see anything else concerning. I have never been so relieved in my life. I dropped off her meds to the vet a few hours later. She told me Puddy urinated a lot! She said now all we can do is hope this helps and she eats. While there she was left on a IV for fluids, they gave her an injection of vitamin b, k, famotidine, cerenia and dexamethasone. Now sure what the last 3 are for but I wanted to list them. Looks like I have more googling to do to understand. I called and checked on Puddy daily.

Today 6/18/16, they ran more bloodwork. She is concerned with her red cell blood count and her ALP is still high. The test showed that her ALT is 125 (went down a lot!), ALP is 611 and her glucose has been high it is at 280. Not too much was noted on this blood work. Not sure where her bilirubin is, still yellow, I know this will take time to go away. She said those can be fixed by her eating. She is home now and after doing more reading online. I plan to force feed her 1 oz every 2-3 hours and about 6x a day. She is currently at 11 lbs, she has lost a lot of weight. I know I have a long road a head of me. It can be weeks to months to get her to start eating again if we can overcome this obstacle. I am trying to stay positive. It's just hard when you know they're suffering and I just feel so sad for her. I love her with all my heart. I am wanting any input and if you have had experience with this and you were successful. Thanks everyone!

My kitty had fatty liver and did survive.  He had a feeding tube which made the feeding much easier.  The famotodine is an antacid, brand name Pepcid, the cerenia is an anti nausea med and the dex is a steroid.  Those are pretty standard medicines though prednisolone is the steroid that is usually given.  Denamarin is a supplement that is good at helping the liver heal.

Getting enough calories in to stop the body from trying to use it's fat stores is what will stop the cycle that is fatty liver.   Fatty liver is almost always secondary and is caused by not eating for a period of time and it can be a short time.  Finding the cause of the anorexia needs to be done.  In my kitty's case it was undiagnosed IBD.

I forgot to mention a couple things.

1.) The 1st bloodwork that was done on 6/5, I am looking at the paperwork and under feline coronavirus it says Positive. I was never told about this, should I be worried? The vet was already closed by the time I read this.

2.) The vet we seen on 6/16, she didn't think it would be safe to put Puddy under to place a feeding tube, due to her jaundice and how weak she looked.

Coronavirus is very common among cats.  You didn't say it but I assume you are concerned about FIP.  It is true that a mutation of the Coronavirus causes FIP but only a very small percentage of kitties that have had Coronavirus go into FIP.  Most of the cats that do are kittens and to a lesser extent elderly cats.

She keeps walking over to her water bowl and just sitting with her face above it and not drinking it. Last night, she was moving the bowl around and not taking a drink. Your kitty ever do this? I have fluids. I have been giving her 100ml daily.

Here's a couple pictures of Puddy. She wanted to be in the bathtub, not sure why. Tried to capture how yellow she is at the moment.

She is such a pretty cat.  I think the behavior of staying by the bowl is a behavior that is seen with nausea.  My kitty would sometimes even pickup a piece of kibble, chew on it and then let it fall out of his mouth.

Thank you! I have had her since she was a baby and love her more than anything!